Profile of estetrol, a promising native estrogen for oral contraception and the relief of climacteric symptoms of menopause

INTRODUCTION: Estrogens used in women's healthcare have been associated with increased risks of venous thromboembolism (VTE) and breast cancer. Estetrol (E4), an estrogen produced by the human fetal liver, has recently been approved for the first time as a new estrogenic component of a novel combined oral contraceptive (E4/drospirenone [DRSP]) for over a decade. In phase 3 studies, E4/DRSP showed good contraceptive efficacy, a predictable bleeding pattern, and a favorable safety and tolerability profile.

AREAS COVERED: This narrative review discusses E4's pharmacological characteristics, mode of action, and the results of preclinical and clinical studies for contraception, as well as for menopause and oncology.

EXPERT OPINION: Extensive studies have elucidated the properties of E4 that underlie its favorable safety profile. While classical estrogens (such as estradiol) exert their actions via both activation of nuclear and membrane estrogen receptor α (ERα), E4 presents a specific profile of ERα activation: E4 binds and activates nuclear ERα but does not induce the activation of membrane ERα signaling pathways in specific tissues. E4 has a small effect on normal breast tissue proliferation and minimally affects hepatic parameters. This distinct profile of ERα activation, uncoupling nuclear and membrane activation, is unique.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:15

Enthalten in:

Expert review of clinical pharmacology - 15(2022), 2 vom: 09. Feb., Seite 121-137

Sprache:

Englisch

Beteiligte Personen:

Gérard, Céline [VerfasserIn]
Arnal, Jean-François [VerfasserIn]
Jost, Maud [VerfasserIn]
Douxfils, Jonathan [VerfasserIn]
Lenfant, Françoise [VerfasserIn]
Fontaine, Coralie [VerfasserIn]
Houtman, René [VerfasserIn]
Archer, David F [VerfasserIn]
Reid, Robert L [VerfasserIn]
Lobo, Rogerio A [VerfasserIn]
Gaspard, Ulysse [VerfasserIn]
Coelingh Bennink, Herjan J T [VerfasserIn]
Creinin, Mitchell D [VerfasserIn]
Foidart, Jean-Michel [VerfasserIn]

Links:

Volltext

Themen:

Combined oral contraception
Contraception
Contraceptives, Oral, Combined
E4
ENB39R14VF
Estetrol
Estrogen
Estrogen receptor
Estrogens
Hemostasis
Journal Article
Menopause
Review
Venous thrombosis

Anmerkungen:

Date Completed 31.03.2022

Date Revised 01.04.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1080/17512433.2022.2054413

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM338374515