Abstract
Recently, a monophasic combined oral contraceptive (COC) containing 1.5 mg 17-beta estradiol (E2) and 2.5 mg nomegestrol acetate (NOMAC) has been developed with a 24/4 regimen. While E2 is identical to the endogenous estrogen, NOMAC is a 19-nor progestogen derivative with no androgenic effects. NOMAC/E2 has demonstrated a good safety profile and less effects on cardiovascular risk, hemostatic, metabolic, and endocrine factors in comparison to COCs containing ethinyl estradiol in combination with levonorgestrel or drospirenone. Evidence suggests that NOMAC/E2 may be a good choice for preserving sexual health in women complaining about sexual side-effect of COCs. Clitoral color Doppler ultrasound (CDU) with assessment of the pulsatility index (PI), reflecting resistance to blood flow, has been proposed as an objective measurement of sexual functioning. Moreover, clitoral PI has been reported to be directly associated with cardiovascular risk factors and self-reported poor peripheral arousal during sexual activity. Our aim was to evaluate, in women consulting our Outpatient Clinic for contraceptive needs, the possible changes in clitoral hemodynamic parameters after 6 months treatment with NOMAC/E2 as compared with other COCs.
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