The non-contraceptive benefits and acceptability of Yasmin®

D. Mansour

Consultant in Community Gynaecology and Reproductive Health Care, Head of Contraception and Sexual Health Services, Newcastle upon Tyne, UK

Health professionals are aware that women complain of hormonal side-effects with different oral contraceptives. Progestogens in oral contraceptives differ, with some improving cycle control and others having anti-androgenic effects on the skin, leading to improved well-being and higher continuation rates. However, complaints related to salt and water retention continue. A new oral contraceptive, Yasmin®, has been developed which contains drospirenone, a progestogen resembling progesterone. This progestogen is quite unique as it is derived from 17-spirolactone and has antimineralocorticoid as well as antiandrogenic properties. The addition of this compound to an oral contraceptive provides additional non-contraceptive benefits and leads to a reduction in salt and fluid retention and an improvement in skin conditions such as acne and seborrhoea.

A non-comparative study of Yasmin® in normal women showed significant decreases from baseline in negative affect, water retention and increased appetite. A randomized, placebo-controlled trial of Yasmin® in women with severe premenstrual syndrome found a consistently greater reduction of symptoms from baseline using the Calendar of Premenstrual Experiences. A recent European 6-month study has assessed the effect of Yasmin® on general well-being and fluid-related symptoms. The results suggest that women who report premenstrual symptoms before starting Yasmin® have improved scores when their Psychological General Well-being Index is measured and also have fewer somatic symptoms. A further study in the USA also found that Yasmin® helped to reduce premenstrual symptomatology and improved health-related quality of life and general sense of well-being.

With these non-contraceptive benefits, do Yasmin users continue to take their pills longer when compared to other oral contraceptive users? In Newcastle, Yasmin® was compared to an oral contraceptive containing ethinylestradiol/norgestimate. At 6 months, discontinuation rates for Yasmin® were significantly lower than for the comparator. Data were also gathered from 150 UK practices. Subjects were followed for 12 months and a significantly lower proportion of discontinuation was found in the Yasmin® cohort compared to the comparator arm. Women taking Yasmin® were found to continue for significantly longer than those in the comparator cohort. The higher continuation rates observed with Yasmin® are attributable to its unique pharmacological profile and corresponding non-contraceptive benefits.