Can You Take Yaz While on 50mg Weekly Testosterone?
You should not take Yaz (drospirenone/ethinyl estradiol) while taking 50mg of testosterone weekly, as the combined oral contraceptive will directly counteract your testosterone therapy by dramatically suppressing free testosterone levels and increasing sex hormone-binding globulin (SHBG).
Why This Combination Is Problematic
Testosterone Suppression by Combined Oral Contraceptives
- Combined oral contraceptives containing drospirenone and ethinyl estradiol reduce free testosterone by 75.6% and total testosterone by 11.3%, making them fundamentally incompatible with testosterone replacement therapy 1
- The mechanism involves both direct suppression of androgen production and a massive increase in SHBG, which binds testosterone and renders it biologically inactive 1
- SHBG concentrations increase significantly with drospirenone-containing COCs, further reducing the bioavailable testosterone that your body can actually use 1
The Pharmacologic Conflict
- Drospirenone itself has antiandrogenic activity, meaning it actively blocks testosterone from binding to androgen receptors in tissues throughout your body 2
- This creates a double mechanism of interference: the COC both lowers your testosterone levels AND blocks whatever testosterone remains from working at the receptor level 2
- Taking these medications together is essentially working against yourself—one medication is trying to increase androgens while the other is designed to suppress and block them 3
What This Means for Your Therapy
Impact on Testosterone Goals
- If you are taking testosterone for gender-affirming care, hypogonadism, or other medical indications, adding Yaz would undermine the entire purpose of your testosterone therapy 1
- The 50mg weekly testosterone dose you're taking would be rendered largely ineffective by the hormonal suppression from the COC 1
Contraceptive Alternatives If Needed
If you need contraception while on testosterone therapy:
- Progestin-only methods (mini-pill, implant, IUD) do not contain ethinyl estradiol and do not cause the same dramatic SHBG elevation or testosterone suppression 4
- Barrier methods (condoms) remain fully compatible with testosterone therapy 4
- Avoid all combined hormonal contraceptives (pills, patches, rings) as they all contain ethinyl estradiol which will suppress your testosterone 4, 5
Critical Clinical Caveat
- The one exception where this combination might be intentionally used is if a provider is specifically trying to reduce your testosterone levels—for example, if you were experiencing adverse effects from testosterone therapy and needed to lower your dose 4
- However, this would be an unusual clinical scenario and should only be done under close medical supervision with clear therapeutic intent 4
Bottom Line
Do not combine Yaz with your testosterone therapy unless your prescribing physician has a specific clinical reason to counteract your testosterone supplementation. The pharmacologic actions of these medications are fundamentally opposed to each other 1, 2.