An update on new orally administered contraceptives for women

Abstract

Introduction: The focus in contraception is shifting from oral contraceptives to more effective methods, such as implants and intrauterine devices. Generics are favored by third-party payors. As a result, potentially exciting developments in branded pills to increase safety or to reduce side effects may have gone unnoticed.

Areas covered: This article reviews the features of each of the four new oral contraceptives that have been introduced in the United States and/or Europe in the last few years. The motivation for the development of each product is outlined as is its efficacy, safety, tolerability and the noncontraceptive applications that have been explored are described.

Expert opinion: The hypothesis that using estradiol in place of ethinyl estradiol would reduce the risk of venous thromboembolism is still to be proven. However, the stronger progestogens used in these formulations may offer other tangible benefits for selected women. The new products for extended cycle pill use may have less impact. The flexible regimen can be adopted using any pill, but the approved product does provide convenience to patients. Cost will continue to be the determining factor in the acceptance of these new products, unless substantial health benefits can be conclusively proven.

Keywords:

• dienogest
• estradiol
• estradiol valerate
• flexible regimens extended cycle oral contraceptives
• nomegestrol acetate
• oral contraceptives
• triphasic extended cycle oral contraceptives

Declaration of interest

AL Nelson declares that in the last year she has received payments or research from Agile Pharmaceuticals, ContraMed and the NIH. She has received honoraria for participation on advisory boards or speakers bureaus for Actavis, Bayer, ContraMed, Merck and Microchips Biotech. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.