Experiences with Yasmin: the acceptability of a novel oral contraceptive and its effect on well-being.

There are well over 100 million women using oral contraceptives world-wide; however, the number of women taking the pill differs from country to country. In the 1960s when 'the pill' was launched, most women wanted an effective, reversible contraceptive method. In the twenty-first century, they take these properties of oral contraceptives as given and now expect a number of non-contraceptive benefits including lighter and less painful periods, 'clear skin' and an overall improvement in well-being. Many oral contraceptives fall short of this ideal, with women discontinuing their pills because of perceived side-effects including weight gain, mood changes and breast tension. A new oral contraceptive has been developed to help fill this need. It contains 3 mg drospirenone, a progestogen resembling endogenous progesterone, and 30 microg ethinylestradiol (DRSP/EE, Yasmin, Schering AG, Berlin, Germany). It has been shown to be highly effective in preventing pregnancies as well as providing good cycle control. Studies have suggested that rates of dysmenorrhea improved in women taking DRSP/EE as well as in women using an oral contraceptive containing 30 microg ethinylestradiol and desogestrel, but symptoms were more often mild or less often severe in the DRSP/EE group. Drospirenone is quite unique as it is derived from 17alpha-spirolactone and has antimineralocorticoid as well as antiandrogenic properties. The effect of DRSP/EE on skin has been evaluated in women with mild to moderate facial acne. A positive effect on acne and seborrhea was observed, with the median acne lesion count decreasing by 62.5% from baseline to cycle 9, whilst seborrhea decreased by 25.1%. Further areas of research are focusing on premenstrual symptoms. A very recent European study has been completed to assess the effect of DRSP/EE on the general well-being and fluid-related symptoms over six treatment cycles in women desiring contraception. Overall, these results suggest that women who report premenstrual symptoms, including psychological and/or somatic problems, before starting DRSP/EE, have improved scores when their Psychological General Well-Being Index is measured and suffer fewer somatic symptoms. In conclusion, the combination ofdrospirenone with ethinylestradiol provides an effective and well-tolerated oral contraceptive with positive effects on body weight, skin and premenstrual symptoms. These unique features of DRSP/EE may improve well-being and have a positive effect on oral contraceptive continuation.