Clinical Trials as Topic; Contraceptives, Oral/pharmacology; Drug Combinations; Estradiol/analogs & derivatives/pharmacology; Female; Humans; Nandrolone/analogs & derivatives/pharmacology
Abstract :
[en] In combined oral contraception (OC), a drastic reduction of both ethinylestradiol and androgenic progestins mostly derived from 19 NOR testosterone, allowed to moderately reduce the adverse impact of classical combined pills on metabolism and circulation (both arterial and venous). However, the marked hepatic action of ethinylestradiol, even in small dosages, lessens the expected risk reduction. For the first time, an OC has been developed, which contains estradiol valerate (with reduced hepatic action because of lack of a 17alpha ethinyl group) with dienogest, a 19 NOR testosterone-derived nonandrogenic progestin, which powerfully inhibits endometrial proliferation. Thanks to a dynamic modulation of estrogen and progestin doses (26 active days + 2 placebo days), an adequate contraceptive effectiveness, a good cycle control and drug tolerance are achieved, similar to those obtained with a classical low-dose OC. Recent data indicate that this new combination reduces the usually observed metabolic impact. An adequate cycle control (with 20% amenorrhea) is achieved for the first time with estradiol valerate + progestin,, in opposition with prior catastrophic results with other formulations containing 17beta-estradiol. A second combination containing estradiol + nomegestrol acetate (monophasic, 24 active days + 4 placebo days) is under study and seems also to yield promising results. Of course, in-depth study of metabolic and vascular effects of these new combinations is mandatory - and ongoing.
Disciplines :
Reproductive medicine (gynecology, andrology, obstetrics)
Author, co-author :
Gaspard, Ulysse ; Université de Liège - ULiège > Services généraux (Faculté de médecine) > Relations académiques et scientifiques (Médecine)
PINTIAUX, Axelle ; Centre Hospitalier Universitaire de Liège - CHU > Gynécologie-Obstétrique CHR
Kridelka, Frédéric ; Université de Liège - ULiège > Département des sciences cliniques > Gynécologie et obstétrique
Language :
French
Title :
Le médicament du mois. Nouvelle contraception orale combinée au valerate d'estradiol et au dienogest (Qlaira).
Alternative titles :
[en] Medication of the month. A new combined oral contraceptive containing estradiol valerate and dienogest (Qlaira)
Publication date :
2010
Journal title :
Revue Médicale de Liège
ISSN :
0370-629X
eISSN :
2566-1566
Publisher :
Université de Liège. Revue Médicale de Liège, Liège, Belgium