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Oral contraceptives and drospirenone: what the research says

490 studies on oral contraceptives and drospirenone in PMS and PMDD, each explained in plain English. 54 of them use the strongest designs: randomised trials and systematic reviews.

Survey study 151Randomised trial 65Study 62Review 61Cohort study 50Non-randomised trial 31
Systematic review, 2026

Does continuous paroxetine or birth control work better for PMDD?

Both antidepressants and birth control pills are effective for PMDD. Continuous paroxetine (an antidepressant) and DROS/EE 24/4 (a specific birth control) showed the strongest effects in studies reviewed, though the evidence comes from relatively few studies.

Cohort study, 2026

Does sleeping longer improve mood and fitness in elite athletes?

Yes. Sleeping longer was linked to better mood and fitness across all athletes, regardless of menstrual cycle status. Sleeping less than 8 hours was linked to below-average mood and fitness.

Randomised trial, 2025

Does mood, well-being, and sexual function change across the menstrual cycle?

No, there were no meaningful changes in sexual function, mood, or well-being across menstrual cycle phases in healthy young women. Being in a stable relationship predicted better sexual function overall, but cycle phase did not.

Cohort study, 2025

Are irregular menstrual cycles linked to lower thinking and memory skills in middle-aged women?

Yes. Women with irregular cycles at ages 29-46 and women with very short cycles (25 days or less) at ages 18-22 both had slightly lower memory scores later in life.

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.

Systematic review, 2024

What are the best treatments for PMDD and PMS?

SSRIs (antidepressants) and combined oral contraceptives (birth control pills) have the strongest evidence. For difficult cases, GnRH agonists and surgery work. Some alternatives like acupuncture and yoga show promise but need better quality research.

Review, 2024

What are the most effective treatments for PMDD?

According to this literature review, SSRIs (antidepressants) and cognitive-behavioral therapy are the most commonly recommended first-line treatments. Birth control pills with drospirenone are also effective.

Systematic review, 2023

What hormonal treatments have been tested for PMDD, menstrual migraine, and catamenial epilepsy?

Hormonal treatments have been tested 56 times for premenstrual mood disorder, 21 times for menstrual migraine, and 8 times for catamenial epilepsy. Combined oral contraceptives were a frequent focus.

Systematic review, 2023

How common are menstrual cycle problems and PMS or PMDD in female athletes?

Menstrual cycle problems are common in female athletes, with dysmenorrhoea affecting about 32%. More athletes report symptoms during their period than in the days before.

Guideline, 2023

How are GnRH agonists used to treat PMDD that doesn't respond to standard medications?

GnRH agonists combined with hormone replacement are effective for severe PMDD that doesn't respond to first-line treatments, but many doctors don't know how to use this option.

Systematic review, 2022

What are the best treatments for PMDD and PMS?

SSRIs (antidepressants) and combined oral contraceptives (birth control pills) have the strongest evidence. For difficult cases, GnRH agonists and surgery work. Some alternatives like acupuncture and yoga show promise but need better quality research.

Cohort study, 2022

Can hormonal contraceptives or antidepressants reduce suicide risk in premenstrual disorders?

Hormonal contraceptives, especially combined pills, are associated with lower suicide risk. Antidepressants are associated with higher suicide risk, though this may reflect that sicker women used them.

Systematic review, 2021

Do birth control pills help with depression and other symptoms of PMS?

Birth control pills help reduce overall PMS symptoms but not depression specifically. No particular pill is more effective than others.

Review, 2020

How do reproductive hormones affect the brain and behavior during the menstrual cycle?

Reproductive hormones like estradiol and progesterone change significantly during the menstrual cycle and affect mood, thinking, perception, and behavior through effects on the brain. The same applies to hormones in oral contraceptives.

Randomised trial, 2020

Does adding fluoxetine to birth control pills help with severe PMS?

