Ethinyl Estradiol and Chlormadinone Acetate

Overview

What is it?

Ethinyl estradiol and chlormadinone acetate (EE/CMA) is a combined monophasic oral contraceptive pill that contains 0.03 mg of ethinyl estradiol (a synthetic estrogen) and 2 mg of chlormadinone acetate (a synthetic progestin with anti-androgenic properties). It is not naturally occurring and is specifically designed to provide contraceptive benefits while also addressing hormonal skin conditions like acne.

How does it work?

EE/CMA works to combat acne by targeting the hormonal causes of acne. Ethinyl estradiol reduces the production of androgens (male hormones) by suppressing luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which in turn lowers serum androgen levels. Chlormadinone acetate blocks androgen receptors in the pilosebaceous unit (the part of the skin responsible for acne), further reducing the effects of androgens on the skin. Together, these actions help decrease sebum production and prevent the formation of acne lesions .

What are the benefits?

EE/CMA is particularly effective in treating acne vulgaris, especially in women with hyperandrogenism (excess male hormones). It has been shown to significantly reduce acne lesions, improve skin texture, and address other androgen-related skin conditions like hirsutism (excessive hair growth) and seborrhea (oily skin). Clinical trials have demonstrated a median reduction of 63.6% in acne lesions, making it a reliable option for hormonal acne management .

Effectiveness

5.4

What does the research say?

Research shows that EE/CMA is highly effective in treating mild-to-moderate acne. In clinical trials, it was found to be more effective than placebo, with a 63.6% reduction in acne lesions compared to 45.3% with placebo. It also performed similarly to other low-dose oral contraceptives, such as ethinyl estradiol/levonorgestrel, in improving acne symptoms. These findings highlight its potential as a treatment option for women seeking both contraception and acne management .

Side Effects

Significant

Breast tenderness or pain

Breast tenderness or pain is a common side effect, likely due to hormonal changes caused by the contraceptive .

Headache or migraine

Headache or migraine may occur, particularly in individuals prone to these conditions, as a result of hormonal fluctuations .

Nausea

Nausea is a frequent but usually mild side effect that often subsides after the first few cycles of use .

Breakthrough bleeding or spotting

Breakthrough bleeding or spotting can happen, especially during the initial months of use, as the body adjusts to the hormonal changes .

Amenorrhea (absence of menstruation)

Amenorrhea, or the absence of menstruation, may occur in some women, though it is not harmful and typically resolves after discontinuation .

Evidence

Strong

Clinical Studies & Trials

[1] Oral Contraceptives in Dermatology

This review discusses the use of oral contraceptives in dermatology, particularly for treating acne and hirsutism. It highlights the importance of choosing progestins with anti-androgenic effects to avoid exacerbating acne.

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[2] Treatment of lean PCOS teenagers: a follow-up comparison between Myo-Inositol and oral contraceptives

This study compares treatments for polycystic ovary syndrome (PCOS) in adolescents, including oral contraceptives, and their effects on acne and other symptoms.

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[3] Ethinylestradiol/chlormadinone acetate

This paper evaluates the efficacy and safety of EE/CMA in treating acne and preventing pregnancy. It highlights its anti-androgenic properties and effectiveness in reducing acne lesions.

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[4] Drospirenone/ethinyl estradiol

This review discusses the benefits of drospirenone/ethinyl estradiol, including its anti-androgenic effects and efficacy in treating acne and premenstrual dysphoric disorder.

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[5] The effects of hormonal contraceptives on female sexuality: a review

This review explores how hormonal contraceptives, including those with anti-androgenic properties, can influence female sexual function.

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[6] Ethinylestradiol/Chlormadinone acetate: dermatological benefits

This review highlights the dermatological benefits of EE/CMA, particularly its effectiveness in treating acne, hirsutism, and seborrhea.

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[7] Dienogest

This review discusses the anti-androgenic properties of dienogest and its use in combination with ethinyl estradiol for treating acne and other androgen-related conditions.

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[8] Gestodene-containing contraceptives

This review examines the effects of gestodene-containing contraceptives on acne and other androgen-related symptoms.

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[9] Quality of life issues. Potential role for an oral contraceptive containing ethinyl estradiol and drospirenone

This review discusses how oral contraceptives with anti-androgenic properties, like drospirenone/ethinyl estradiol, can improve quality of life by treating acne and other symptoms.

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