From the Guidelines
Yaz is not recommended for teenagers unless specifically prescribed by a healthcare provider for certain medical conditions, due to the potential risks of blood clots, stroke, and heart attack, as well as other contraindications and side effects 1. When considering the use of Yaz (drospirenone and ethinyl estradiol) in teenage girls, it is essential to weigh the benefits against the potential risks. Yaz is a combined hormonal contraceptive that can be prescribed for birth control or treatment of conditions like moderate acne, premenstrual dysphoric disorder (PMDD), or certain menstrual disorders. However, the medication carries risks, including blood clots, stroke, and heart attack, which are higher in smokers 1.
Key Considerations
- A thorough medical evaluation is necessary before starting Yaz to check for contraindications like history of blood clots, certain types of migraines, liver disease, or uncontrolled high blood pressure 1.
- The typical regimen involves taking one active pill daily for 24 days followed by 4 placebo pills, with no breaks between packs, and teens should take it at the same time each day to maintain effectiveness.
- Pediatricians should counsel about and ensure access to a broad range of contraceptive services for their adolescent patients, including educating patients about all contraceptive methods that are safe and appropriate for them and describing the most effective methods first 1.
Recommendations for Healthcare Providers
- Pediatricians should be aware that it is appropriate to prescribe contraceptives or refer for IUD placement without first conducting a pelvic examination, and screenings for STIs can be performed without a pelvic examination and should not be delayed 1.
- Any teen prescribed Yaz should be monitored regularly by their healthcare provider to assess for side effects and ensure the medication is appropriate as they continue to develop.
- The medication works by preventing ovulation, thickening cervical mucus to block sperm, and thinning the uterine lining, and patients should be informed about common transient adverse effects of COCs, including irregular bleeding, headache, and nausea 1.
From the FDA Drug Label
Safety and efficacy of drospirenone and ethinyl estradiol tablets have been established in women of reproductive age. Efficacy is expected to be the same for postpubertal adolescents under the age of 18 and for users 18 years and older. Use of this product before menarche is not indicated.
Yaz (drospirenone and ethinyl estradiol) is suitable for postpubertal teenage girls, but not for those who have not yet started their menstring (menarche) 2
From the Research
Suitability of Yaz for Teenage Girls
- The studies do not provide direct evidence on the suitability of Yaz (drospirenone and ethinyl estradiol) for teenage girls specifically 3, 4, 5, 6, 7.
- However, the available evidence suggests that drospirenone, a component of Yaz, has antimineralocorticoid and antiandrogenic properties, which may be beneficial for women, including potential teenage girls, who experience weight gain, bloating, and acne due to hormonal fluctuations 3, 4.
- A study on a combined oral contraceptive with estetrol plus drospirenone suggests that this formulation may be a viable choice for young girls in need of oral contraception, due to its high tolerability, safety, and satisfaction 5.
- Another study found that a combined oral contraceptive containing 30 mcg ethinyl estradiol and 3.0 mg drospirenone does not impair endothelium-dependent vasodilation, which is an important aspect of cardiovascular health 6.
- Additionally, a study on the effects of a combined oral contraceptive containing 20 mcg of ethinylestradiol and 3 mg of drospirenone on healthy young women found no significant changes in blood pressure or BMI, and no negative influence on risk factors for cardiovascular disease 7.
- Overall, while the evidence does not directly address the suitability of Yaz for teenage girls, it suggests that drospirenone-based oral contraceptives may be a safe and effective option for women, including potential teenage girls, who require hormonal contraception.