Drug Database
CH

chlormadinone acetate + ethinyl estradiol (Balianca / Belara / CG5025)

✓ Approved

Faes · AR · Small Molecule

What is chlormadinone acetate + ethinyl estradiol?

chlormadinone acetate + ethinyl estradiol is a small molecule developed by Faes. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand NamesBalianca, Belara, CG5025
CompanyFaes
Drug ClassSmall Molecule
Molecular TargetAR, ESR1
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, Faes

Mechanism of Action

Molecular Targets

chlormadinone acetate + ethinyl estradiol acts on 2 molecular targets:

ARandrogen receptor (TFM, NR3C4)
ESR1estrogen receptor 1 (ESR, ESTRR)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

chlormadinone acetate + ethinyl estradiol is developed for 2 unique indications across 2 therapeutic areas.

Therapeutic AreaConditionPhase
Reproductive system and breast disordersPolycystic ovaries✓ Approved
Endocrine disordersPolycystic ovarian syndrome✓ Approved

Related Research Articles

PubMedFrontiers in endocrinology2026-08-08

Estetrol/drospirenone for combined oral contraception: a systematic review of efficacy, cycle control, and safety.

Sánchez-Prieto Manuel M, Coll Sandra S, Romero-Domínguez Marina M, Avella-Marcos Marta M et al.

To systematically evaluate the evidence on the contraceptive efficacy, cycle control, safety, and selected noncontraceptive effects of estetrol 15 mg/drospirenone 3 mg (E4/DRSP) and to assess certainty of evidence by outcome using the GRADE approach. A systematic review was conducted in accordance with PRISMA 2020. PubMed/MEDLINE, Scopus, and Google Scholar were searched for eligible studies published through February 2026. Clinical trials and comparative studies evaluating E4/DRSP in women of reproductive age were included. Outcomes were grouped into contraceptive efficacy, bleeding/cycle control, safety and tolerability, hemostatic and endocrine-metabolic effects, ovarian suppression, and noncontraceptive clinical outcomes. Risk of bias was assessed using design-specific tools, and certainty of evidence was graded by outcome. A total of 25 eligible publications/study reports were included, comprising phase 2 dose-finding studies, pivotal phase 3 contraceptive trials, pooled analyses, mechanistic comparator studies, adolescent data, and indication-specific studies. E4/DRSP demonstrated robust contraceptive efficacy, predictable bleeding patterns, and an acceptable tolerability profile. Across mechanistic studies, E4/DRSP showed less pronounced hemostatic and endocrine-metabolic effects than ethinyl estradiol-containing comparators. The most consistent biological differentiation of E4/DRSP was observed for APC resistance and thrombin-generation endpoints, which were less affected than with EE-containing comparators. The strongest noncontraceptive evidence was observed for dysmenorrhea, supported by a randomized, double-blind, placebo-controlled trial. Certainty of evidence was moderate for contraceptive efficacy, cycle control, common adverse events, and surrogate hemostatic/metabolic outcomes; high for dysmenorrhea versus placebo; low for endometriosis-related and menstrual symptom outcomes; and very low for clinical thromboembolic risk. E4/DRSP is an effective combined oral contraceptive with favorable cycle control and a consistent biologic profile suggesting lower hepatic/hemostatic impact than ethinyl estradiol-containing formulations. However, current evidence does not establish comparative thromboembolic safety, which requires dedicated postauthorization and real-world comparative studies.

PMID 42568434
Read full article →
PubMedTheriogenology2026-08-08

Exploring the postpartum period in mares: hormonal dynamics and ovarian activity under physiological and pathological conditions.

Perina Francesca F, Lanci Aliai A, Fanelli Diana D, Maltinti Saverio S et al.

