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Bitzer J, Bouchard C, Zatik J, Weyers S, Piltonen T, Suturina L, Apolikhina I, Gemzell-Danielsson K, Jost M, Creinin MD, Foidart JM. Effects of E4/DRSP on self-reported physical and emotional premenstrual and menstrual symptoms: data from the phase 3 clinical trial in Europe and Russia. EUR J CONTRACEP REPR 2024; 29:150-159. [PMID: 38904165 DOI: 10.1080/13625187.2024.2359117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 05/14/2024] [Indexed: 06/22/2024]
Abstract
PURPOSE To describe the effects of estetrol (E4) 15 mg/drospirenone (DRSP) 3 mg on physical and emotional premenstrual and menstrual symptoms. MATERIALS AND METHODS We used Menstrual Distress Questionnaire (MDQ) data from a phase-3 trial (NCT02817828) in Europe and Russia with participants (18 - 50 years) using E4/DRSP for up to 13 cycles. We assessed mean changes in MDQ-t-scores from baseline to end of treatment in premenstrual (4 days before most recent flow) and menstrual (most recent flow) scores for 4 MDQ domains in starters and switchers (use of hormonal contraception in prior 3 months) and performed a shift analysis on individual symptoms within each domain. RESULTS Of 1,553 treated participants, 1,398(90.0%), including 531(38%) starters, completed both MDQs. Starters reported improvements for premenstrual Pain (-1.4), Water Retention (-3.3) and Negative Affect (-2.5); and for menstrual Pain (-3.5), Water Retention (-3.4), and Negative Affect (-2.7) (all p < 0.01). For switchers, no changes were significant except an increase in premenstrual (+1.0, p = 0.02) and menstrual (+1.5, p = 0.003) Water Retention. We observed a change in symptom intensity in >40% of participants for Cramps, Backache and Fatigue (domain Pain), Painful or Tender Breast and Swelling (domain Water Retention) and Mood Swings and Irritability (domain Negative Affect). CONCLUSION E4/DRSP starters experienced significant improvements in the domains Pain, Water Retention and Negative Affect particularly benefiting those with more severe baseline symptoms. Switchers showed minimal changes.
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Affiliation(s)
- Johannes Bitzer
- Department of Obstetrics and Gynaecology, University Hospital of Basel, Basel, Switzerland
| | | | - János Zatik
- Szent Anna Szuleszeti, Nogyogyaszati es Ultrahang Maganrendelo, Debrecen, Hungary
| | - Steven Weyers
- Department of Obstetrics and Gynaecology, Ghent University Hospital, Ghent, Belgium
| | - Terhi Piltonen
- Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Centre, Oulu University Hospital, Oulu, Finland
| | - Larisa Suturina
- Department of Reproductive Health Protection, Scientific Center for Family Health and Human Reproduction, Irkutsk, Russian Federation
| | - Inna Apolikhina
- National Medical Research Center for Obstetrics, Gynaecology and Perinatology named after Academician V.I. Kulakov, Ministry of Healthcare of Russia, Moscow, Russia
| | - Kristina Gemzell-Danielsson
- Department of Women's and Children's Health, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden
| | - Maud Jost
- Estetra SRL, an affiliate company of Mithra Pharmaceuticals, Liège, Belgium
| | - Mitchell D Creinin
- Department of Obstetrics and Gynecology, University of CA, Sacramento, California, USA
| | - Jean-Michel Foidart
- Department of Gynaecology and Obstetrics, University of Liège, Liège, Belgium
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Fruzzetti F, Machado RB, Lete I, Patel A, Boolell M. A review of the pharmacology, clinical outcomes, and real-world effectiveness, safety, and non-contraceptive effects of NOMAC/E2. Eur J Obstet Gynecol Reprod Biol X 2024; 21:100283. [PMID: 38318398 PMCID: PMC10839580 DOI: 10.1016/j.eurox.2024.100283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/15/2024] [Accepted: 01/21/2024] [Indexed: 02/07/2024] Open
Abstract
