Yasmin (birth control)

Yasmin (birth control)
Tradename	Yasmin, others
Other names	DRSP/EE
Type	Combined oral contraceptive pill
Component1	Drospirenone
Class1	Progestin
Component2	Ethinylestradiol
Class2	Estrogen
ATC prefix	G03
ATC suffix	AA12
Pregnancy AU	B3
Legal AU	S4
Legal CA	Rx-only
Legal UK	POM
Legal US	Rx-only
Routes of administration	Oral administration

Yasmin (birth control) is a combined oral contraceptive pill containing the progestin drospirenone and the estrogen ethinylestradiol. It is primarily used for contraception and is also prescribed for the treatment of moderate acne in women seeking oral contraception. Marketed by the pharmaceutical company Bayer, Yasmin was one of the first pills to utilize drospirenone, a progestin with anti-mineralocorticoid and anti-androgenic properties.

Composition and formulation

Each active tablet of Yasmin contains 3.0 mg of the synthetic progestogen drospirenone and 0.03 mg of the estrogen ethinylestradiol. The formulation is presented in a 28-day regimen, with 21 active hormone tablets and 7 inert placebo tablets. Drospirenone is chemically derived from 17α-spirolactone and is structurally analogous to the diuretic spironolactone. This composition distinguishes it from earlier progestins like levonorgestrel or norethisterone, as it lacks androgenic activity. The Food and Drug Administration approved this specific combination for use in the United States.

Medical uses

The primary medical use of Yasmin is for the prevention of pregnancy through the inhibition of ovulation, thickening of cervical mucus, and alteration of the endometrium. It is also indicated for the treatment of moderate acne in females at least 14 years old who have achieved menarche, desire contraception, and have no known contraindications to oral contraceptive therapy. Some clinicians may prescribe it off-label for symptoms of Premenstrual dysphoric disorder due to drospirenone's anti-mineralocorticoid effects, which can alleviate fluid retention.

Side effects and risks

Common side effects include headaches, nausea, breast tenderness, and irregular menstrual bleeding. Serious risks, though rare, include an increased risk of venous thromboembolic events, such as deep vein thrombosis and pulmonary embolism. The risk associated with drospirenone-containing pills like Yasmin has been the subject of studies by the FDA and agencies like the European Medicines Agency, with some data suggesting a potentially higher risk compared to pills containing levonorgestrel. Other serious risks include arterial thrombosis, myocardial infarction, increased blood pressure, and benign hepatic adenomas.

Pharmacodynamics

Drospirenone acts as an antagonist at the mineralocorticoid receptor, promoting mild diuresis and counteracting the salt-retaining properties of ethinylestradiol. Its anti-androgenic activity is achieved by blocking androgen receptors and potentially reducing testosterone synthesis. Ethinylestradiol provides negative feedback on the hypothalamic-pituitary-gonadal axis, suppressing the secretion of follicle-stimulating hormone and luteinizing hormone from the pituitary gland. This combined action effectively inhibits follicular development and ovulation.

History and development

Yasmin was developed by the German pharmaceutical company Schering AG, which was later acquired by Bayer. It received approval for use in Europe in 2000 and from the Food and Drug Administration in the United States in 2001. The development of drospirenone was a significant innovation in hormonal contraception, aiming to provide a progestin with a more favorable side-effect profile regarding weight gain and acne. Following its introduction, Bayer also launched a lower-dose successor, Yaz, containing 3.0 mg drospirenone and 0.02 mg ethinylestradiol.

Society and culture

Yasmin and its successor Yaz have been widely marketed, with significant direct-to-consumer advertising campaigns in the United States. These products have been involved in major product liability litigation, with Bayer settling thousands of lawsuits alleging that the company failed to adequately warn about the risk of blood clots. The pills have been referenced in popular culture, including on television shows like *Law & Order*. Debates over the relative safety of drospirenone versus older progestins have been covered by media outlets such as *The New York Times* and have prompted regulatory reviews by health authorities worldwide.

Category:Drugs Category:Contraception