Yasmin Online UK

Yasmin is a combined oral contraceptive (COC) pill containing drospirenone, a progestogen with anti-mineralocorticoid and anti-androgenic properties, and ethinylestradiol, a synthetic oestrogen.

Its primary mechanism of contraception involves suppression of ovulation via inhibition of the hypothalamic-pituitary-ovarian axis, alongside alterations in cervical mucus consistency and endometrial receptivity.

The anti-mineralocorticoid activity of drospirenone may reduce water retention, which some women find beneficial for premenstrual bloating.

The anti-androgenic effect can improve mild acne and seborrhoea. Clinical trials report a Pearl Index of approximately 0.72 per 100 woman-years.

Yasmin is taken in a 21/7 regimen: 21 active tablets followed by a 7-day pill-free interval during which withdrawal bleeding occurs.

It is listed in the BNF under combined hormonal contraceptives and is one of the most widely prescribed COCs in Europe.

NICE guidelines recommend that all combined hormonal contraceptives should be prescribed at the lowest effective oestrogen dose consistent with reliable contraception and acceptable cycle control.

Take one tablet daily for 21 consecutive days, at approximately the same time each day, followed by a 7-day tablet-free interval. Swallow the tablet whole with water.

Start the first pack on day 1 of the menstrual cycle; contraceptive cover is immediate. If starting on days 2-5, use additional barrier contraception for the first 7 days.

If one tablet is missed (more than 24 hours but less than 48 hours late), take it as soon as remembered and continue the remaining tablets at the usual time.

If two or more consecutive tablets are missed, refer to the patient information leaflet for detailed guidance, as additional contraception may be required.

Vomiting within 3-4 hours of taking a tablet counts as a missed dose.

One tablet daily for 21 days, followed by a 7-day break. Each tablet delivers drospirenone 3 mg and ethinylestradiol 0.03 mg. No dose escalation or reduction is available within this formulation.

The 7-day break must not exceed 7 days; longer gaps compromise contraceptive protection.

Yasmin can be taken continuously (omitting the pill-free week) on medical advice to manage conditions such as endometriosis-related pain or menstrual migraine, though this is off-label.

No dose adjustment for body weight is required.

Side effect frequencies are from clinical trial data and post-marketing surveillance.

Common (≥1/100 to <1/10): Mood changes and depressed mood, headache, nausea, breast pain or tenderness, irregular bleeding or spotting, vaginal discharge.

Uncommon (≥1/1,000 to <1/100): Migraine, decreased or increased libido, vomiting, diarrhoea, acne, urticaria, breast enlargement, fluid retention, weight gain or loss.

Rare (≥1/10,000 to <1/1,000): Venous thromboembolism (VTE — deep vein thrombosis, pulmonary embolism), arterial thromboembolism (stroke, myocardial infarction), erythema nodosum, erythema multiforme.

Drospirenone has anti-mineralocorticoid activity equivalent to 25 mg spironolactone; although generally clinically insignificant, potassium levels should be monitored during the first cycle in patients taking ACE inhibitors, angiotensin II receptor antagonists, potassium-sparing diuretics, aldosterone antagonists, or NSAIDs.

All combined hormonal contraceptives carry a risk of venous and arterial thromboembolism.

The MHRA and European Medicines Agency have determined that drospirenone-containing pills may carry a slightly higher VTE risk than levonorgestrel-containing pills (approximately 9-12 vs 5-7 per 10,000 woman-years).

Discuss individual risk factors before prescribing. Discontinue Yasmin at least 4 weeks before major elective surgery or prolonged immobilisation.

Smoking, particularly above age 35, substantially increases cardiovascular risk and is a relative contraindication. Blood pressure should be measured before starting and regularly during use.

A small increased risk of breast cancer exists with current and recent use of combined hormonal contraceptives, declining after cessation.

Drospirenone has anti-mineralocorticoid properties; caution in patients at risk of hyperkalaemia.

Yasmin must not be used in women with current or history of VTE or arterial thromboembolism, known thrombogenic coagulopathies, migraine with aura, uncontrolled hypertension, diabetes with vascular complications, severe hepatic disease or liver tumours, known or suspected sex steroid-dependent malignancies, undiagnosed vaginal bleeding, pancreatitis associated with severe hypertriglyceridaemia, severe renal insufficiency or acute renal failure, or hypersensitivity to drospirenone, ethinylestradiol, or any excipient.