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Evidence summaries

Oral Contraceptives Containing Drospirenone for Premenstrual Syndrome

Oral contraceptives containing drospirenone might possibly have some effect on severe premenstrual symptoms compared to placebo in short term, but the evidence is limited. Level of evidence: "D"

A Cochrane review [Abstract] 1 included 5 trials with a total of 858 women.Drospirenone (plus ethinyl estradiol 20μg) improved overall premenstrual symptoms (standardised mean difference (SMD) -0.41, 95% CI -0.59 to -0.24; 2 RCTs, n=514; I²=64%); productivity (WMD -0.31; 95% CI -0.55 to -0.08), social activities (WMD --0.29; 95% CI -0.54 to -0.04), and relationships (WMD -0.30; 95% CI -0.54 to -0.06). Side effects more common with oral contraceptive (COC) use were nausea, intermenstrual bleeding, and breast pain.

Comment: The quality of evidence is downgraded by study quality (high losses to follow-up and several other limitations), by inconsistency (heterogeneity and marked placebo effect), by indirectness (short follow-up), by imprecise results (limited study size), and by potential publication bias.

    References

    • Ma S, Song SJ. Oral contraceptives containing drospirenone for premenstrual syndrome. Cochrane Database Syst Rev 2023;6(6):CD006586.[PubMed]

Primary/Secondary Keywords