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FSRH Guideline (August 2022) Progestogen-only Pills. BMJ SEXUAL & REPRODUCTIVE HEALTH 2022; 48:1-75. [PMID: 36316023 DOI: 10.1136/bmjsrh-2022-pop] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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Römer T, Bitzer J, Egarter C, Hadji P, Kiechle M, Kramer H, Oppelt PG, Peters K, Stute P, Schaudig K, Wiegratz I, Regidor PA. Oral Progestins in Hormonal Contraception: Importance and Future Perspectives of a New Progestin Only-Pill Containing 4 mg Drospirenone. Geburtshilfe Frauenheilkd 2021; 81:1021-1030. [PMID: 34565826 PMCID: PMC8454215 DOI: 10.1055/a-1471-4408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/28/2021] [Indexed: 12/14/2022] Open
Abstract
Hormonal contraceptives are an effective and safe method for preventing pregnancy. Progestins used in contraception are either components of combined hormonal contraceptives (tablets, patches or vaginal rings) or are used as a single active ingredient in progestin mono-preparations (the progestin-only pill (POP), implants, intrauterine systems or depot preparations). Progestins are highly effective in long-term contraception when used properly, and have a very good safety profile with very few contraindications. A new oestrogen-free ovulation inhibitor (POP) has recently been authorised in the USA and the EU. This progestin mono-preparation contains 4 mg of drospirenone (DRSP), which has anti-gonadotropic, anti-mineralocorticoidic and anti-androgenic properties. The hormone administration regimen of 24 days followed by a 4-day hormone-free period was chosen to improve bleeding control and to maintain oestradiol concentrations at early follicular-phase levels, preventing oestrogen deficiency. Clinical trials have demonstrated a high contraceptive effectiveness, a very low risk of cardiovascular side effects and a favourable menstrual bleeding pattern. Due to the long half-life of DRSP (30 - 34 hours), the effectiveness of the preparation is maintained even if a woman forgets to take a pill on a single occasion. Studies involving deliberate 24-hour delays in taking a pill have demonstrated that ovulation inhibition is maintained if a single pill is missed. Following a summary of the current status of oestrogen-free contraception, this review article will describe the clinical development programme of the 4 mg DRSP mono-preparation and the resulting data on the effectiveness and safety of this new oestrogen-free oral hormonal contraceptive.
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Affiliation(s)
- Thomas Römer
- Abteilung für Gynäkologie und Geburtshilfe, Evangelisches Klinikum Köln Weyertal GmbH, Köln, Germany
| | - Johannes Bitzer
- Klinik für Geburtshilfe und Gynäkologie, Universitätskrankenhaus Basel, Basel, Switzerland
| | - Christian Egarter
- Abteilung für Gynäkologische Endokrinologie, Medizinische Universität Wien, Wien, Austria
| | - Peyman Hadji
- Frankfurter Hormon und Osteoporosezentrum, Frankfurt am Main, Germany,Philipps Universität Marburg, Marburg, Germany
| | - Marion Kiechle
- Direktorin der Frauenklinik, Universitätsklinikum Rechts der Isar der Technischen Universität München (TUM), München, Germany
| | - Heike Kramer
- Ärztliche Gesellschaft zur Gesundheitsförderung e. V., Spardorf/Erlangen, Germany
| | | | | | - Petra Stute
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Inselspital Bern, Bern, Switzerland
| | - Katrin Schaudig
- Praxis für gynäkologische Endokrinologie HORMONE HAMBURG, Hamburg, Germany
| | - Inka Wiegratz
- Kinderwunsch & Hormonzentrum Frankfurt – Am Palmengarten, Frankfurt am Main, Germany,Goethe-Universität Frankfurt, Frankfurt am Main, Germany
| | - Pedro-Antonio Regidor
- Medical Director Exeltis Europe, Ismaning, Germany,Correspondence/Korrespondenzadresse Prof. Pedro-Antonio Regidor, MD PhD Medical Director Exeltis EuropeAdalperostraße 8485737 IsmaningGermany
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Chiara Del Savio M, De Fata R, Facchinetti F, Grandi G. Drospirenone 4 mg-only pill (DOP) in 24+4 regimen: a new option for oral contraception. Expert Rev Clin Pharmacol 2020; 13:685-694. [DOI: 10.1080/17512433.2020.1783247] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Maria Chiara Del Savio
- Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Di Modena, 41124, Modena, Italy
| | - Riccardo De Fata
- Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Di Modena, 41124, Modena, Italy
| | - Fabio Facchinetti
- Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Di Modena, 41124, Modena, Italy
| | - Giovanni Grandi
- Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Di Modena, 41124, Modena, Italy
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Palacios S, Regidor PA, Colli E, Skouby SO, Apter D, Roemer T, Egarter C, Nappi RE, Skřivánek A, Jakimiuk AJ, Weyers S, Ács N, Elia D, Gemzell Danielsson K, Bitzer J. Oestrogen-free oral contraception with a 4 mg drospirenone-only pill: new data and a review of the literature. EUR J CONTRACEP REPR 2020; 25:221-227. [DOI: 10.1080/13625187.2020.1743828] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Santiago Palacios
- Department of Gynecology and Obstetrics, Palacios Institute of Women’s Health, Madrid, Spain
| | | | | | - Sven Olaf Skouby
- Endocrinological and Reproductive Unit, Department of Obstetrics and Gynaecology, Herlev/Gentofte Hospital, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Dan Apter
- Department for Gynecology, VL-Medi Clinical Research Center, Helsinki, Finland
| | - Thomas Roemer
- Department of Obstetrics and Gynaecology, University Hospital of Cologne, Cologne, Germany
| | - Christian Egarter
- Department of Gynaecological Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria
| | - Rossella E. Nappi
- Research Center for Reproductive Medicine, IRCCS San Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Aleš Skřivánek
- Obstetrics and Gynaecology Clinic, G-CENTRUM Olomouc, Olomouc, Czech Republic
| | - Artur J. Jakimiuk
- Center for Reproductive Health, Institute of Mother and Child, Warsaw, Poland
| | - Steven Weyers
- Department of Obstetrics and Gynaecology, Ghent University Hospital, Ghent, Belgium
| | - Nándor Ács
- Department of Obstetrics and Gynaecology, Semmelweis University, Budapest, Hungary
| | - David Elia
- Department for Gynecology and Obstetrics, Gynecole.com, rue Saint-Honoré, Paris, France
| | - Kristina Gemzell Danielsson
- Department of Women’s and Children’s Health, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Johannes Bitzer
- Clinic for Obstetrics and Gynecology, University Hospital Basel, Basel, Switzerland
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