Selecting an appropriate oral contraceptive can be challenging for healthcare professionals due to the abundance of marketed contraceptive options with different clinical and real-world effectiveness and safety profiles. Nomegestrol acetate + 17β-estradiol (NOMAC/E2) is a combined oral contraceptive (COC) that inhibits ovulation by suppressing ovarian function by a 17-hydroxy-progesterone derivative and an estrogen identical to that endogenously produced by the ovaries. This narrative review examines clinical and real-world studies of NOMAC/E2 based on a background literature search using PubMed and Google Scholar. The review outlines the pharmacology of NOMAC/E2, including its progestational activity, pharmacokinetics, and effects on carbohydrate metabolism, lipid metabolism, and coagulation parameters, and summarizes key clinical efficacy and safety data that led to the approval of NOMAC/E2 in Europe, Brazil, and Australia. To help elucidate how NOMAC/E2 clinical trial data translate into a real-world setting, this review describes the effectiveness and safety of NOMAC/E2 in prospective studies that include over 90,000 users (half of whom received NOMAC/E2), outlining its effects on risk of thrombosis, menstrual bleeding patterns, weight, mood, acne, bone health, and patient quality of life. Non-contraceptive benefits of NOMAC/E2 for women with endometriosis, dysmenorrhea, or pre-menstrual dysphoric disorder are also discussed. These data demonstrate that NOMAC/E2 has a long half-life and rapid absorption, is effective at preventing unwanted pregnancies, and exhibits a favorable safety profile in both clinical trials and real-world settings. Importantly, NOMAC/E2 is not associated with increased risk of venous thromboembolism, a major safety concern of healthcare professionals for women receiving hormonal contraceptives. This review highlights NOMAC/E2 as a differentiated option among COCs and could help inform oral contraceptive choice to ultimately improve patient management and outcomes in real-world settings.
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Affiliation(s)
- Franca Fruzzetti
- Clinica San Rossore, Viale delle Cascine, 152/f, 56122 Pisa, Italy
| | - Rogerio Bonassi Machado
- Faculty of Medicine of Jundiai, Jundiai, R. Francisco Telles, 250, 13202-550 Jundiaí, São Paulo, Brazil
| | - Iñaki Lete
- Jose Atxotegi Kalea, s/n, 01009 Gasteiz, Araba, Spain
- University Hospital Araba, s/n, 01009 Gasteiz, Araba, Spain
| | - Amisha Patel
- Theramex HQ UK Ltd, 50 Broadway, 5th Floor, London SW1H 0BL, UK
| | - Mitra Boolell
- Theramex HQ UK Ltd, 50 Broadway, 5th Floor, London SW1H 0BL, UK
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Lete I. Evolución del estrógeno en la anticoncepción hormonal combinada: del etinilestradiol al estetrol pasando por el estradiol. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2022. [DOI: 10.1016/j.gine.2022.100755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Caruso S, Vitale SG, Fava V, Pasqua SD, Rapisarda AMC, Cianci S. Quality of life of women using the etonogestrel long-acting reversible contraceptive implant after abortion for unplanned pregnancy. EUR J CONTRACEP REPR 2020; 25:251-258. [PMID: 32436733 DOI: 10.1080/13625187.2020.1760240] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES The aims of the study were to investigate the effect of a subcutaneous etonogestrel-containing contraceptive implant on the quality of life (QoL) and sexual function of women who had undergone termination of an unplanned pregnancy. METHODS At pregnancy termination 140 women received contraceptive counselling on the etonogestrel implant. The Short Form-36 questionnaire, the Female Sexual Function Index and the Female Sexual Distress Scale were used to investigate, respectively, the QoL, sexual function and sexual distress of the women at baseline and at 6, 12, 24 and 36 months of follow-up. RESULTS The study group comprised 86 (61.4%) women who chose to use the contraceptive implant. The control group comprised 28 (20.0%) women who chose to use short-acting reversible contraception (SARC) and 26 (18.6%) women who chose not to use hormonal contraception. In the women not using hormonal contraception there were 23 (88.5%) unintended pregnancies before the end of the 3 year study period. QoL, sexual function and sexual distress improved in the study group from the 6 months follow-up until the end of the study (p < 0.001). QoL (p < 0.02) and sexuality (p < 0.001) gradually improved in the control group after 24 and 12 months of follow-up, respectively. None of the women using the etonogestrel implant became pregnant during the study. Inter-group analysis showed better improvement in QoL, sexual function and sexual distress in the study group than in the control group from 6 months (p < 0.004) until the end of the study (p < 0.001). CONCLUSION Compared with SARC and non-hormonal contraception, the contraceptive implant promoted better QoL and sexuality in users and reduced the incidence of unplanned pregnancy. However, the women who opted for SARC or non-hormonal contraception did so because of the lower cost compared with that of the contraceptive implant.
