Yasmin

Yasmin is a combined hormonal contraceptive pill (combination pill) that contains two active ingredients: the progestin drospirenone and the estrogen ethinylestradiol. It is manufactured by Bayer.

The pill is distinguished by the progestin drospirenone, which is very similar to the body's own progesterone. Unlike older progestins, drospirenone has a mild diuretic effect and an antiandrogenic effect – so it can improve acne and excessive body hair.

When used correctly, Yasmin offers very high protection against pregnancy, with a Pearl Index of about 0.1 to 0.9.

Yasmin prevents pregnancy through several mechanisms:

Inhibition of ovulation: The hormones in Yasmin suppress ovulation by influencing the body's own hormone production. The brain receives the signal that sufficient hormones are already present, and the release of FSH and LH – the hormones that trigger ovulation – is inhibited.

Thickening of the cervical mucus: The mucus in the cervix becomes more viscous, making it harder for sperm to enter the uterus.

Changes to the uterine lining: The lining of the uterus builds up less, which would make it more difficult for a fertilized egg to implant.

Special feature of drospirenone: The drospirenone contained in Yasmin also has an antimineralocorticoid effect – it has a mild diuretic effect and can thus reduce water retention before the period.

Yasmin is suitable for women who:

• Want reliable hormonal contraception
• Prefer a pill with a constant hormone level

Particularly suitable for:

• A desire for a regular cycle

Before taking it for the first time, the following should be clarified:

• Are there risk factors for thrombosis?
• Is there high blood pressure or severe obesity?
• Are other medications being taken?
• Has pregnancy been reliably ruled out?

Active ingredient content:

• Drospirenone: 3 mg per tablet
• Ethinylestradiol: 0.030 mg (30 micrograms) per tablet

Pack sizes:

• 1 x 21 tablets (1 monthly cycle)
• 3 x 21 tablets (3 monthly cycles)
• 6 x 21 tablets (6 monthly cycles)

Dosing schedule: One tablet daily for 21 days, followed by a 7-day break. A withdrawal bleed usually occurs during the break.

Starting the pill: Ideally, start on the first day of the menstrual period – this provides immediate contraceptive protection. If you start later (day 2-5), condoms should also be used for the first 7 days.

Daily intake:

• Take one tablet at the same time every day
• Swallow with a little water
• With or without meals

Pill-free break: After 21 tablets, there are 7 days without taking the pill. A bleed normally occurs during this time. On day 8, the next pack is started – regardless of whether the bleeding is still ongoing.

Missed tablet:

• Missed by up to 12 hours: Take it immediately, protection is maintained
• Missed by more than 12 hours: Protection is no longer fully ensured. Take the last missed tablet as soon as possible, even if this means taking two tablets at the same time. Take the remaining tablets at the usual time. What to do next depends on the week of pill-taking:
• Week 1: Also use a condom for contraception for the next 7 days. If you had sexual intercourse in the 7 days before, pregnancy is possible.
• Week 2: If the tablets were taken correctly on the 7 days before the first missed tablet, no additional protection is needed. Otherwise, or if more than 1 tablet was missed, also use a condom for 7 days.
• Week 3: Once the current pack is finished, start the next pack straight away without a pill-free break. Alternatively, stop taking tablets from the current pack and start the new pack after a break of no more than 7 days, including the days on which tablets were missed. Both options only apply if the tablets were taken correctly on the 7 days before the first missed tablet. Otherwise, continue with the next pack without a break and also use a condom for 7 days.
• If no bleeding occurs in the next regular pill-free break after missed tablets, pregnancy is possible.

In case of vomiting or diarrhea: If vomiting or severe diarrhea occurs within 3-4 hours after taking the tablet, absorption of the active ingredients may be incomplete. Take another tablet from a reserve pack.

Yasmin must not be taken in case of:

• Current or previous thrombosis (blood clots in the legs, lungs, heart, or brain)
• Increased risk of thrombosis due to multiple risk factors (smoking over the age of 35, severe obesity, prolonged immobility)
• Migraine with focal neurological symptoms in the past
• Diabetes mellitus with vascular damage
• Severe liver disease or liver tumors
• Hormone-dependent tumors (certain types of breast cancer, uterine cancer)
• Unexplained vaginal bleeding
• Pregnancy or suspected pregnancy
• Severe renal insufficiency (drospirenone increases potassium levels)

Caution is advised in:

• Smokers over 35 years of age
• High blood pressure
• Migraine
• Diabetes mellitus
• Elevated blood lipid levels
• Familial tendency toward thrombosis

Important note: Combination pills slightly increase the risk of venous thromboembolism. With drospirenone-containing pills, this risk is somewhat higher than with levonorgestrel-containing products.

Common side effects (1-10%):

• Headache
• Nausea
• Breast tension or tenderness
• Mood swings
• Breakthrough bleeding (especially in the first months)
• Changes in libido

Uncommon side effects (0.1-1%):

• Migraine
• Water retention
• Weight changes
• Skin rash
• Increased blood pressure

Rare but serious side effects:

• Venous thromboembolism (leg vein thrombosis, pulmonary embolism)
• Arterial thromboembolism (heart attack, stroke)

Warning signs of thrombosis – see a doctor immediately:

• Sudden severe pain or swelling in the leg
• Shortness of breath or stabbing chest pain
• Sudden visual disturbances
• Severe headache, dizziness, speech disorders

Reduced effectiveness due to:

• Antiepileptic drugs (phenytoin, carbamazepine, phenobarbital)
• HIV medications (ritonavir, nevirapine)
• St. John's wort (herbal antidepressant)
• Rifampicin (antibiotic for tuberculosis)
• Some antibiotics (rifabutin)

Particular caution with:

• Potassium-sparing diuretics and aldosterone antagonists – drospirenone has potassium-sparing properties. Blood potassium levels should be checked during the first cycle of use
• NSAIDs such as ibuprofen with prolonged use

No relevant effect with:

• Most antibiotics (penicillins, cephalosporins)
• Short-term use of pain relievers

Recommendation: When taking medications that can affect how well the pill works, condoms should also be used for the duration of the treatment plus 7 days.