Dienogest

In a 1998 study, dienogest, a selective progestogen, was combined with ethinylestradiol and found to be an effective oral contraceptive with a Pearl Index of 0.2, indicating high efficacy. The study involved 2,291 women over 24,719 cycles, resulting in only 15 pregnancies. Dienogest was shown to have a 90% oral bioavailability, did not accumulate in the body, and did not significantly affect cytochrome P450 3A4 activity. It also improved cycle control, with a reduction in irregular vaginal bleeding and dysmenorrhea. Androgenic symptoms such as hirsutism, seborrhoea, alopecia, acne vulgaris, and skin greasiness improved with treatment. Adverse events, which were more common in the first few months, included headache, breast pain, and nausea/vomiting, but dienogest did not significantly affect body weight, blood pressure, or metabolic and biochemical parameters. The study concluded that dienogest, in combination with ethinylestradiol, offers effective contraception, good cycle stability, and a tolerable side effect profile.