The acceptability of a novel oral contraceptive containing drospirenone and its effect on well-being.Eur J Contracept Reprod Health Care 2000; 5 Suppl 3:34-40EJ
Low-dose combined oral contraceptives are generally well tolerated and represent an excellent reversible form of contraception that is suitable for most women. Certain aspects of the clinical profile of combined oral contraceptives, such as intermenstrual bleeding and a tendency to weight gain, are, however, known to have an adverse effect on compliance, which may in a few women lead to contraceptive failure or pill discontinuation. Conversely, factors that have a positive effect, such as relief from the symptoms of premenstrual syndrome, can enhance compliance. An oral contraceptive that minimizes the adverse and enhances the positive effects would, therefore, be likely to improve compliance. Recently, a new combined oral contraceptive containing 30 microg ethinylestradiol and 3 mg drospirenone (Yasmin, EE/DRSP) has been developed. The pharmacological profile of drospirenone is very similar to that of natural progesterone; in particular, it has antimineralocorticoid activity. This counteracts estrogen-mediated fluid retention, resulting in stable or slightly lowered body weight. In addition, drospirenone has antiandrogenic activity and therefore a positive effect on skin conditions. Present data also indicate that EE/DRSP has a favorable effect on the symptoms of premenstrual syndrome. In order to evaluate whether the positive effects of drospirenone on body weight, skin and the symptoms of premenstrual syndrome are also observed on well-being, a survey was carried out. This asked women who had been involved in two major clinical trials how they felt after these trials had ended, in comparison with the study periods when they were taking EE/DRSP or a combined oral contraceptive containing 30 microg ethinylestradiol/150 microg desogestrel (Marvelon, EE/DSG). The returned questionnaires demonstrated that, with respect to their disposition before and during menses, women who had taken EE/DRSP felt worse after the trial had ended and they had returned to taking a conventional preparation. This was also evident on the basis of their body weights and the condition of their skin and hair. These results from clinical trials with EE/DRSP indicate that it is a well-tolerated combined oral contraceptive that has a positive effect on body weight, skin and the symptoms of premenstrual syndrome. Overall, the combination of 30 microg ethinylestradiol/3 mg drospirenone appears to improve specific aspects associated with feelings of well-being, which may result in better compliance.