A novel estetrol-containing combined oral contraceptive: European expert panel review

Kristina Gemzell-Danielsson, Angelo Cagnacci, Nathalie Chabbert-Buffet, Jonathan Douxfils, Jean-Michel Foidart, Ali Kubba, Luis Ignacio Lete Lasa, Diana Mansour, Joseph Neulen, Jaoquim Neves, Fátima Palma, Thomas Römer, Robert Spaczyński, Vera Tóth

Research output: Contribution to journalArticlepeer-review


PURPOSE: Despite considerable advances in recently developed combined oral contraceptives (COCs), resulting in lower rates of adverse events while maintaining contraceptive efficacy, there is interest in further innovation.

MATERIALS AND METHODS: Estetrol (E4), a native oestrogen, and progestin drospirenone (DRSP) were combined in a new COC. A European expert panel reviewed the pharmacology, efficacy, and safety and tolerability of this combination. Their findings are presented as a narrative review.

RESULTS: E4 15 mg/DRSP 3 mg in a 24/4 regimen provided effective contraception with good cycle control, characterised by a predictable regular bleeding pattern and minimal unscheduled bleeding, together with a good safety profile. The combination was associated with high user satisfaction, well-being, and minimal changes in body weight. The effects on endocrine and metabolic parameters were limited, and the combination was found to have a limited impact on liver function and lipid and carbohydrate metabolism. Moreover, its effect on several haemostatic parameters was lower than that of comparators containing ethinyl oestradiol (EE) 20 µg/DRSP 3 mg and EE 30 µg/levonorgestrel 150 µg.

CONCLUSION: E4 15 mg/DRSP 3 mg provides safe and effective contraception, with high user satisfaction and predictable bleeding. Further research will evaluate the long-term safety of the COC.

Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalThe European journal of contraception & reproductive health care : the official journal of the European Society of Contraception
Early online date21 Jul 2022
Publication statusE-pub ahead of print - 21 Jul 2022


  • bleeding pattern
  • combined oral contraceptive
  • contraceptive efficacy
  • drospirenone
  • Estetrol
  • safety profile
  • satisfaction


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