The aims of the study were to evaluate factors influencing the resumption of postpartum ovarian activity and to compare hormone concentrations among mares with physiological/pathological postpartum period and cyclic non-lactating mares. Follicular dynamics were monitored ultrasonographically in 38 postpartum mares from foaling or admission (Tpp/Ta) every other day until the emergence of a dominant follicle (Td), then daily until ovulation (To). Blood samples were collected at Tpp/Ta, Td, and To in postpartum mares and at Td and To in cyclic mares to determine serum estradiol, progesterone, leptin and cortisol concentrations. Ovulation occurred in 34/38 (90%) mares. The χ2 test showed that ovulation was significantly more frequent in mares with physiological postpartum (p = 0.005), in multiparous (p = 0.03) and in lactating mares (p = 0.00011). Age and foaling month were not associated with ovulation. In physiological postpartum mares, estradiol and progesterone concentrations decreased significantly over time (p = 0.002; p = 0.004 respectively), whereas leptin and cortisol remained unchanged. No significant temporal changes were observed for any hormone in mares with pathological postpartum or in cyclic mares. Hormone concentrations did not differ significantly among groups at any time point. Progesterone concentrations at Tpp/Ta were lower in primiparous mares (p = 0.048). Overall, parity, type of postpartum and lactation status influenced the likelihood of postpartum ovulation. Although hormone concentrations were largely comparable among groups, pathological postpartum mares exhibited delayed or absent ovulation, suggesting that postpartum disorders may affect the resumption of ovarian activity.

PMID 42567120
Read full article →
PubMedAnalytica chimica acta2026-08-08

Conformational changes in a Pseudo[1]catenane induced by ethyl acetate and temperature: A combined HPLC and electronic circular dichroism study.

Mazzaferro Martina M, Mammone Francesca Romana FR, Pisagatti Ilenia I, Gattuso Giuseppe G et al.

Stereochemistry plays a pivotal role in the recognition properties of macrocyclic systems bearing multiple stereogenic elements. This study investigates a chiral pseudo[1]catenane based on a pillar[5]arene core covalently fused to a second macrocycle containing two carboxylic acid groups. The molecule contains three stereogenic elements: the planar stereogenicity of the pillararene macrocycle, a helical (P/M) stereogenicity induced by macrocycle closure, and central stereogenicity arising from the two stereocenters introduced by the side chain. Its synthesis yields two pairs of enantiomers, the main product being the racemic mixture of the enantiomers with identical configurations at both stereocenters of the side chain. The presence of COOH groups facilitates the selective binding of linear diamino guests, highlighting the potential of chiral pseudo[1]catenanes in molecular recognition. Understanding the conformational behavior of this system is crucial for its application in molecular recognition and sensing. A multidisciplinary approach combining HPLC on an immobilized polysaccharide-based stationary phase (Chiralpak IA) and electronic circular dichroism was used to characterize the dynamic stereochemistry of the molecule. Two dominant conformers, designated in and out, defined by the location of the alkyl chain inside or outside the macrocyclic cavity, exhibited stability at room temperature. Their relative abundance shifted with varying ethyl acetate content in hexane. Lowering the HPLC column temperature from sub-ambient to cryogenic conditions resulted in each conformer splitting into two distinct peaks, revealing additional stereoisomeric species. Dynamic chromatographic profiles observed between -7 °C and -22 °C showed interconversion plateaus indicative of on-column isomerization. Computational simulation of these profiles enabled the estimation of the thermodynamic activation data associated with the conformational transitions. This study thoroughly examines the stereodynamic behavior of a multifunctional chiral pillar[5]arene derivative, demonstrating how solvent composition and temperature influence its conformational equilibrium. By integrating chromatographic and chiroptical techniques, we present a model for studying stereoisomeric interconversion in dynamic systems. These findings are valuable for designing chiral molecular hosts and devices that respond to external guests, with potential applications in enantioselective recognition and sensing.

PMID 42567583
Read full article →
PubMedStructure (London, England : 1993)2026-08-08

Ligand-dependent interdomain rearrangements drive catalysis by acetyl-CoA synthetases.

Li Meng M, Zhou Mingyang M, Marmorstein Ronen R

Acetyl-coenzyme A synthetases convert ATP, acetate, and coenzyme A (CoA) into acetyl-CoA, a central metabolite that fuels lipid biosynthesis and regulates protein and RNA acetylation. ACS enzymes contain N- and C-terminal domains that coordinate a two-step ping-pong mechanism involving sequential adenylation and thioester formation at the interdomain interface. How domain motions coordinate these chemical steps remains unclear. Here, we report single-particle cryo-electron microscopy structures of Schizosaccharomyces pombe ACSA captured in apo, pre-adenylation, intermediate, and product states. These structures reveal ligand-dependent reorganization of the C-terminal domain: apo and pre-adenylation forms display increased conformational heterogeneity, whereas intermediate- and product-bound states adopt ordered conformations compatible with catalysis. Structure-guided mutagenesis and in vitro activity assays, together with sequence conservation, support the functional importance and evolutionary conservation of the observed conformational transitions across ACS homologs. These findings establish a ligand-coupled interdomain rearrangement mechanism underlying catalysis by ACS enzymes and a structural framework for inhibitor development.

