Hormonal contraceptives: pharmacology tailored to women's health
Open accessAbstract
BACKGROUND: In recent years, several new oral contraceptives have become available. In some ways, they represent an evolution in terms of individualization and compliance on the part of women. The new formulations make it increasingly possible to prescribe a specific hormonal contraceptive on an individual basis. METHODS: A systematic literature search of PubMed was performed using the following combination of terms: 'oral contraceptives', 'estroprogestins' and 'combined oral contraceptive'. Only English-language papers published between January 2000 and July 2014 were included in our analysis. The present review analyzes all aspects of the choice of oral contraceptives in the different phases of a woman's life in detail. RESULTS: Regarding the estrogen component, lowering the dose of ethinylestradiol (EE) helped reduce associated side effects. Natural estradiol is now available and represents a valid alternative to EE. And regarding progestins, the dose has changed over time, as well as the endocrine and metabolic characteristics. These are the fruit of much research into improvement of old products (19-nor-progesterone-derived progestins) with androgenic effects and testing of new molecules with improved metabolic neutrality in terms of insulin sensitivity and lipid parameters. New progestins were a genuine turning point because they greatly reduced major side effects, such as water retention, and their anti-androgenic properties made them indicated for all forms of hyperandrogenism associated with acne and mild hirsutism. The associations of estradiol/dienogest and estradiol/nomegestrol acetate are the most suitable contraceptives for women with abundant menstrual bleeding and can increase the number of potential users of hormonal contraception. CONCLUSION: Progress in the provision of new oral contraceptives has improved the risk/benefit ratio, by increasing benefits and reducing risks. The present challenge is to tailor contraceptives to individual needs in terms of efficacy and protection of reproductive health.
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COCPs containing CPA might be more effective in reducing hirsutism compared to conventional COCPs.
“COCPs containing cyproterone acetate (CPA) might be more effective in reducing hirsutism compared to conventional COCPs (14, 15);”
From Metformin and Combined Oral Contraceptive Pills in the Management of Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis (2024) · cites this paper as [14]
The PCOS section reports that CPA improved hirsutism compared with placebo. The Acne and hirsutism section describes CPA as an anti-androgen that can be used in a contraceptive pill when COCs alone do not work. Neither passage establishes that CPA-containing COCs reduce hirsutism more effectively than conventional COCs; page numbers are unavailable in our copy. (LLM, conf=0.84)
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Hampson, E. (2020) · Hormones and Behavior · doi:10.1016/j.yhbeh.2019.104655 · Cited by 136 · see citing works
An Update on Contraception in Polycystic Ovary Syndrome
Oguz, S. H., & Yildiz, B. O. (2021) · Endocrinology and Metabolism · doi:10.3803/enm.2021.958 · Cited by 76 · see citing works
Melin, J., Forslund, M., Alesi, S., Piltonen, T., Romualdi, D., Spritzer, P. M., Tay, C. T., Pena, A., Witchel, S. F., Mousa, A., et al. (2024) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad465 · Cited by 78 · see citing works
Pharmacological Approaches to Controlling Cardiometabolic Risk in Women with PCOS
Cignarella, A., Mioni, R., Sabbadin, C., Dassie, F., Parolin, M., Vettor, R., Barbot, M., & Scaroni, C. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21249554 · Cited by 36 · see citing works
Forslund, M., Melin, J., Alesi, S., Piltonen, T., Romualdi, D., Tay, C. T., Witchel, S., Pena, A., Mousa, A., & Teede, H. (2023) · Clinical Endocrinology · doi:10.1111/cen.14913 · Cited by 32 · see citing works
- Authors
- De Leo, V., Musacchio, M. C., Cappelli, V., Piomboni, P., & Morgante, G.
- Affiliations
- University of Siena (IT)
- Venue
- Human Reproduction Update
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-06-15
- Volume
- 22
- Issue
- 5
- Pages
- 634-646
- ISSN
- 1355-4786 (ISSN-L)
- 1460-2369
- OpenAlex
- W2424140206
- Cited by
- 188
- References
- 99
- Citations by year
- 2026: 13 · 2025: 22 · 2024: 23 · 2023: 25 · 2022: 20 · 2021: 36 · 2020: 17 · 2019: 15 · 2018: 10 · 2017: 5 · 2016: 1
- FWCI
- 1.53
- Type
- journal article
- Language
- en
- Open access
- Licence
- other-oa
- Locations
- Human Reproduction Update (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Use Siena air (University of Siena) (submittedVersion)
- INFM-OAR (INFN Catania) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- hormonal contraception, oral contraceptives, estroprogestins, ethinyl estradiol, progestins, hyperandrogenism, acne, hirsutism, menstrual bleeding, insulin sensitivity, lipid profile, contraceptive side effects, women's health
- MeSH terms
- Chemistry, Pharmaceutical, Contraception, Contraceptives, Oral, Combined, Contraceptives, Oral, Hormonal, Drug Combinations, Ethinyl Estradiol, Female, Humans, Menstruation, Norpregnenes, Progestins, Women's Health, Risk Assessment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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