Enhancement of the specific advantages of the drospirenone-containing pill by long-cycle contraception

A.O. Mueck (1), R. Schneidereit (2), R. Heithecker (2), M. Sillem (3)

University Women’s Hospital, Section of Endocrinology and Menopause, Tuebingen, Germany (1); Schering AG, Berlin, Germany (2); Dept. of Obstetrics and Gynecology, Hospital of the Red Cross, Neuwied, Germany (3)

Objectives: Due to its specific antimineralocorticoid and antiandrogenic properties drospirenone has already been shown to ameliorate cycle-dependent disorders like symptoms of water retention, premenstrual syndrome (PMS) and skin problems. Using Yasmin®, Schering AG, Germany (i.e. 30 µg ethinylestradiol + 3 mg drospirenone), the aim of this study was to investigate if long cycle contraception (42–126 days) compared to conventional 21-day cycle administration (short cycle) could further improve the tolerability and the non-contraceptive efficacy of this novel pill.

Methods: 1433 women were observed for 6 months in an open prospective observational study, using an online questionnaire. Descriptive comparisons were made using Fisher’s exact test and t-test as applicable.

Results: On long cycle treatment (n=175), withdrawal bleedings were similar in duration and intensity compared to short cycle treatment (n=1221). Spottings were observed in 15% on long cycle versus 6% on short cycle. The number of women with breast tenderness at 0/3/6 months of treatment was 37/3/2% of women on long cycle and 25/6/3% of women on short cycle (p<0.05, long versus short cycle). The number of women with abdominal bloating was 24/3/2% of women on long cycle and 18/4/4% of women on short cycle (difference between groups not significant). The number of women with edema was 21/0/ 1% of women on long cycle and 14/2/1% of women on short cycle (p<0.001). Weight was reduced by 0.57 kg on long cycle (p<0.005) and 0.61 kg on short cycle (p<0.0001). Body mass index was reduced by 0.21kg/m2 on long cycle (p<0.005) and 0.22 kg/m2 on short cycle (p<0.0001). General well-being was improved in 85% on long cycle versus 66% on short cycle (p<0.0001). 97% of long cycle users and 91% of short cycle users recommend this preparation for further application.

Conclusions: These results in a large group of women not only confirm previous observations that the drospirenone-containing oral contraceptive reduces premenstrual symptoms and improves general well-being but also demonstrate that these effects were increased through long cycle application. Provided by the antimineralocorticoid activity of drospirenone, therapeutic effects can be further enhanced improving breast tenderness, edema and bloating, and its antiandrogenic activity can lead to stronger reduction of skin problems. In addition particularly further improvement of dysmenorrhea and less frequent bleedings are regarded as very positive by most women.