Antiandrogen-oestrogen combinations

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 26.10.2022

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  • Oral contraceptives with antiandrogenic effect, consisting of an estrogen component(ethinyl estradiol 20-35 µg, estradiol, estradiol valerate, esttrol) and an antiandrogenic progestogen(cyproterone acetate, dienogest, drospirenone, chlormadinone acetate)
  • Estrogen-progestin combinations for hormone replacement therapy in the climacteric (estradiol, estradiol valerate and cyproterone acetate, dienogest, drospirenone)

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Hormonal contraception, androgen-dependent diseases in women, such as acne papulopustulosa, acne conglobata, seborrhea, milder forms of hirsutism, alopecia androgenetica (see alopecia androgenetica in women, alopecia androgenetica in men).

Limited indication
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  • Lactation, long-term immobilization (e.g. after accidents), smokers > 30 years, liver diseases (e.g. porphyria), post-thrombophlebitis.
  • Monitoring in diabetes mellitus, hypertension, varicosis, phlebitis, otosclerosis, multiple sclerosis, epilepsy, chorea minor, latent tetany; women > 40 years.

Dosage and method of use
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When taking for the first time, start on the 1st day of menstruation. Rhythm 21 days - 7 days break. Long cycles are possible without any problems and are recommended especially if symptoms occur during the break (e.g. acne flare-up).

Preparations for hormone replacement therapy are usually taken continuously.

Undesirable effects
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visual and hearing disorders, weight gain, chest tensions, changes in libido, thrombosis, gastrointestinal problems, liver tumours, chloasma, blood pressure increase, dizziness, headaches, depression.

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See Table 1.

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Pregnancy, idiopathic icterus or severe pruritus (in the medical history), severe liver dysfunction, Dubin-Johnson or Rotor syndrome, previous or existing liver tumours, lipid metabolism disorders, Z. n. thrombosis or embolism, Z.n. apoplexy, Z.n. myocardial infarction, tendency to thrombosis, sickle cell anaemia, pemphigoid gestationis (in the medical history), worsening of otosclerosis in pregnancy, severe diabetes mellitus, migraine, severe forms of hypertension, breast or endometrial carcinoma.

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  • Cyproterone acetate: 100% antiandrogenic efficacy. Indication limited to moderate to severe acne, hirsutism and androgenetic alopecia (Diane 35, Juliette, Jennifer 35).
  • Dienogest: 40% antiandrogenic efficacy. There is an approval for acne therapy (Valette, Dienovel, Maxim).
  • Drospirenone: 30% antiandrogenic efficacy, at the same time there is still an antimineral corticoid effect (Yasmin, Aida, Xellia)
  • chlormadinone acetate: 20% antiandrogenic efficacy (Belara, Chariva, Enriqa)
  • oral contraceptives with bioidentical estrogen: Qlaira (estradiol valerate/dienogest), Drovelis (estretol/drospirenone)
  • preparations for hormone replacement therapy: Climen (estradiol valerate/cyproterone acetate, no longer available on the German market), Lafamme (estradiol valerate/dienogest), Angeliq (estradiol/drospirenone)

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Essential interactions of antiandrogen-estrogen combinations

Antidiabetics, oral

Carbohydrate Tolerance ↓


contraceptive effect ↓

Broad spectrum antibiotics

contraceptive effect ↓


contraceptive effect ↓


contraceptive effect ↓


contraceptive effect ↓

Incoming links (1)

Cyproterone acetate;


Last updated on: 26.10.2022