--- title: Does estetrol/drospirenone birth control improve PMS symptoms? description: Yes. Women who started this birth control experienced significant improvements in pain, bloating, and negative mood symptoms. Women already on other birth con url: https://niyora.com/research/papers/effects-of-e4-drsp-on-self-reported-physical-and-emotional-premenstrual-and-2024/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Does estetrol/drospirenone birth control improve PMS symptoms? Randomised trial, 2024 # Does estetrol/drospirenone birth control improve PMS symptoms? Yes. Women who started this birth control experienced significant improvements in pain, bloating, and negative mood symptoms. Women already on other birth control saw minimal improvements. Strong study design 1,553 women aged 18-50 in Europe and Russia, 1,398 completed the study, 531 were new birth control users ## What they did Phase 3 randomized trial with 1,553 women in Europe and Russia who took estetrol 15mg/drospirenone 3mg birth control for up to 13 cycles. Participants rated PMS-related symptoms at the start and end of treatment using the Menstrual Distress Questionnaire. ## What they found New birth control users reported premenstrual pain improvement of -1.4 points, bloating improvement of -3.3 points, and negative mood improvement of -2.5 points. Menstrual pain improved -3.5 points, bloating -3.4 points, and negative mood -2.7 points. More than 40% experienced changes in cramping, backache, fatigue, breast tenderness, swelling, mood swings, and irritability. Women switching from other birth control reported minimal changes. ## What it means for you This birth control helps reduce PMS symptoms for new users, especially those with worse baseline symptoms. Women already using other birth control saw less benefit. 1,553 women in trial 531 new users 13 cycles ## About the study Original title Effects of E4/DRSP on self-reported physical and emotional premenstrual and menstrual symptoms: data from the phase 3 clinical trial in Europe and Russia Authors Bitzer J, Bouchard C, Zatik J et al. Journal The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception Year 2024 Study design Randomised trial Participants 1,553 What was tested Estetrol 15mg/drospirenone 3mg birth control taken for up to 13 cycles Open access Yes Read the paper [doi.org/10.1080/13625187.2024.2359117](https://doi.org/10.1080/13625187.2024.2359117) Original abstract Purpose: To describe the effects of estetrol (E4) 15 mg / drospirenone (DRSP) 3 mg on physical and emotional premenstrual and menstrual symptoms. Materials and methods: We used Menstrual Distress Questionnaire (MDQ) data from a phase-3 trial (NCT02817828) in Europe and Russia with participants (18 - 50 years) using E4/DRSP for up to 13 cycles. We assessed mean changes in MDQ- t -scores from baseline to end of treatment in premenstrual (4 days before most recent flow) and menstrual (most recent flow) scores for 4 MDQ domains in starters and switchers (use of hormonal contraception in prior 3 months) and performed a shift analysis on individual symptoms within each domain. Results: Of 1,553 treated participants, 1,398(90.0%), including 531(38%) starters, completed both MDQs. Starters reported improvements for premenstrual Pain (-1.4), Water Retention (-3.3) and Negative Affect (-2.5); and for menstrual Pain (-3.5), Water Retention (-3.4), and Negative Affect (-2.7) (all p p = 0.02) and menstrual (+1.5, p = 0.003) Water Retention. We observed a change in symptom intensity in >40% of participants for Cramps, Backache and Fatigue (domain Pain), Painful or Tender Breast and Swelling (domain Water Retention) and Mood Swings and Irritability (domain Negative Affect). Conclusion: E4/DRSP starters experienced significant improvements in the domains Pain, Water Retention and Negative Affect particularly benefiting those with more severe baseline symptoms. Switchers showed minimal changes. Reproduced under CC-BY. ## Topics [Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Dysmenorrhea and period pain](https://niyora.com/research/topics/condition-dysmenorrhea/)[Bloating, breast tenderness and physical symptoms](https://niyora.com/research/topics/symptom-physical-symptoms/)[Pain and headache](https://niyora.com/research/topics/symptom-pain/)[Oral contraceptives and drospirenone](https://niyora.com/research/topics/treatment-hormonal-contraceptives/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Survey study, 1982 How common are premenstrual symptoms in American women, and what factors affect them? Non-randomised trial, 2025 Does the pill estetrol/drospirenone ease period pain, bloating and premenstrual mood symptoms? Review, 2014 Do birth control pills help PMS? Cohort study, 2006 How should severe period pain in teenagers be treated? Systematic review, 2021 Does damask rose help reduce menstrual pain, headache, fatigue, anxiety, and bloating? Systematic review, 2020 Does Vitex agnus-castus help cyclic breast pain? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