Consensus statement of dienogest as a progestin in contraception and non-contraceptive clinical entities (heavy menstrual bleeding, acne and hirsutism). Narrative review of the literature and recent developments

BACKGROUND: Combined oral contraceptives (COC)s, besides offering a reliable and safe contraception, offer a variety of non-contraceptive health benefits and therapeutic positive aspects. METHODS: While contraceptive use is the primary indication for COC use, a variety of medical conditions have been added in the summary of product characteristics (SmPC) of these formulations. RESULTS: Dienogest, a 17a-cyanomethyl-17ß-hydroxy-4,9-estradien-3-one progestin is used in different dosage regimes with different oestrogens and with different release forms in contraception and has, depending on the type of COC additional medical treatment indications. CONCLUSIONS: This narrative review will focus on the effects, apart from contraception, of these COCs on female target organs like the uterus and the skin and clinical entities as the polycystic ovarian syndrome (PCOS).