Estetrol: The Future of Hormonal Contraception Unveiled: A literature review
DOI:
https://doi.org/10.37800/RM.4.2024.427Keywords:
contraception, combined oral contraceptives (COCs), estrogen, estetrol (E4), drospirenone (DRSP)Abstract
Background: The evolution of oral contraceptives is a milestone in the history of women's reproductive health. This revolutionary medical advance has profoundly impacted society, changing views on sexuality, family planning, and women's empowerment. Over the years, contraceptives have undergone significant changes in composition, dosage, and administration methods. A good contraceptive should be highly effective, provide reliable cycle control, have a low incidence of side effects, and have non-contraceptive benefits. Innovative research in the field of hormonal contraception continues to this day. Recently, a combined oral contraceptive (COC) has become available that includes a new native estrogen, estetrol (E4), in combination with drospirenone (DRSP). This article presents an analysis of the available data on estetrol.
Objective: The purpose of the study is to analyze current publications on the features of estetrol and its use as a contraceptive.
Methods: The literature search included online databases such as Medline, Scopus, Web of Science, Google Scholar, Springer, PubMed, ResearchGate, and Cyberleninka. Papers published in English and Russian were included using relevant titles and key terms and following defined inclusion and exclusion criteria. This review evaluates the currently available information on estetrol.
Results: E4 is a native estrogen produced by the liver of the human fetus during pregnancy, has high bioavailability, is not metabolized by cytochrome 450 enzymes, and is the end product of its own pathway. E4 is the first Natural Estrogen with Selective Tissues activity (NEST). A recently launched COC containing E4 in combination with DRSP has been shown to be an effective contraceptive with good cycle control, predictable regular bleeding, and a high safety profile due to minimal effects on liver metabolism, hemostasis, lipids, and breast tissue. E4 has a low risk of drug interactions and a favorable risk profile for venous thromboembolic complications. Clinical trials are currently underway to study the therapeutic potential of E4 treatment for the relief of menopausal symptoms, prevention of bone loss, and its potential use in breast cancer.
Conclusion: E4 15 mg/DRSP 3 mg provides safe and effective contraception with high user satisfaction and predictable bleeding.
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