The Contraceptive Profile of a New Oral Contraceptive with Antimineralocorticoid and Antiandrogenic Effects

Yasmin (Schering AG, Berlin, Germany), a new oral contraceptive containing 30 microg ethinylestradiol combined with 3 mg drospirenone, effectively inhibits ovulation, as demonstrated by measurement of plasma hormone levels (follicle stimulating hormone, luteinizing hormone, estradiol and progesterone), and echographic evaluation of follicular ripening. Like other low-dose oral contraceptives, the combination of ethinylestradiol and drospirenone markedly limits cervical function, spinnbarkeit and degree of crystallization, resulting in a hostile environment for sperm penetration. Two large, randomized, multicenter, open-label clinical studies have compared the contraceptive efficacy of ethinylestradiol/drospirenone with that of Marvelon, a well-established contraceptive containing 30 microg ethinylestradiol plus 150 microg desogestrel. Both preparations provided effective contraception and good cycle control. There were no negative effects on hemostatic parameters, lipids and carbohydrate metabolism. However, in both studies, ethinylestradiol/drospirenone had a more favorable effect on body weight than ethinylestradiol/desogestrel, with mean body weight remaining lower in the ethinylestradiol/ drospirenone group, the difference between the two preparations being statistically significant. Pre-existing acne and seborrhea were improved by ethinylestradiol/ drospirenone and blood pressure was essentially unchanged. These studies show that ethinylestradiol/drospirenone provides effective oral contraception, excellent cycle control and good tolerability, with effects on body weight and skin condition that are likely to confer a significant beneficial effect on compliance, especially in women with a tendency to gain weight under oral contraceptives due to water retention.