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PMS Health Center

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Low-Dose Birth Control Pill Treats Severe PMS

First Oral Contraceptive for PMDD May Be Approved for Sale Early Next Year

24 On, 4 Off continued...

Yaz is similar to another oral contraceptive marketed by Berlex under the brand name Yasmin, but there are important differences, Schillace says. Both contain a unique progestin that mimics the activity of a diuretic (water pill) used to treat the symptom of bloating or water retention seen in PMS.

But women who take Yaz get 24 days of active hormone followed by four days off hormones, instead of the standard 21 days of active hormone treatment followed by seven days of no hormone treatment.

Yonkers and colleagues says the shorter time off hormones offered by Yaz treatment may help women avoid severe menstrual-related symptoms.

"We know that women taking oral contraceptives often complain of symptoms like headaches, bloating, and other problems during the week that they are off hormones," she tells WebMD. "This has been broadly characterized as 'hormonal withdrawal.' It is total hypothesis at this point, but it may be that shortening the time off hormones may help women avoid this withdrawal."

SSRIs Don't Work for Everyone

Jean Endicott, PhD, says it is not clear if the new contraceptive is uniquely useful for treating PMS and PMDD because other contraceptives have not been tested.

"What we do know is that the high-dose estrogen and progestin contraceptives did not help and seemed to [promote symptoms] in some women," she says. "But that doesn't seem to be the case with the low-dose formulations."

Endicott directs the Premenstrual Evaluation Unit at Columbia Presbyterian Medical Center and is also affiliated with the New York State Psychiatric Institute.

She says the low-dose contraceptive could prove to be a useful alternative treatment for the 35% to 40% of women with PMDD who are not helped by antidepressants and for women who simply don't want to take them."

"Certainly for many women there is a stigma attached to taking antidepressants," she says. "And others are bothered by the side effects, especially the sexual side effects [seen with many SSRIs]. There is a need for more treatment options."

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