Antiandrogenic and antimineralocorticoid health benefits of COC containing newer progestogens: dienogest and drospirenone.

Pedro-Antonio Regidor,Adolf E Schindler

doi:10.18632/oncotarget.19833

Abstract

Data have demonstrated that COCs, besides offering a satisfactory and safe contraception, offer a variety of non-contraceptive health benefits and therapeutic positive aspects. Many prescribes and users, however, do not realize these positive aspects especially the non-contraceptive health benefits. While the contraceptive use is the primary indication for COC use for most women, these users should be advised in regard of the non-contraceptive benefits when contraception is discussed and prescribed.Using COCs specifically for non-contraceptive indications is an off-label use in many clinical situations (only some exceptions as e.g. acne vulgaris in some countries are allowed clinical entities for the use of these drugs). Therefore, appropriate discussions with the patient regarding this fact should performed and documented by the prescribing physicians.Independent of the off-label situation, COCs containing the newer progestogens dienogest and drospirenone with their antiandrogenic and antimineralocorticoid health benefits play an important role in the management of many diseases and their use should therefore be considered by clinician’s.This review will focus on the effects of these COCs on the endometrium, the skin, the fat tissue and the premenstrual syndrome.

Highlights

Since starting the use of oral hormonal contraceptives as combined estrogen/progestogen drugs in 1960, COC have experienced a continuous change in used progestogens showing changing aspects of the partial effects in addition to its inhibition of ovulation [1]
These aspects of progestogen actions have been shown to be useful in incorporating aspects of non-contraceptive use into the possibilities of therapeutic uses creating a wide range of positive effects besides the primary use as contraceptives
A general awareness to the non-contraceptive benefits of hormonal contraceptives has to be reached, as these drugs, besides their objective high efficacy and safety have been shown to have non-contraceptive benefits. In addition to their clinical value in different medical indications, COCs have a very favorable cost/benefit ratio and a good level of compliance in comparison to other drugs used for medical indications

Summary

INTRODUCTION

Since starting the use of oral hormonal contraceptives as combined estrogen/progestogen drugs in 1960, COC have experienced a continuous change in used progestogens showing changing aspects of the partial effects in addition to its inhibition of ovulation [1]. As the pearl index between all three day intake formulations in combined oral contraceptives is almost similar, COC with the lowest ethinyl estradiol dosage and the lowest amount of drug day intake should be used to achieve the lowest side effect profile; especially the thromboembolic risks [36, 37] For those women with pms and/or pms better non contraceptive results will be obtained with the 24 day regime [38] and for those with very prolonged menstrual cycles with late ovulations (after day 20 or more) before starting the use of COC to improve the contraceptive efficacy.

CONCLUSIONS

Findings

Methods