Ethinylestradiol/drospirenone/levomefolic acid

Ethinylestradiol/drospirenone/levomefolic acid is a combination drug used in oral contraceptives to prevent pregnancy. It combines three active ingredients: ethinylestradiol, a synthetic form of the hormone estrogen; drospirenone, a type of progestin; and levomefolic acid, a form of folic acid which is a type of vitamin B. This combination not only serves to prevent pregnancy but also aims to address folate deficiency which can be a concern in women of childbearing age.

Composition

The medication consists of three key components:

• Ethinylestradiol: A synthetic version of estrogen, it works by preventing ovulation (the release of an egg from an ovary) during the menstrual cycle. It also makes vaginal fluid thicker to help prevent sperm from reaching an egg (fertilization) and changes the lining of the uterus to prevent attachment of a fertilized egg.
• Drospirenone: A synthetic form of progestin, drospirenone helps in the prevention of ovulation and also contributes to the changes in the uterus and cervical mucus. It has the added benefit of reducing acne and premenstrual syndrome (PMS) symptoms in some women.
• Levomefolic acid: The bioactive form of folic acid, it is included in this medication to help prevent folate deficiency. Folate is important for preventing neural tube defects in a developing fetus, making this component particularly beneficial in the early stages of pregnancy before a woman may know she is pregnant.

Indications

Ethinylestradiol/drospirenone/levomefolic acid is primarily indicated for the prevention of pregnancy in women who choose to use oral contraceptives as a method of contraception. The inclusion of levomefolic acid also makes it suitable for women of childbearing age who may benefit from supplemental folate to prevent potential birth defects.

Mechanism of Action

The contraceptive effect of this combination is achieved through various mechanisms:

• Inhibition of ovulation by ethinylestradiol and drospirenone.
• Thickening of cervical mucus to prevent sperm entry.
• Alteration of the uterine lining to prevent implantation of a fertilized egg.

Levomefolic acid does not contribute to the contraceptive effect but provides nutritional support to reduce the risk of neural tube defects in the event of an unintended pregnancy.

Side Effects

Common side effects include nausea, headache, breast tenderness, and mood changes. Some women may experience changes in their menstrual cycle, such as spotting or missed periods. Drospirenone may increase the risk of blood clots, so women with a history of clotting disorders should discuss their risks with a healthcare provider.

Contraindications

This medication should not be used by women who are pregnant, have a history of blood clots, severe liver disease, breast cancer, or are allergic to any of the components. Smoking increases the risk of serious cardiovascular side effects, especially in women over 35.

Conclusion

Ethinylestradiol/drospirenone/levomefolic acid is a comprehensive oral contraceptive option that not only prevents pregnancy but also addresses the need for folate supplementation in women of childbearing age. As with any medication, it is important to discuss individual health needs and risks with a healthcare provider.