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.
