From the Guidelines
Yaz is not the preferred treatment option for perimenopausal women due to its potential risks and the availability of more targeted hormone therapies for menopausal symptoms. Yaz (drospirenone/ethinyl estradiol) is primarily indicated for contraception, treatment of premenstrual dysphoric disorder (PMDD), and moderate acne in women who desire contraception 1. For perimenopausal women experiencing symptoms like irregular bleeding, hot flashes, or mood changes, hormone therapy specifically designed for menopause may be more effective in addressing these symptoms while minimizing risks 1. The use of combined estrogen and progestin therapy, like Yaz, has been associated with an increased risk for serious adverse events, such as stroke, invasive breast cancer, dementia, gallbladder disease, DVT, and pulmonary embolism 1.
Key Considerations
- Perimenopausal women should be aware of the potential risks associated with Yaz, including increased risks of blood clots, especially in women over 35 who smoke.
- Hormone therapy specifically designed for menopause may be more effective in addressing perimenopausal symptoms.
- A healthcare provider should evaluate individual risk factors, symptom profile, and contraceptive needs before prescribing any medication during perimenopause.
- The standard dosage of Yaz is one active pill (3 mg drospirenone/0.02 mg ethinyl estradiol) daily for 24 days followed by 4 placebo pills, but this may not be the most appropriate regimen for perimenopausal women.
Recommendations
- Perimenopausal women should consider alternative treatment options that are specifically designed for menopausal symptoms and have a more favorable risk-benefit profile.
- Healthcare providers should carefully evaluate the individual needs and risk factors of perimenopausal women before prescribing any medication.
- Women should be informed about the potential risks and benefits of different treatment options and involved in the decision-making process.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Indication of Yaz for Perimenopausal Women
- Yaz, which contains drospirenone and ethinylestradiol, is primarily used as an oral contraceptive, but its use in perimenopausal women is considered for managing symptoms 2.
- Perimenopause is a transition period before menopause, characterized by hormonal changes, and women in this phase may experience various symptoms such as hot flashes, night sweats, and menstrual irregularities 3, 4.
- Hormone replacement therapy (HRT) and oral contraceptives like Yaz can be beneficial for perimenopausal women, offering relief from symptoms and providing contraception 3, 5, 6.
- The use of oral contraceptives in perimenopausal women can help regulate menstrual cycles, reduce the risk of endometrial and ovarian cancers, and improve bone density 3.
- However, the decision to use Yaz or any hormonal therapy in perimenopausal women should be made on an individual basis, considering the woman's health status, symptoms, and potential risks 5, 6.
Benefits and Considerations
- Drospirenone, a component of Yaz, has antimineralocorticoid properties, which may help reduce water retention and blood pressure 2.
- The combination of drospirenone and ethinylestradiol in Yaz has been shown to be effective in inhibiting ovulation and providing contraception 2.
- While Yaz may offer benefits for perimenopausal women, it is essential to weigh these against potential risks, such as venous thromboembolism and breast cancer, particularly in women over 35 years old or with certain health conditions 5.
Clinical Guidance
- Healthcare providers should assess each perimenopausal woman's individual needs and health status before prescribing Yaz or any other hormonal therapy 5, 6.
- Women should be informed about the potential benefits and risks of Yaz and other treatment options to make informed decisions about their care 5, 6.