Effects of a monophasic combined oral contraceptive containing nomegestrol acetate and 17 beta-oestradiol on ovarian function in comparison to a monophasic combined oral contraceptive containing drospirenone and ethinylestradiol

Eur J Contracept Reprod Health Care. 2010 Oct;15(5):314-25. doi: 10.3109/13625187.2010.504313.


Objective: To compare the effects on ovarian activity of two oral contraceptives containing nomegestrol acetate (NOMAC)/17 beta-oestradiol (E2) or drospirenone (DRSP)/ethinylestradiol (EE).

Methods: In this open-label, randomised, six-cycle study, 32 subjects using NOMAC/E2 (2.5-1.5 mg; 24/4-day regimen) were compared to 16 subjects using DRSP/EE (3 mg-30 microg; 21/7-day regimen). Measurements included serum oestradiol, progesterone, follicle stimulating hormone (FSH) and luteinising hormone (LH), and ultrasonography of follicular diameter.

Results: No ovulations occurred during treatment. Progesterone was fully suppressed, with mean maximum values <2 nmol/l in both groups over all cycles. For NOMAC/E2, mean maximum follicular diameter decreased from 19.3 mm before treatment to between 6.9 and 8.2 mm during treatment, with no subject having a follicular diameter ≥15 mm. For DRSP/EE, a decrease from 19.6 to between 7.4 and 10.8 mm was observed, with two subjects (12.5%) having a maximum follicle diameter ≥15 mm. These findings were consistent with observed FSH reductions; full suppression of LH surges was observed in both groups. Post-treatment return of ovulation in both groups occurred on average 21 days after the last active tablet intake.

Conclusions: NOMAC/E2 achieves consistent ovulation inhibition, with suppressive effects on the ovaries at least similar to those of DRSP/EE.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Androstenes / pharmacology
  • Contraceptives, Oral, Combined / pharmacology*
  • Estradiol / pharmacology*
  • Estrogens / pharmacology*
  • Ethinyl Estradiol / pharmacology
  • Female
  • Follicle Stimulating Hormone / blood
  • Humans
  • Megestrol / pharmacology*
  • Menstrual Cycle / drug effects
  • Mineralocorticoid Receptor Antagonists / pharmacology
  • Norpregnadienes / pharmacology*
  • Ovulation / drug effects*
  • Ovulation / physiology
  • Progesterone / blood
  • Young Adult


  • Androstenes
  • Contraceptives, Oral, Combined
  • Estrogens
  • Mineralocorticoid Receptor Antagonists
  • Norpregnadienes
  • Ethinyl Estradiol
  • Progesterone
  • Estradiol
  • nomegestrol acetate
  • Follicle Stimulating Hormone
  • Megestrol
  • drospirenone