Clinical perspectives on a new gestodene oral contraceptive containing 20mug of ethinylestradiol [antikvár]

Introduction S. O. Skouby Medical programs and contraception in particular should never end up in a vacuum. To improve compliance and avoid clinical side-effects, a continuous refinement of oral contraceptives is necessary based not only upon epidemiological but alsó upon clinical research. The new generation of gonanes have high anovulatory potency and are, therefore, effective in combination with ultra-low doses of ethinylestradiol. Although much attention has been focused upon the possible risk of deep venous thrombosis associated with use of the third-generation oral contraceptives containing these progestins, the possibility of improving, by lowering the hormonal content, the overall clinical profilé and the risk of more serious cardiovascular complications such as myocardial infarction and stroke should not be ignored. Gestodene is one of the three new-generation progestins. Its pharmacological profilé is highly interesting because the desired biological effect on follicular activity and on the endometrium is obtained without concomitant androgen activity; this is often referred to as progestational selectivity. In 1987, a combination of 30|Lig ethinylestradiol with 75 jixg gestodene was introduced. The Symposium, of which this book is the Proceedings, was devoted to a similar combination with 20 \ig ethinylestradiol only. From these papers, it appears that the pharmacokinetic and pharmacodynamic properties of such a compound are very attractive with regard to clinical, metabolic and endometrial effects. It alsó appears that, in many countries, there is a need to improve information on oral contraceptive developments in order to enhance compliance. It is hoped that this book will contribute to the understanding that today's pilis are of major importance for the reproductive health of all women and, dependent on choice and correct use, side-effects may virtually be eliminated.