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estradiol +levonorgestrel (Fem7 Plus / HRT, Merck)

✓ Approved

Merck KGaA · ESR1 · Small Molecule

What is estradiol +levonorgestrel?

estradiol +levonorgestrel is a small molecule developed by Merck KGaA. It is approved for therapeutic indications via topical or transdermal.

Drug Profile

Brand NamesFem7 Plus, HRT, Merck
CompanyMerck KGaA
Drug ClassSmall Molecule
Molecular TargetESR1, PGR
RouteTopical, Transdermal
StatusApproved
Sources: ClinicalTrials.gov, Merck KGaA

Mechanism of Action

Molecular Targets

estradiol +levonorgestrel acts on 2 molecular targets:

ESR1estrogen receptor 1 (ER, ESR)
PGRprogesterone receptor (NR3C3, PR)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

estradiol +levonorgestrel is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Surgical and medical proceduresHormone replacement therapy✓ Approved

Related Research Articles

PubMedPacing and clinical electrophysiology : PACE2026-10-15

Pulsed Field Versus Radiofrequency Ablation of Atrial Fibrillation: Esophageal Lesions and Suspected Gastroparesis.

Murakami Atsushi A, Fukuzawa Koji K, Takami Mitsuru M, Imamura Kimitake K et al.

Esophageal mucosal injury and gastroparesis are clinically important complications of radiofrequency ablation (RFA) of atrial fibrillation (AF). Pulsed-field ablation (PFA) is a non-thermal modality that may spare these complications due to its myocardial tissue selectivity. We aimed to compare the incidence of endoscopically detected esophageal lesions (EDELs) and suspected gastroparesis between RFA and PFA as the primary endpoints. Secondary endpoints included perioperative complications, procedural parameters, and 365-day clinical outcomes. Between July 2023 and July 2025, patients undergoing a first-time AF ablation with RFA or PFA were enrolled. RFA was performed using either a QDOT MICRO catheter (Biosense Webster, Inc., Irvine, CA, USA) or a TactiFlex Ablation Catheter, Sensor Enabled (Abbott, Abbott Park, IL, USA), while PFA was performed using the FARAPULSE system or the PulseSelect system. All patients underwent upper gastrointestinal endoscopy on the day after ablation. An EDEL was defined as esophageal erythema, erosion, ulcer, or atrio-esophageal fistula. Suspected gastroparesis was defined as gastric food residue after > 12 h of overnight fasting. Clinical follow-up was performed with 12-lead or Holter electrocardiography. A total of 84 patients were included (RFA: n = 43; PFA: n = 41). Esophageal erosion was observed in 2 patients in the RFA group (4.7%) and in none in the PFA group (p = 0.49). Suspected gastroparesis occurred in 15 patients treated with RFA (34.9%) and in none treated with PFA (P<0.001). All patients were asymptomatic during endoscopy. No other procedural complications were observed in either group. The total procedure time was significantly shorter with PFA (158.5 ± 40.8 vs. 193.8 ± 38.3 min, p < 0.001), while the fluoroscopy time was longer. At 365 days, atrial arrhythmia recurrence rates were comparable between the two groups (p = 0.47). In this single-center cohort, PFA was associated with a significantly lower incidence of suspected gastroparesis than RFA, and no EDELs were observed in the PFA group. PFA may reduce gastrointestinal injury associated with AF ablation. Further studies are needed to confirm these findings and clarify their clinical significance.

PMID 42875927
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PubMedInternational journal of primatology2026-10-15

Hair Steroid Signatures of Cooperative Breeding in Male and Female Common Marmosets (Callithrix jacchus).

Laubi Benjamin N BN, Glauser Gaëtan G, Willems Erik P EP, van Schaik Carel P CP et al.

