Boschitsch E, Skarabis H, Wuttke W, Heithecker R
Ambulatorium Klimax, Vienna, Austria.
Eur J Contracept Reprod Health Care. 2000 Dec;5 Suppl 3:34-40.
Low-dose combined oral contraceptives are generally well tolerated and represent an excellent reversible form of contraception that is suitable for most women. Certain aspects of the clinical profile of combined oral contraceptives, such as intermenstrual bleeding and a tendency to weight gain, are, however, known to have an adverse effect on compliance, which may in a few women lead to contraceptive failure or pill discontinuation. Conversely, factors that have a positive effect, such as relief from the symptoms of premenstrual syndrome, can enhance compliance. An oral contraceptive that minimizes the adverse and enhances the positive effects would, therefore, be likely to improve compliance. Recently, a new combined oral contraceptive containing 30 microg ethinylestradiol and 3 mg drospirenone (Yasmin, EE/DRSP) has been developed. The pharmacological profile of drospirenone is very similar to that of natural progesterone; in particular, it has antimineralocorticoid activity. This counteracts estrogen-mediated fluid retention, resulting in stable or slightly lowered body weight. In addition, drospirenone has antiandrogenic activity and therefore a positive effect on skin conditions. Present data also indicate that EE/DRSP has a favorable effect on the symptoms of premenstrual syndrome. In order to evaluate whether the positive effects of drospirenone on body weight, skin and the symptoms of premenstrual syndrome are also observed on well-being, a survey was carried out. This asked women who had been involved in two major clinical trials how they felt after these trials had ended, in comparison with the study periods when they were taking EE/DRSP or a combined oral contraceptive containing 30 microg ethinylestradiol/150 microg desogestrel (Marvelon, EE/DSG). The returned questionnaires demonstrated that, with respect to their disposition before and during menses, women who had taken EE/DRSP felt worse after the trial had ended and they had returned to taking a conventional preparation. This was also evident on the basis of their body weights and the condition of their skin and hair. These results from clinical trials with EE/DRSP indicate that it is a well-tolerated combined oral contraceptive that has a positive effect on body weight, skin and the symptoms of premenstrual syndrome. Overall, the combination of 30 microg ethinylestradiol/3 mg drospirenone appears to improve specific aspects associated with feelings of well-being, which may result in better compliance.
低剂量复方口服避孕药一般耐受性良好，是一种出色的可逆避孕方式，适合大多数女性。然而，复方口服避孕药临床特征的某些方面，如经间期出血和体重增加倾向，已知会对依从性产生不利影响，这在少数女性中可能导致避孕失败或停药。相反，一些具有积极作用的因素，如经前综合征症状的缓解，可提高依从性。因此，一种能将不利影响降至最低并增强积极作用的口服避孕药可能会提高依从性。最近，一种含有30微克炔雌醇和3毫克屈螺酮的新型复方口服避孕药（优思明，炔雌醇/屈螺酮）已研发出来。屈螺酮的药理特性与天然孕酮非常相似；特别是，它具有抗盐皮质激素活性。这抵消了雌激素介导的液体潴留，导致体重稳定或略有下降。此外，屈螺酮具有抗雄激素活性，因此对皮肤状况有积极影响。目前的数据还表明，炔雌醇/屈螺酮对经前综合征症状有有益作用。为了评估屈螺酮对体重、皮肤和经前综合征症状的积极作用是否也体现在幸福感方面，开展了一项调查。该调查询问参与两项主要临床试验的女性，与服用炔雌醇/屈螺酮或含有30微克炔雌醇/150微克去氧孕烯的复方口服避孕药（妈富隆，炔雌醇/去氧孕烯）的研究期间相比，她们在试验结束后感觉如何。回收的问卷显示，就月经前和月经期间的状态而言，服用炔雌醇/屈螺酮的女性在试验结束并恢复服用传统制剂后感觉更差。这在她们的体重以及皮肤和头发状况方面也很明显。这些关于炔雌醇/屈螺酮的临床试验结果表明，它是一种耐受性良好的复方口服避孕药，对体重、皮肤和经前综合征症状有积极作用。总体而言，30微克炔雌醇/3毫克屈螺酮的组合似乎改善了与幸福感相关的特定方面，这可能会带来更好的依从性。