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Affiliation(s)
- Salvatore Caruso
- Sexology Research Group, Gynaecology Clinic, Department of General Surgery and Medical Surgical Specialties, School of Medicine, University of Catania, Catania, Italy
| | - Salvatore Giovanni Vitale
- Sexology Research Group, Gynaecology Clinic, Department of General Surgery and Medical Surgical Specialties, School of Medicine, University of Catania, Catania, Italy
| | - Valentina Fava
- Sexology Research Group, Gynaecology Clinic, Department of General Surgery and Medical Surgical Specialties, School of Medicine, University of Catania, Catania, Italy
| | - Salvatore Di Pasqua
- Sexology Research Group, Gynaecology Clinic, Department of General Surgery and Medical Surgical Specialties, School of Medicine, University of Catania, Catania, Italy
| | - Agnese Maria Chiara Rapisarda
- Sexology Research Group, Gynaecology Clinic, Department of General Surgery and Medical Surgical Specialties, School of Medicine, University of Catania, Catania, Italy
| | - Stefano Cianci
- Department of Woman, Child and General and Specialised Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
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Leon-Larios F, Vazquez-Valeo CG, Sanchez-Sanchez A, Gomez-Baya D, Macías-Seda J, Cabezas-Palacios MN. Health-related quality of life in undergraduate women using any contraceptive. Health Qual Life Outcomes 2019; 17:90. [PMID: 31126343 PMCID: PMC6534913 DOI: 10.1186/s12955-019-1157-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 05/08/2019] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE The aim of this research was to assess university students' health-related quality of life whether they use some contraceptive method or not. METHODS This research is a cross-sectional study. Female participants who studied a degree in health at the University of Seville (Spain) were recruited. Respondents completed a demographic questionnaire and health-related quality of life was measured with validated instrument SEC-QoL (Sociedad Española de Contracepción- Quality of Life) in Spanish that measured five dimensions: sexual, social, breast, menstrual and psychosocial. RESULTS A total of 992 women aged 21.37 (3.6) years old participated in this study. Women who used a contraceptive method reached higher scores at the SEC-QoL questionnaire 47.09 (17.04) and 46.91 (18.73) than those that didn't. Likewise, women who chose a hormonal method showed a better overall health-related quality of life, compared to those who used a non-hormonal method. Participants who used hormonal contraceptives obtained higher scores in all health-related quality of life domains (social, menstrual, breast and sexual), except psychological domain when compared to those who used a non hormonal method or none. Furthermore, a moderated mediation model showed that the effect of the current contraceptive method on health-related quality of life was partially explained by the moderated mediation of the time using this method, the reason for using it and the existence of a partner. CONCLUSION The usage of hormonal contraceptives increases health-related quality of life in young women. Several variables regarding the experience with contraceptive methods should be considered in order to examine the effect on health-related quality of life in undergraduate women.