Cooperative breeding presents social and reproductive challenges that differ from those associated with independent breeding, but its endocrine correlates are not well understood. We investigated cumulative steroid hormone profiles in common marmosets (Callithrix jacchus), a primate species characterized by shared caregiving and clearly defined reproductive roles between primary breeders and non-breeding helper group members. Using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) on hair samples, we simultaneously quantified six steroid hormones across 71 individuals varying in breeding role, sex, age, and group reproductive context. Glucocorticoids were highest in breeder females, declined with age, and were higher in breeders when dependent offspring were present. Testosterone showed a comparatively modest male-female difference and was positively associated with the presence of dependent offspring in breeders, whereas androstenedione closely paralleled testosterone across age, consistent with shared regulation. Ovarian steroids showed clear sex differentiation in progesterone, with markedly elevated levels in breeder females, whereas estradiol differences were smaller, emerging as a modest sex effect within breeders and an age effect in helpers. Together, these findings highlight weaker sexual dimorphism in sex hormone profiles than often reported for independently breeding primates. They also reveal hormonal signatures of stress and vigilance related to caregiving, consistent with cooperative breeding in marmosets. Our study demonstrates the value of hair for long-term hormonal assessment and underscores the utility of HPLC-MS/MS for quantifying multiple hormones with high specificity in socially complex primates. The online version contains supplementary material available at https://doi.org/10.1007/s10764-026-00568-9.

PMID 42876644
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PubMedPrzeglad menopauzalny = Menopause review2026-10-14

Modulation of hormones in perimenopausal women by probiotics associated by specific gut bacteria: a pilot study.

Lozano Herrera Sara Julietta SJ, Aguilar López Tania T, Cruz Sancen Niko Alain NA, Gutiérrez Nataly García NG et al.

Perimenopause is characterised by hormonal fluctuations that can affect metabolism. Recent studies suggest that the gut microbiota, which can be regulated by taking probiotics, influences hormone regulation. One proposed mechanism is the activity of β-glucuronidase, which hydrolyzes excreted hormones, allowing them to be reabsorbed. The objective of this study was to investigate the effects of supplementation with Lactobacillus acidophilus, Lactobacillus rhamnosus and Bifidobacterium longum on oestrogen levels through their β-glucuronidase activity. A single-arm pre-post pilot study was conducted on 20 perimenopausal women aged 50-55 years who received 109 colony-forming units/day of probiotics for 12 weeks. Symptoms were assessed with the greene climacteric scale. Samples were collected before and after the intervention to determine hormone levels and biochemical parameters in the blood, as well as β-glucuronidase activity, oestrone and specific gut bacteria in the stool. Probiotic supplementation with Lactobacillus acidophilus, Lactobacillus rhamnosus, and Bifido- bacterium longum resulted in benefits, including improvement in specific gut bacteria, an increase in estradiol (6.86 ±-5.20 pg/ml), and an increase in β-glucuronidase activity (1.21 ±-1.15 mg phenolphthalein). It can be concluded that supplementation under the described conditions improves specific bacteria, increases estradiol, and increases β-glucuronidase activity. Although methodological limitations prevent demonstrating a direct impact on quality of life, this mechanistic approach to the estrobolome provides valuable support for guiding the design of new research on hormonal homeostasis in perimenopause.

PMID 42871936
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PubMedCirculation journal : official journal of the Japanese Circulation Society2026-10-14

Nationwide Evolution of Durable Left Ventricular Assist Device Outcomes Following Introduction of the HeartMate 3 and Destination Therapy in Japan　- The Third Official Report From J-MACS.

Imamura Teruhiko T, Kinugawa Koichiro K, Nishimura Takashi T, Toda Koichi K et al.

