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.