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Dienogest / Estradiol Review


Indications for use

Hormonal contraception

Mechanism of action

Estradiol and dienogest is aplied to prevent an unwanted pregnancy. This drug belongs to a birth control pill. This drug contains two types of hormones: estrogens and progestins. Such a combination prevents pregnancy. The main function of this birth control drug is to stop an egg from full development. The egg rejects a sperm. As a result, fertilization is prevented.

Estradiol valerate and dienogest combination is also applied as the treatment of heavy menstrual bleeding. This combined drug does not prevent AIDS or other sexually transmitted diseases. This drug is not used as an emergency contraception.

Mode of application and dose

Dienogest / Estradiol contains 4 phases of doses throughout the 28-day cycle:

  • the 1-2 days: estradiol valerate dose is 3 mg;
  • 3-7 days: estradiol valerate is 2 mg and dienogest is 2 mg;
  • 8-24 days: estradiol valerate is 2 mg and dienogest is 3 mg;
  • 25-26 days: estradiol valerate is 1 mg.


  • Tumors of the mammary glands;
  • Cancer of the endometrium and ovaries;
  • Acute diseases and swelling of the liver;
  • Intracranial hypertension (including a history);
  • History of thrombophlebitis and thromboembolism;
  • Undiagnosed bleeding from the genitals and urinary tract;
  • Diabetes mellitus;
  • Complicated and angiopathy pregnancy and lactation;
  • Age up to 18 years old;
  • Individual intolerance.

Side Effects

>10% 1-10% <1%
Headache, including migraines (13.2%) Metrorrhagia and irregular menstruation (8%) Venous thromboembolism
Breast pain, discomfort, or tenderness (6.6%) Jaundice or cholestasis
Nausea or vomiting (6.5%) Gallbladder disease
Acne (3.9%) Depression
Weight gain (2.85)


  • A decrease in the effectiveness of estrogens is observed while combining with penicillin antibiotics, tetracyclines, ritonavir.
  • Ascorbic acid, paracetamol, atorvastatin increase the concentration of estrogen.
  • This birth control drug reduces the effectiveness of glucocorticoids, clofibrate.
  • Dienogest / Estradiol enhances the effect of hepatotoxic drugs due to the activation of hepatic blood flow by estrogens.
  • The simultaneous use with cyclosporine produces the risk of toxicity increases.
  • Dienogest influences the effectiveness of anticoagulants and hypoglycemic drugs.

What if I miss a dose?

Do not miss pills or delay taking the next dose by more than 12 hours. If you miss pills, pregnancy may occur. The more pills you miss, the more likely you are to get pregnant.

Dienogest / Estradiol and pregnancy

The drug is contraindicated during pregnancy and lactation. There is a risk of birth defects.

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