The nationwide impact in Japan of contemporary improvement in the clinical management of durable left ventricular assist device (LVAD), together with the introduction of the HeartMate 3 (Abbott, Pleasanton, CA, USA), on clinical outcomes remains uncertain. Using the Japanese Registry for Mechanically Assisted Circulatory Support (J-MACS), we analyzed all patients undergoing durable LVAD implantation in Japan between 2011 and 2025. Patients were divided into an early era (up to 2018) and the contemporary era (since 2019), reflecting introduction of the HeartMate 3 in Japan. The primary outcome was all-cause mortality during LVAD support. Among 1,859 patients, 1,587 underwent bridge-to-transplantation and 272 underwent destination therapy. Survival improved significantly in the contemporary era compared with the early era (5-year survival 84% vs. 76%, respectively; P=0.0002). Device dysfunction-free, pump thrombus-free, stroke-free, major bleeding-free, and pump exchange-free survival also improved significantly after 2019 (all P<0.0001). Right ventricular failure and ventricular arrhythmia that required appropriate defibrillation remained frequent complications. Among patients who received a durable LVAD since 2019, destination therapy recipients had lower survival than bridge-to-transplantation recipients (3-year survival 81% vs. 91%; P=0.0057). Clinical outcomes after durable LVAD implantation improved substantially following the introduction of HeartMate 3 in Japan, particularly regarding pump-related and hemocompatibility-related complications. However, right ventricular failure and ventricular arrhythmia remain major unresolved challenges.

PMID 42875230
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PubMedDevice2026-10-14

Multiplex ovarian hormone monitoring in sweat using a dual-aptamer wearable sensor.

Lee Yerim Y, Ye Cui C, Yeom Jeonghee J, Chen Yonglin Y et al.

Estradiol (E2) and progesterone (P4) jointly regulate reproductive function, menopausal transition, and hormone-therapy response, yet their assessment relies on intermittent blood sampling that provides only snapshots of dynamic endocrine processes. We report a wearable sweat sensor for multiplex E2 and P4 monitoring. Two redox-orthogonal aptamer-reporter systems, encoded by methylene blue and ferrocene, are integrated on a single inkjet-printed gold electrode, enabling independent quantification of the hormones through sequential square-wave voltammetry scans at physiologically relevant picomolar concentrations. An integrated passive microfluidic module normalizes sweat pH and ionic strength before analysis, eliminating auxiliary correction channels and enabling consistent operation across different sweat-induction methods and body locations. In a single-subject feasibility study spanning reproductive, perimenopausal, and postmenopausal participants, measurements agreed with laboratory reference assays and enabled longitudinal tracking of ovarian hormone dynamics. This approach establishes a strategy for multiplex wearable endocrine profiling and motivates larger cohort studies for personalized women's health monitoring.

PMID 42871933
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PubMedExpert opinion on drug delivery2026-10-14

A pharmacokinetic study comparing a low-dose estrogen contraceptive transdermal system with an oral contraceptive tablet in healthy adult females.

Hummel Matthew M, Liu Mark M, Jagtap Sandeep S, Bose Debdipta D et al.

This study evaluated the pharmacokinetics (PK) of a once-weekly low-dose estrogen contraceptive transdermal system (TDS) and a once-daily combined oral contraceptive (COC) in healthy women. In this Phase 1 study, 24 healthy women aged 18-35 years were randomized to a crossover sequence of three consecutive 168-h applications of the norelgestromin (NGMN; drug load, 4.86 mg)/ethinyl estradiol (EE; drug load, 0.264 mg) TDS to the abdomen (Treatment A) or buttock (Treatment B), followed by once-daily COC (drug load 0.18 mg norgestimate/0.025 mg EE) for 7 days (Treatment C). Plasma NGMN and EE concentrations were assessed using PK parameters. Application-site irritation, residual patch analysis, and safety were also evaluated. Variability in NGMN and EE exposure was lower for Treatments A and B versus Treatment C (AUCτ,ss: NGMN, 38.4% and 31.7% versus 47.0%; EE, 49.3% and 35.4% versus 51.2%) with comparable/lower Cp, ss(max) variability. EE Cp, ss(max). Normalized exposure were lower with the NGMN/EE TDS. No serious adverse events occurred. Residual patch analysis indicated delivery of ~200 µg/day NGMN and 19 µg/day EE. The NGMN/EE TDS demonstrated lower PK variability, EE peak concentrations and normalized EE exposure than the COC. No new safety signals were reported.

PMID 42873096
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