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Q:  Recently, a new oral contraceptive has been approved and is available on the market (Yasmin) containing a synthetic progesterone called drospirenone. Drospirenone is an analogue of spironolactone and has anti-androgenic properties, including blocking activity at androgen receptors. In your experience, is this preparation as effective for androgenic alopecia/hirsutism; as taking spironolactone, with or without a concomitant oral contraceptive?

Many have asked me about the oral contraceptive, Yasmin which has become very popular. Although this was only recently approved in the US, it has been used in Europe for several years. The progesterone-like hormone it contains, drospirenone, is closely related to spironolactone (Aldactone®).
However the 3 mg of drospirenone in Yasmin is equivalent to only 25 mg of spironolactone. The doses of spiro which seem to be effective for androgenic skin and hair problems (persistent acne, increased hair growth and alopecia) are usually 100 to 200 mg per day. Less than 75 mg, at least in my experience, tends not to be effective. So using Yasmin is like taking a very small dose of spiro. It might help somewhat but is unlikely to be as effective as spiro in higher doses. It is, of course, effective as an oral contraceptive.

Hope this is helpful.

Geoffrey Redmond, MD

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