Neues aus der hormonellen Kontrazeption

Recently, two new oral contraceptives became available both of which are taken continuously in a 24/4 schedule. These are the progestin monopreparation with the active ingredient drospirenone and the combination preparation with the active ingredients estetrol and drospirenone. Estetrol in combination with drospirenone has a contraceptive safety comparable to other combined oral contraceptives. The antiandrogenic progestins cyproterone acetate, chlormadinone acetate and nomegestrol acetate are associated with a dose-dependent increased risk of meningioma. With the commonly used oral contraceptives the critical cumulative dose is reached only after several years but the exact timeframe could be different for these three progestins and cannot be derived from the data. Therefore, they should be prescribed only after exclusion of contraindications and a thorough education of the patients. Alternatives include contraceptives containing other antiandrogenic progestins, such as dienogest or drospirenone.