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Affiliation(s)
- Fatima Leon-Larios
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | | | | | - Diego Gomez-Baya
- Department of Social, Developmental and Educational Psychology, University of Huelva, Huelva, Spain
- Department of Social, Developmental and Educational Psychology, Faculty of Education, Psychology and Sport Sciences, Universidad de Huelva, Campus “El Carmen”, Avda. Fuerzas Armadas s/n., 21007 Huelva, Spain
| | - Juana Macías-Seda
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
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Zhang J, Shao S, Wu P, Liu D, Yang B, Han D, Li Y, Lin X, Song W, Cao M, Zhang J, Kang F, Qin W, Wang J. Diagnostic performance of 68Ga-PSMA PET/CT in the detection of prostate cancer prior to initial biopsy: comparison with cancer-predicting nomograms. Eur J Nucl Med Mol Imaging 2019; 46:908-920. [PMID: 30635755 DOI: 10.1007/s00259-018-4255-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 12/27/2018] [Indexed: 01/01/2023]
Abstract
PURPOSE To assess the diagnostic performance of 68Ga-PSMA PET/CT for detecting suspected prostate cancer (PCa) and to compare it with that of two cancer-predicting nomograms. METHODS We performed a retrospective analysis of 146 consecutive patients with suspected PCa based on symptoms or elevated total prostate-specific antigen (tPSA) levels who underwent 68Ga-PSMA PET/CT and histopathologic examinations from April 2017 to April 2018 in a large tertiary care hospital in China. The 68Ga-PSMA PET/CT results (PCa or benignancy) were evaluated by two experienced nuclear medicine specialists. The risk of positive PCa was evaluated using ERSPC and PCPT nomograms. The diagnostic performances of 68Ga-PSMA PET/CT and that of the two nomograms were compared via receiver operating characteristic (ROC) curve analysis, decision curve analysis, and logistic regression. RESULTS A total of 58 patients with tPSA of 0.4-50 ng/ml were included in the final analysis; PCa diagnosis was confirmed in 37 patients and excluded in 21 patients. ROC analysis showed that the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 68Ga-PSMA PET/CT were 91.67, 81.82, 89.19, and 85.71%, respectively, in per-patient analyses. 68Ga-PSMA PET/CT exhibited a higher AUC (0.867) than those of ERSPC-RC3 (0.855) and PCPT-RC (0.770). The net benefit of 68Ga-PSMA PET/CT was greatest for patients within threshold probabilities of 15-90%. Among the 58 patients, 11 (19%) biopsies suggested by ERSPC-RC3 were unnecessary and could have been avoided if judged by the 68Ga-PSMA PET/CT results. Multivariate analysis revealed that the maximum standardised uptake value (SUVmax) and prostate volume were significant predictive factors for positive PCa results. CONCLUSION In suspected PCa patients with tPSA of 0.4-50 ng/ml, 68Ga-PSMA PET/CT outperformed the nomograms in predicting cancer and reducing unnecessary biopsies. In addition, the risk of PCa was positively correlated with a higher SUVmax and lower prostate volume, which could help clinicians in making preliminary estimates of individual cancer risk, monitoring 68Ga-PSMA PET/CT false-positive results and making biopsy decisions in daily medical practice.
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Affiliation(s)
- Jingliang Zhang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China.,Department of Health Services, Health Service Training Base, Fourth Military Medical University, Xi'an, 710032, China
| | - Shuai Shao
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Peng Wu
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Daliang Liu
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Bo Yang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Donghui Han
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Yu Li
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Xiaoyu Lin
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Wei Song
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Milin Cao
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Jing Zhang
- Department of Pathology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Fei Kang
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China.
| | - Weijun Qin
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China.
| | - Jing Wang
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China.
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FSRH Guideline (January 2019) Combined Hormonal Contraception (Revision due by January 2024). BMJ SEXUAL & REPRODUCTIVE HEALTH 2019; 45:1-93. [PMID: 30665985 DOI: 10.1136/bmjsrh-2018-chc] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Cagnacci A, Bastianelli C, Neri M, Cianci A, Benedetto C, Calanni L, Vignali M, De Leo V, Cicinelli E, Borrelli G, Volpe A. Treatment continuation and satisfaction in women using combined oral contraception with nomegestrol acetate and oestradiol: a multicentre, prospective cohort study (BOLERO). EUR J CONTRACEP REPR 2018; 23:393-399. [DOI: 10.1080/13625187.2018.1541080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Angelo Cagnacci
