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Obstetrics and Gynegology2022№10
The effect of a new...

The effect of a new contraceptive with estetrol on the thrombotic safety profile of hormonal contraception

DOI
https://dx.doi.org/10.18565/aig.2022.10.159-168

Akinshina S.V., Koloda Yu.A.

1) Deparment of Obstetrics and Gynecology, N.F. Filatov Clinical Institute of Children’s Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow, Russia; 2) Department of Obstetrics and Gynecology, Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia, Moscow, Russia
Thromboembolic complications are rare but potentially life-threatening adverse events associated with combined hormonal contraceptives (CHCs). The thrombogenic safety of CHCs is an issue that customarily causes the greatest concern among specialists and patients when choosing a birth control method, whereas the need to design new contraceptives with a minimal adverse effect on the hemostatic system has always remained relevant. Esteretta is the first CHC containing estetrol, a selective estrogen, which belongs to a fundamentally new class of estrogen with selective action in tissues and has a neutral metabolic profile and a minimal effect on the hemostatic system. The paper presents the current guidelines for selection of hormonal contraception in patients at high thrombotic risk; a review on the effect of various combined hormonal contraceptives on the hemostatic system; an analysis of the effects of the new contraceptive Esteretta on the parameters of the hemostatic system and on the risk of thromboembolic complications in the view of an obstetrician/gynecologist and hematologist.
Conclusion: Despite a more favorable safety profile with regard to the hemostatic system, contraindications to the use of Esterette are the same as to that of other CHCs, while the thrombotic safety of this drug remains to be analyzed from the results of studies involving a large number of patients and in terms of real clinical practice.

Keywords

hormonal contraceptives
thrombosis
thromboembolism
estetrol
drospirenone
estrogens
thrombophilia
Full text (in Russian)

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Received 07.10.2022

Accepted 13.10.2022

About the Authors

Svetlana V. Akinshina, PhD, MD, obstetrician-gynecologist, hematologist, Assistant Professor of the Department of Obstetrics and Gynecology, Children’s Health Center,
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, +7(903)238-80-48, svetlana_akin@mail.ru, https://orcid.org/0000-0002-1388-5827, 119435, Russia, Moscow, B. Pirogovskaya str., 19-1.
Yulia A. Koloda, PhD., MD, obstetrician-gynecologist, Associate Professor of the Department of Obstetrics and Gynecology, Russian Medical Academy of Continuous Professional Education, Ministry of Health of Russia; medical director, Center for reproduction «LifeLine», Moscow, Russia, +7(903)105-31-89, julkol@yandex.ru, https://orcid.org/0000-0003-2502-575X, 125993, Russia, Moscow, Barriсadnaya str., 2/1-1.
Corresponding author: Svetlana V. Akinshina, svetlana_akin@mail.ru

Authors’ contributions: Akinshina S.V. – the topic material reviewing and processing, literature search and analysis, writing the text of the manuscript; Koloda Yu.A. – peer-reviewing, final article editing.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The paper has been written without sponsorship.
For citation: Akinshina S.V., Koloda Yu.A. The effect of a new contraceptive with estetrol on the thrombotic safety profile of hormonal contraception.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 10: 159-168 (in Russian)
https://dx.doi.org/10.18565/aig.2022.10.159-168

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