Hemostasiologic safety of the estetrol-drospirenone combined oral contraceptive

Currently, realization of thrombotic events against the background of using hormonal contraception remains one of the controversial issues of today’s gynecology. The available research data demonstrate a significantly increased risk of realization of hypercoagulable states in patients using COCs based on synthetic estrogens (in particular, ethinylestradiol). It is well known that oral contraceptives based on bioidentical estrogens have a less prominent effect on the coagulation/fibrinolysis system. In 2022, a COC based on the unique bioidentical estrogen, estetrol, emerged in the Russian Federation, having certain personalized pharmacological advantages over other representatives of the estrogen “family”. The paper reports evidence-based data on hemostasiologic safety of the estetrol-drospirenone COC. © 2025 Elsevier B.V., All rights reserved.