From the Guidelines
Yaz (drospirenone and ethinyl estradiol) is a suitable treatment option for patients with Polycystic Ovary Syndrome (PCOS), as it can help manage several PCOS symptoms by regulating menstrual cycles, reducing androgen levels, and improving acne and hirsutism, as supported by recent studies 1. The typical regimen involves taking one active pill daily for 24 days followed by 4 placebo pills, with continuous monthly cycles. Yaz is particularly beneficial for PCOS patients because drospirenone, unlike other progestins, has anti-androgenic properties and mild antimineralocorticoid activity, which can help reduce testosterone levels and minimize fluid retention. The ethinyl estradiol component helps suppress ovarian androgen production and increases sex hormone-binding globulin, further reducing free testosterone levels. Some key points to consider when prescribing Yaz for PCOS patients include:
- The medication can help regulate menstrual cycles and reduce androgen levels, leading to improved acne and hirsutism symptoms
- Drospirenone has anti-androgenic properties, which can help reduce testosterone levels and minimize fluid retention
- Ethinyl estradiol helps suppress ovarian androgen production and increases sex hormone-binding globulin, further reducing free testosterone levels
- Patients should be aware that improvement in symptoms may take 3-6 months of consistent use
- Yaz is contraindicated in women with certain conditions, including history of blood clots, certain heart conditions, uncontrolled hypertension, migraine with aura, liver disease, or smokers over age 35
- Regular monitoring of blood pressure is recommended as Yaz may cause slight increases in some patients, as noted in studies such as 1 and 1. It's also important to consider the potential risks and benefits of Yaz, including the increased risk of venous thromboembolism and cardiovascular events, as well as the potential benefits of reduced risk of certain cancers, such as colon, uterine, and ovarian cancer, as discussed in studies like 1 and 1. Overall, Yaz can be a effective treatment option for PCOS patients, but it's essential to carefully evaluate the individual patient's medical history and risk factors before prescribing the medication.
From the Research
Yaz as a Treatment Option for PCOS
- Yaz, which contains drospirenone and ethinyl estradiol, has been studied as a potential treatment option for patients with Polycystic Ovary Syndrome (PCOS) 2, 3, 4, 5, 6.
- The studies suggest that Yaz can provide good cycle control for women with PCOS, with improvements in acne and a reduction in androgen levels 2, 3.
Effects on Clinical and Biochemical Parameters
- A prospective randomized trial compared the efficacy of a drospirenone-containing combined oral contraceptive (COC) with a desogestrel-containing COC in women with PCOS, and found that the drospirenone-containing COC had better outcomes in terms of persistent regular cycles, antiandrogenic effect, fall in BMI and BP, and favorable lipid and glycemic profiles 3.
- Another study compared the effects of oral contraceptive pills containing desogestrel, cyproterone acetate, and drospirenone in patients with PCOS, and found that cyproterone acetate had the strongest antiandrogen activities after 12 months of treatment 5.
Comparison of Different Ethinyl Estradiol Doses
- A randomized study compared the effects of 30 μg and 20 μg ethinyl estradiol (EE) among women with PCOS, and found that an oral contraceptive pill containing 20 μg EE had similar effects on androgen levels to those of a pill containing 30 μg EE 6.
- The study suggests that a lower dose of EE may be effective in reducing androgen levels in women with PCOS, which could be beneficial for patients who are sensitive to the side effects of higher doses of EE 6.
Overall Efficacy of Yaz for PCOS
- The available evidence suggests that Yaz can be a suitable treatment option for patients with PCOS, particularly for those who require good cycle control and improvement in acne and androgen levels 2, 3, 4, 5, 6.
- However, the choice of treatment should be individualized based on the patient's specific needs and medical history, and patients should be monitored regularly for any potential side effects or changes in their condition 2, 3, 4, 5, 6.