title: Ethinylestradiol/dienogest in oral contraception.
abstract: The low-dose combined oral contraceptive of ethinylestradiol 30 microg and dienogest 2 mg was launched in Germany in 1995, and is now the most commonly prescribed oral contraceptive in this country. Dienogest is a novel 19-nortestosterone-derived progestin with a unique pharmacokinetic and pharmacological profile, including antiandrogenic properties. Clinical studies have demonstrated that ethinylestradiol/dienogest is a reliable ovulation inhibitor with high contraceptive efficacy that is comparable with other combined oral contraceptives. It also provides effective cycle control, with reduced intensity and duration of menstrual bleeding, and improves dysmenorrhoea. The combination of ethinylestradiol and dienogest reduces serum androgen levels, and increases the levels of thyroid hormones; however, although thyroid hormone levels increase, there is no increased activity due to increases in transporter protein. Like other low-dose oral contraceptives, ethinylestradiol/dienogest has only minor influences on lipid and carbohydrate metabolism, adrenal hormones and blood pressure parameters, and appears to have a balanced effect on the haemostatic system. Ethinylestradiol/dienogest also has beneficial effects on hair and skin; a number of studies have reported decreased hair and skin greasiness, and improvements in acne vulgaris following treatment with ethinylestradiol/dienogest. After discontinuation of ethinylestradiol/dienogest, there may be a small delay in conception during the first three cycles, but there is no subsequent impairment of fertility. Furthermore, the duration of use of ethinylestradiol/dienogest does not seem to influence the rate of conception or time to conception. Ethinylestradiol/dienogest is well tolerated; adverse reactions associated with treatment include breast pain, headache and nausea/vomiting. These adverse reactions are rare and decrease in incidence over time.
authors.affiliation: Service of Gynaecology, Hospital General Requena, Valencia, Spain. Perez_eze@gva.es
authors.forename: Ezequiel F
authors.initials: EF
authors.lastname: Pérez-Campos
mesh_terms: D000818:Animals; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage* / Q000493:pharmacokinetics; D004997:Ethinyl Estradiol / Q000008:administration & dosage* / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D008597:Menstrual Cycle / Q000187:drug effects / Q000378:metabolism; D009277:Nandrolone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000493:pharmacokinetics
chemical_list: D003277:Contraceptives, Oral, Combined; D004997:Ethinyl Estradiol; C023635:dienogest; D009277:Nandrolone
references.citation: Acta Obstet Gynecol Scand. 1989;68(7):633-5
references.pmid: 2631529
references.citation: Adv Contracept. 1996 Jun;12(2):129-38
references.pmid: 8863908
references.citation: Drugs. 1998 Nov;56(5):825-33; discussion 834-5
references.pmid: 9829156
references.citation: Contraception. 2003 Jan;67(1):25-32
references.pmid: 12521654
references.citation: Contraception. 1991 Feb;43(2):101-10
references.pmid: 2040166
references.citation: Ann N Y Acad Sci. 1997 Jun 17;816:457-65
references.pmid: 9238302
references.citation: Contraception. 1995 Jan;51(1):3-12
references.pmid: 7750281
references.citation: Int J Clin Pract. 2000 Mar;54(2):85-91
references.pmid: 10824362
references.citation: Mol Hum Reprod. 2001 Apr;7(4):341-7
references.pmid: 11279296
references.citation: Zentralbl Gynakol. 1989;111(12):793-9
references.pmid: 2763749
references.citation: Contraception. 1997 Mar;55(3):139-44
references.pmid: 9115001
references.citation: Contraception. 2003 May;67(5):361-6
references.pmid: 12742558
references.citation: Int J Fertil. 1987;32 Suppl:21-8
references.pmid: 2906344
references.citation: Am J Obstet Gynecol. 1987 Oct;157(4 Pt 2):1042-8
references.pmid: 2960241
references.citation: Contraception. 2008 Nov;78(5):384-91
references.pmid: 18929735
references.citation: Methods Find Exp Clin Pharmacol. 2002 Dec;24(10):689-96
references.pmid: 12616963
references.citation: Contraception. 2000 Nov;62(5):259-69
references.pmid: 11172797
references.citation: Contraception. 2009 Apr;79(4):282-9
references.pmid: 19272497
references.citation: Contraception. 2008 Jun;77(6):420-5
references.pmid: 18477491
references.citation: Fertil Steril. 2006 Jun;85(6):1812-9
references.pmid: 16759929
references.citation: Fertil Steril. 2008 May;89(5 Suppl):1344-7
references.pmid: 17511992
references.citation: Contraception. 2002 Mar;65(3):223-9
references.pmid: 11929644
references.citation: Eur J Contracept Reprod Health Care. 1999 Sep;4(3):155-64
references.pmid: 10574641
references.citation: Contraception. 2008 Jul;78(1):4-9
references.pmid: 18555811
references.citation: Methods Find Exp Clin Pharmacol. 2002 Nov;24(9):585-92
references.pmid: 12616705
references.citation: J Reprod Med. 1983 Jan;28(1 Suppl):85-91
references.pmid: 6834350
references.citation: Contraception. 1997 Sep;56(3):185-91
references.pmid: 9347211
references.citation: Contraception. 2006 Jun;73(6):566-70
references.pmid: 16730485
references.citation: Contraception. 1997 Aug;56(2):67-75
references.pmid: 9315414
references.citation: Obstet Gynecol. 2004 Jan;103(1):51-6
references.pmid: 14704244