Oestrogen-free oral contraception with a 4 micrograms drospirenone-only pill: new data and a review of the literature

Santiago Palacios, Pedro Antonio Regidor, Enrico Colli, Sven Olaf Skouby, Dan Apter, Thomas Roemer, Christian Egarter, Rossella E. Nappi, Aleš Skřivánek, Artur J. Jakimiuk, Steven Weyers, Nándor Ács, David Elia, Kristina Gemzell Danielsson, Johannes Bitzer

Research output: Contribution to journalReview articlepeer-review


Purpose: The contraceptive pill is an effective and safe method of preventing pregnancy. The progestins used for contraception either are components of a combined hormonal contraceptive (tablets, patches or vaginal rings) or are used alone in progestin-only formulations. Progestin-only contraceptives are available as daily oral preparations, subcutaneous or intramuscular injectables (every 1–3 months), subdermal implants (every 3–5 years) and intrauterine systems (every 3–5 years). Long-acting progestins are highly effective in typical use and have a very low risk profile and few contraindications. Material and Methods: A new progestin-only, oestrogen-free contraceptive, drospirenone, in a dosage of 4 mg/day in a 24/4 regimen, has received regulatory approval in the USA and the EU. The molecule has antigonadotropic, antimineralocorticoid, antiestrogenic and antiandrogenic properties. Results: The regimen was chosen to improve the bleeding profile; maintain plasma oestradiol levels at those of the early follicular phase, to avoid hypoestrogenism; and preserve efficacy even with a missed pill, as drospirenone has a half-life of 30–34 h. Conclusions: Clinical studies have shown good efficacy, very low cardiovascular side effects and a favourable bleeding pattern, as well as maintenance of ovulation inhibition after scheduled 24 h delays in pill intake.

Original languageEnglish
JournalEuropean Journal of Contraception and Reproductive Health Care
Publication statusAccepted/In press - Jan 1 2020


  • Drospirenone
  • oestrogen-free contraception
  • progestins
  • spirolactone derivative

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology
  • Pharmacology (medical)

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