Combined oral contraceptives with estetrol: Reduced risk of thrombosis and other benefits. A review

Demographic trends indicate a decrease in the number of children per woman, a change in reproductive patterns and a late age of motherhood. These factors increase the importance of effective contraception. The article is devoted to the study of current trends in the use of combined oral contraceptives (COCs) with estherol (E4). E4 is a new estrogen secreted by the fetus during pregnancy. The focus is on estherol's unique pharmacological profile, its effects on various tissues and organs of the female body, as well as its potential advantages over traditional synthetic estrogens such as ethinyl estradiol. A distinctive feature of E4 is its ability to selectively affect different types of tissues and organs, which reduces the risk of side effects. E4 has minimal effect on the hemostasis system, reduces the risk of venous thromboembolic complications. Preclinical and clinical studies confirm the absence of a proliferative effect of E4 on breast cancer cells, which makes it a promising candidate for the development of new selective estrogen receptor modulators. Taking COCs with E4 is not accompanied by significant changes in the metabolic profile, provides weight control and maintains blood pressure stability. Multicenter studies have confirmed the high efficacy and acceptability of COCs with E4, a low percentage of serious adverse events, and a high degree of user satisfaction.