PMID 42567156
Read full article →
PubMedFrontiers in endocrinology2026-08-08

Effect of different acupuncture modalities on sex hormone levels in perimenopausal women: a network meta-analysis.

Pang Shuyue S, Wang Zhongtian Z, Zhang Lili L, Qin Qi Q et al.

Acupuncture, a common intervention in traditional Chinese medicine (TCM), has been widely applied for regulating hormonal fluctuations in perimenopausal women. However, the efficacy of various acupuncture modalities is not comprehensively compared. This network meta-analysis (NMA) evaluated the effects of different acupuncture approaches on sex hormone levels, specifically estradiol (E2), follicle-stimulating hormone (FSH), and luteinizing hormone (LH), in perimenopausal women. PubMed, Embase, the Cochrane Library, Web of Science, CNKI, Wanfang, and the VIP Database were searched until March 17, 2026. Randomized controlled trials (RCTs) on acupuncture interventions for perimenopausal women were included. The risk of bias was assessed for included studies, and data were synthesized based on a Bayesian NMA framework. 36 studies on 1, 480 participants were included. Compared with control interventions, acupoint application (AA) and acupuncture therapy (AT) significantly reduced Kupperman scores. In terms of FSH reduction, AA, abdominal moxibustion (AM), and AT were superior to control. For LH, AA, AT, and AM demonstrated notable reductions compared with control. As for E2 elevation, AA, AT, and compression acupuncture (PN) achieved statistically significant improvements. AM, AT, and AA significantly improved Kupperman scores, with AM being the most effective. Catgut implantation acupoint (CA) and PN showed significant effects in reducing FSH levels, followed by AT and AM, whereas plum blossom needling exhibited the greatest efficacy in increasing E2 levels. Overall, acupuncture presents a promising non-pharmacological strategy for modulating hormonal balance and alleviating menopausal symptoms in perimenopausal women. https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251066613.

PMID 42568455
Read full article →
PubMedJournal of pediatric endocrinology & metabolism : JPEM2026-08-08

Environmental neonicotinoid exposure and early gonadal development in girls with central precocious puberty.

Wang Pingping P, Jin Xuefeng X, Yang Suhong S, Wang Qiangwei Q

Environmental endocrine disruptors (EDCs), particularly prevalent pesticide residues, are suspected contributors to the increasing incidence of central precocious puberty (CPP). This study explored the associations of urinary neonicotinoid insecticides (NNs) with sex hormones and pelvic ultrasound indicators in girls with CPP. Girls were divided into three subgroups: CPP, non-CPP pubertal and prepubertal groups. Urinary levels of nine pesticides were screened via Kruskal-Wallis H test with Dunn's test; only nitenpyram (NIT) with intergroup differences was further analyzed. Stratified correlation and adjusted linear regression assessed links between NIT and sexual development markers, while quartile-based logistic regression examined the dose-response association between NIT and CPP risk. Thiamethoxam (THI), clothianidin (CLO), flupyradifurone (FPF), and sulfoxaflor (SUL) showed a 100 % detection rate, while thiacloprid (THIA) was the least detected (85.8 %). The NIT concentration was significantly higher in the CPP group (p<0.05). Stratified multivariate linear regression adjusted for age and BMI-SDS demonstrated that elevated NIT was independently positively associated with ovarian volume (OV) (B=0.73, 95 % CI: 0.15-1.31, p=0.014, β=0.294) and estradiol (E2) (B=116.64, 95 % CI: 49.58-183.70, p=0.002, β=0.682) only in CPP group, while no significant correlations were detected in non-CPP pubertal or prepubertal groups. Logistic regression revealed a significant ascending dose-response trend between elevated NIT quartiles and CPP risk (p for trend=0.048). NIT exposure acts as an independent environmental risk factor for CPP in girls, and aggravates sex hormone disturbance and abnormal ovarian development only in children with CPP. Restricting daily children's exposure to NNs is clinically and public health meaningful.

PMID 42568329
Read full article →

+9996 more articles available with a free account

Sign up free to view all articles →

Ask about chlormadinone acetate + ethinyl estradiol