Last update April 22, 2026

Estetrol + Drospirenone

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

Combined oral contraceptive (COC) containing estrogen (estestrol) and progestin (drospirenone) in the form of oral tablets. Taken daily.

For a detailed discussion with references:

  • on why non-hormonal methods are the first choice during the first 4–6 weeks postpartum, followed by IUDs and progestin implants,
  • on the potential problems associated with the use of combined estrogen-progestin contraceptives,
  • the possible decrease in milk production with estrogen use,
  • and why progestin-only contraceptives are preferable during breastfeeding,

see below: “(Combined Estrogen + Progestin Contraceptives, COCs)”

ESTETROL is a natural estrogen that occurs spontaneously during pregnancy but is synthesized from a plant source for use as a contraceptive. It is more potent than the synthetic estrogen ethinyl estradiol (EE2), which is present in 97% of oral contraceptive pills.

As of the last update, we found no published data on its excretion in breast milk.

Its pharmacokinetic properties (low molecular weight, low plasma protein binding, and long elimination half-life) would facilitate its excretion into breast milk.

Until more published data on this drug in relation to breastfeeding become available, safer known alternatives, such as ethinylestradiol, may be preferable.

DROSPIRENONE is a progestin analogous to spironolactone with antiandrogenic activity.

It is excreted into breast milk in clinically insignificant amounts, and no problems have been reported in infants whose mothers were taking it. (Melka 2020, Blode 2001)


See below the information of these related products:

Alternatives

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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Other names

Estetrol + Drospirenone in other languages or writings:

Group

Estetrol + Drospirenone belongs to this group or family:

Tradenames

Main tradenames from several countries containing Estetrol + Drospirenone in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 76 / 76 %
Molecular weight 304 / 367 daltons
Protein Binding 46 - 50 / 97 %
VD ? / 4 l/Kg
Tmax 0.5 - 2 / 3 - 4 hours
T½ 27 (19 - 40) / 32 hours
M/P ratio ? / 0.17 -
Theoretical Dose ? / 0.0005 mg/Kg/d
Relative Dose ? / 1.1 (0.4 - 2.1) %

References

  1. EMA. Drovelis: Estetrol + Drospirenona. Ficha técnica. 2021 Full text (in our servers)
  2. Melka D, Kask K, Colli E, Regidor PA. A single-arm study to evaluate the transfer of drospirenone to breast milk after reaching steady state, following oral administration of 4 mg drospirenone in healthy lactating female volunteers. Womens Health (Lond). 2020 Jan-Dec;16:1745506520957192. Abstract
  3. Blode H, Foidart JM, Heithecker R. Transfer of drospirenone to breast milk after a single oral administration of 3 mg drospirenone + 30 microg ethinylestradiol to healthy lactating women. Eur J Contracept Reprod Health Care. 2001 Sep;6(3):167-71. Abstract

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