Can a 14-year-old take Yaz (drospirenone and ethinyl estradiol)?

Use of Yaz (Drospirenone/Ethinyl Estradiol) in a 14-Year-Old

Yes, a 14-year-old can take Yaz (drospirenone and ethinyl estradiol) as it is FDA-approved for females ≥14 years of age for both contraception and acne treatment. 1

FDA Approval and Indications

Yaz (drospirenone 3mg/ethinyl estradiol 0.02mg) is specifically approved for:

• Contraception in women who choose an oral contraceptive
• Treatment of moderate acne vulgaris in females at least 14 years of age who have achieved menarche and desire contraception 2

The FDA has explicitly approved drospirenone-containing oral contraceptives for females ≥14 years of age, making Yaz an appropriate option for this age group when clinically indicated. 1

Efficacy for Acne Treatment

For adolescents with acne, Yaz has demonstrated significant efficacy:

• Clinical trials showed statistically significant improvement in moderate acne compared to placebo 2
• Improvement typically becomes noticeable after 3 months of treatment 1
• Acne reduction rates of 42-46% in total lesions were observed in clinical trials 2

Safety Considerations

Before prescribing Yaz to a 14-year-old, consider these important safety factors:

Required Screening

• Thorough medical history
• Blood pressure measurement
• Assessment of pregnancy status 1

Absolute Contraindications

• History of thromboembolism or thrombophilia
• Uncontrolled hypertension (≥160/100 mmHg)
• Complicated valvular heart disease
• Migraines with aura or focal neurologic symptoms
• Current breast cancer
• Liver disease with abnormal liver function 1

Common Side Effects

• Nausea
• Intermenstrual bleeding
• Breast pain 3
• Headache
• Mood changes 2

Practical Administration

• Take 1 tablet daily at the same time every day
• For acne treatment, improvement may not be noticeable until after 3 months of use 1
• Can be used in combination with topical acne treatments for enhanced efficacy 1

Benefits Beyond Contraception and Acne

Yaz offers several additional benefits for adolescents:

• Regulation of menstrual cycle
• Reduction in menstrual pain and heavy bleeding
• Improvement in premenstrual symptoms 1, 4
• May help with symptoms of premenstrual dysphoric disorder (PMDD) 3, 4

Important Counseling Points

• Effectiveness for contraception is 91% with typical use (9% failure rate) 1, 5
• Condoms should be used in addition to hormonal contraception to protect against STIs 5
• Backup contraception (condoms or abstinence) should be used for the first 7 days after starting 1, 5
• Missing pills increases pregnancy risk; follow specific instructions for missed pills 1

Common Pitfalls to Avoid

1. Misconception about antibiotics: Most antibiotics (except rifampin and griseofulvin) do not reduce the effectiveness of combined oral contraceptives 1

2. Delayed effectiveness: Patients should be counseled that acne improvement typically takes at least 3 months 1

3. Unnecessary testing: Pap smears and pelvic examinations are not mandatory before starting Yaz 1

4. Inadequate follow-up: Schedule follow-up visits 1-3 months after initiation to assess for side effects and adherence 5

Yaz represents an appropriate option for 14-year-old females who have achieved menarche and require treatment for acne and/or contraception, provided there are no contraindications to its use.