Efficacy, tolerability and anti-androgenic properties of the treatment with oral contraceptive containing 0.03 ethinylestradiol and 2 mg chlormadinone acetate: our experience

The monophasic combined low-dose oral contraceptive containing 0.03 mg ethinylestradiol (EE) and 2 mg chlormadinone acetate (CMA) represent an effective oral contraceptive. Chlormadinone acetate (CMA) is a derivative of progesterone. In contrast to progesterone, it has a slight glucocorticoid effect, a pronounced anti-androgenic effect and no antimineralocorticoid effect. The CMA shows marked antiandrogenic properties. It reduces clinical manifestations of androgen-related disorders by competing with endogenous androgens at their receptors in the sebaceous gland cells and by inhibiting alfa 5 alpha-reductase type I. The more recent application of CMA as an oral contraceptive in combination with EE has proven highly successful, with studies reporting excellent contraceptive efficacy, high tolerability and adherence due to a good side effect profile and positive effects on preexisting dysmenorrhea, skin and hair conditions. In this study we examinated 143 women who were taking the oral contraceptive in the period between January 2009 and July 2010. Our patients were assessed for up to 18 cycles. The women were invited to give us informations about this kind of oral contraceptive, thanks to a specific questionnaire. The aim of our study was to investigate long-term efficacy and tollerablity of oral contraceptive ( chlormadinone acetate 2.0 mg and etinylestardiol 0.03 mg, EE/CMA) and to investigate some possible androgenetic effects on skin and hair of our patients. At the end of our study the Pearl Index was 0.08 %. Approximately 67.7 % of women had regular withdrawal bleeding in each cycle, while incidence of intracyclic bleedings was low. We observed a remarkable improvement (85.6%) of general skin condition, stained, fatty skin and seborrea throughout our study. Moreover, a great part of our patients responded the question on tolerability of oral contraceptive as "very good" or "good".