Yasmin--a new oral contraceptive, a new progestogen: the reasons why

There are over 60 million women using oral contraceptives worldwide, yet there are wide differences between different countries in the use of oral contraceptives and, in particular, in discontinuation rates. Large differences in rates of sterilization and of teenage pregnancy also highlight the fact that there are considerable geographical differences in oral contraceptive use. There are probably many reasons for these differences, including lack of information about the non-contraceptive benefits of oral contraceptives, differences in national health-care policies and systems, women's fears about side-effects and possible side-effects, and social, cultural and religious differences. In order to provide better choices of oral contraceptives, there is a need to consider new oral contraceptives, such as Yasmin (Schering AG, Berlin, Germany), which is formulated with ethinylestradiol and drospirenone, a progestogen which is pharmacologically very similar to progesterone. Unlike other progestogens, drospirenone is associated with weight stability or slight weight loss due to less water retention, one of the factors which is known to be of great importance in supporting compliance with oral contraceptives. Drospirenone also shares with some other progestogens the capacity to improve acne and seborrhea in hyperandrogenic women. Taken together, these properties make it likely that the combination of ethinylestradiol with drospirenone will contribute to improving oral contraceptive compliance, thereby maximizing the overall benefits of oral contraception.