Etynodiol diacetate, or ethynodiol diacetate, sold under the brand name Ovulen among

others, is a progestin medication which is used in birth control pills.[4][5][6] The medication is
available only in combination with an estrogen.[7] It is taken by mouth.[8]

Etynodiol diacetate is a progestin, or a synthetic progestogen, and hence is an agonist of

the progesterone receptor, the biological target of progestogens like progesterone.[9][10] It has
weak androgenic and estrogenic activity and no other important hormonal activity.[11][12][13] The
medication is a prodrug of norethisterone in the body, with etynodiol occurring as
an intermediate.[9][10][14]

Etynodiol, a related compound, was discovered in 1954, and etynodiol diacetate was introduced
for medical use in 1965.[15][16] The combination ethynodiol with mestranol (Ovulen) was approved
for medical use in the United States in 1966.[17] The combination ethinylestradiol with ethynodiol
(Demulen) was approved for medical use in the United States in 1970.[18]

In 2021, the combination with ethinylestradiol was the 276th most commonly prescribed
medication in the United States, with more than 800,000 prescriptions. [19][20]

Medical uses[edit]
Etynodiol diacetate is used in combination with an estrogen such as ethinylestradiol
or mestranol in combined oral contraceptives for women for the prevention of pregnancy.[8]

Side effects[edit]
See also: Norethisterone § Side effects, and Progestin § Side effects

Pharmacology[edit]

Norethisterone (3-ketoetynodiol), the active metabolite of

etynodiol diacetate.
Etynodiol diacetate is virtually inactive in terms of affinity for the progesterone and androgen
receptors and acts as a rapidly converted prodrug of norethisterone, with etynodiol occurring as
an intermediate.[9][10][14] Upon oral administration and during first-pass metabolism in the liver,
etynodiol diacetate is rapidly converted by esterases into etynodiol,[14] which is followed
by oxygenation of the C3 hydroxyl group to produce norethisterone.[10] In addition to its
progestogenic activity, etynodiol diacetate has weak androgenic activity,[11][12] and, unlike most
progestins but similarly to norethisterone and noretynodrel,[21] also has some estrogenic activity.[12]
[13]

The pharmacokinetics of etynodiol diacetate have been reviewed.[22]