- Clinica Ginecologica e Ostetrica, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Carlo Bastianelli
- Dipartimento di Scienze Ostetriche e Ginecologiche e Scienze Urologiche, La Sapienza Università di Roma, Rome, Italy
| | - Manuela Neri
- Clinica Ostetrica e Ginecologica, Dipartimento di Scienze Chirurgiche, Università degli Studi di Cagliari, Azienda Ospedaliero Universitaria di Cagliari, Policlinico Universitario Duilio Casula, Monserrato, Italy
| | - Antonio Cianci
- Dipartimento Chirurgia Generale e Specialità Medico Chirurgiche, Azienda Ospedaliero Universitaria Policlinico-Vittorio Emanuele, Catania, Italy
| | - Chiara Benedetto
- Dipartimeto di Scienze Chirurgiche, Università degli Studi di Torino, Turin, Italy
| | - Luana Calanni
- Clinica Ostetrica e Ginecologia, Ospedale Policlinico San Martino, Genoa, Italy
| | - Michele Vignali
- Dipartimento di Scienze Biomedicine per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Vincenzo De Leo
- Dipartimento di Medicina Molecolare e dello Sviluppo, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Ettore Cicinelli
- 2° Unità Operativa di Ginecologia ed Ostetricia, Dipartimento di Medicina e Oncologia (DIMO), Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Bari, Italy
| | | | - Annibale Volpe
- Facoltà di Medicina e Chirurgia Materno-Infantili e dell’Adulto, Università degli Studi di Modena e Reggio Emilia, Modena, Italy
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Cuevas-Romero E, Sánchez-Cardiel A, Zamora-Gallegos AM, Cruz-Lumbreras R, Corona-Quintanilla DL, Castelán F, Martínez-Gómez M. Moderate-to-high normal levels of thyrotropin is a risk factor for urinary incontinence and an unsuitable quality of life in women over 65 years. Clin Exp Pharmacol Physiol 2017; 44 Suppl 1:86-92. [DOI: 10.1111/1440-1681.12788] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 04/17/2017] [Accepted: 05/12/2017] [Indexed: 01/03/2023]
Affiliation(s)
- Estela Cuevas-Romero
- Centro Tlaxcala de Biología de la Conducta; Universidad Autónoma de Tlaxcala; Tlaxcala Mexico
| | | | | | - Rosalía Cruz-Lumbreras
- Doctorado en Ciencias Biológicas; Universidad Autónoma de Tlaxcala; Tlaxcala Mexico
- Facultad de Ciencias de la Salud; Universidad Autónoma de Tlaxcala; Tlaxcala Mexico
| | | | - Francisco Castelán
- Centro Tlaxcala de Biología de la Conducta; Universidad Autónoma de Tlaxcala; Tlaxcala Mexico
- Instituto de Investigaciones Biomédicas; Universidad Autónoma de México; Tlaxcala Mexico
| | - Margarita Martínez-Gómez
- Centro Tlaxcala de Biología de la Conducta; Universidad Autónoma de Tlaxcala; Tlaxcala Mexico
- Instituto de Investigaciones Biomédicas; Universidad Autónoma de México; Tlaxcala Mexico
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Apter D, Zimmerman Y, Beekman L, Mawet M, Maillard C, Foidart JM, Coelingh Bennink HJT. Estetrol combined with drospirenone: an oral contraceptive with high acceptability, user satisfaction, well-being and favourable body weight control. EUR J CONTRACEP REPR 2017. [DOI: 10.1080/13625187.2017.1336532] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Dan Apter
- Sexual Health Clinic (Väestöliitto), Helsinki, Finland
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Lete I, Lapuente O. Contraceptive options for women with premenstrual dysphoric disorder: current insights and a narrative review. Open Access J Contracept 2016; 7:117-125. [PMID: 29386943 PMCID: PMC5683150 DOI: 10.2147/oajc.s97013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Premenstrual syndrome and its most severe form, premenstrual dysphoric disorder (PMDD), are two well-defined clinical entities that affect a considerable number of women. Progesterone metabolites and certain neurotransmitters, such as gamma-aminobutyric acid and serotonin, are involved in the etiology of this condition. Until recently, the only treatment for women with PMDD was psychoactive drugs, such as selective serotonin reuptake inhibitors. Several years ago, there has been evidence of the beneficial role of combined hormonal contraceptives in controlling PMDD symptoms. Oral combined hormonal contraceptives that contain drospirenone in a 24+4-day regimen are the only drugs that have been approved by US Food and Drug Administration for the treatment of PMDD, but there is scientific evidence that other agents, with other formulations and regimens, could also be effective for the treatment of this condition. However, it remains unclear whether the beneficial effect of combined hormonal contraceptives is associated with the type of estrogen or progestogen used or the treatment regimen.
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Affiliation(s)
- Iñaki Lete
- Department of Obstetrics and Gynecology, University Hospital Araba.,Bioaraba Research Unit.,School of Medicine, Basque Country University, Vitoria, Spain
| | - Oihane Lapuente
- Department of Obstetrics and Gynecology, University Hospital Araba.,Bioaraba Research Unit
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