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Is ▼Drovelis a major breakthrough in contraception?

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What you need to know

  • Drovelis is a combined oral contraceptive (COC) that consists of 24 active pink tablets containing estetrol and drospirenone and 4 inactive white lactose tablets.

  • Estetrol is a synthetic version of an oestrogen molecule produced by the fetal liver.

  • Data on contraceptive efficacy from one study met the European Medicine Agency’s regulatory standard for preventing pregnancy.

  • Common adverse effects include metrorrhagia, headache, acne, vaginal haemorrhage and dysmenorrhoea.

  • There are limited data on long-term efficacy or adverse effects.

  • Drovelis is significantly more expensive than many other COCs.


More than 3 million prescriptions for combined hormonal contraceptives (CHCs) are dispensed annually in England alone, at a cost of £22 million.1 The majority of such prescriptions are for combined oral contraceptives (COCs). ▼Drovelis is a newly licensed COC and the first product in the UK to contain the oestrogen estetrol, a synthetic version of an oestrogen molecule produced by the fetal liver, and the progestogen drospirenone.2 A company press release states that it has ‘been working on Estetrol, a native hormone produced by the human body during pregnancy, for more than ten years to develop a new generation contraceptive pill with a clear benefit/risk aiming to improve women’s quality of life’.3 The company also claims that the product ‘promises to be a major breakthrough in a space where there hasn’t been any innovation in decades’.3 Here we review the effectiveness and place of this new product.

Contraceptive efficacy

Contraceptive efficacy can be assessed by measuring the number of unplanned pregnancies that occur over a specified time period while contraception is used.4 One method of determining the efficacy of contraceptives uses the Pearl Index, which is defined as the number of unintended pregnancies per 100 women-years of using a contraceptive and ranges from 0 (no pregnancies) to 1200 (all participants became pregnant in the first …

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  • Competing interests None declared. Refer to the online supplementary files to view the ICMJE form(s).

  • Provenance and peer review Commissioned; externally peer reviewed.

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