Yes. Adding fluoxetine to birth control pills helped more women with severe PMS than pills alone. In the final month, 65% of women taking both improved, versus 50% on pills alone.

Systematic review, 2020

How common is PMS among women of reproductive age in Ethiopia?

PMS is very common. About 53% of women of reproductive age have it. Age at first period, menstrual pattern, and hormonal contraceptive use were not significantly associated with PMS.

Systematic review, 2020

Does Vitex agnus-castus help cyclic breast pain?

Vitex appears moderately effective for reducing cyclic breast pain compared to placebo, works as well as some medications, and is safe with minimal side effects.

Review, 2018

What are the most effective treatments for premenstrual syndrome and PMDD?

Serotonin reuptake inhibitors and contraceptives with shortened or no hormone-free interval are the most effective treatments. Some women who do not respond may benefit from GnRH agonist treatment.

Review, 2018

What causes PMS and PMDD, and how are they treated?

PMS affects 30-40% of women and is likely caused by sensitivity to normal hormone changes and neurotransmitter problems. Treatment includes antidepressants, birth control pills, counseling, and lifestyle changes.

Randomised trial, 2017

Does the combined oral contraceptive pill affect mood?

Yes, but effects vary by cycle phase. The pill causes small increases in anxiety and irritability between periods but improves depression in the days before menstruation.

Review, 2017

What causes PMDD and what are the best treatments?

PMDD involves an abnormal response to normal hormone changes affecting the serotonin system and brain circuits that control emotion. SSRIs are the first-line treatment, with several other options available.

Systematic review, 2017

Does Vitex agnus castus help treat premenstrual syndrome?

The meta-analysis found a large pooled effect of Vitex agnus castus compared to placebo, but the included studies have significant quality problems, publication bias, and very different results from each other, so we cannot confidently say it truly works.

Randomised trial, 2015

Which birth control pill better reduces PMS and menstrual symptoms: nomegestrol acetate or drospirenone?

Nomegestrol acetate reduced more PMS and menstrual symptoms than drospirenone pills in this large study of 3522 women, though drospirenone was better for emotional arousal.

Review, 2015

Do hormonal contraceptives have benefits beyond preventing pregnancy?

Yes. Combined oral contraceptives can reduce heavy periods, anemia, and PMDD symptoms. Several other contraceptive methods also offer additional health benefits.

Systematic review, 2015

What are the effects of continuous hormonal treatments for premenstrual syndrome?

The systematic overview evaluated continuous combined oral contraceptives, continuous transdermal estradiol, and continuous subcutaneous estradiol implants, but the abstract does not specify the efficacy results for each treatment.

Review, 2015

What do we know about PMS and PMDD and how are they treated?

PMS affects 30 to 40 percent of reproductive-age women and PMDD affects 3 to 8 percent. Serotonergic antidepressants are the most effective treatment, but oral contraceptives, lifestyle changes, cognitive behavioral therapy, and herbal supplements are also available options.

Cohort study, 2015

Do women with PMS have a higher risk of developing hypertension later?

Yes, women with PMS had 1.4 times higher risk of developing hypertension, with 3.3 times higher risk before age 40. This prospective study with long follow-up provides strong evidence.

Systematic review, 2014

Do estrogen and progesterone change how the brain processes emotions and decisions?

Yes. These hormones affect which brain areas activate when women process emotions and make decisions, particularly in areas involved in mood and choice-making. The specific pattern varies by hormone level and person.

Randomised trial, 2014

What treatments work best for PMS?

Both conventional medicines and herbal remedies can help PMS. The birth control pill drosperinone with ethinylestradiol showed great improvement in clinical trials, and micronutrients and herbs were also found effective.

Case-control study, 2014

How common is severe period pain and what causes it?

Period pain affects 16% to 91% of women of reproductive age, with severe pain in 2% to 29%. It's less common as women age, after having children, and when using birth control pills, but more common with stress or family history of it.

Randomised trial, 2012

Does continuous birth control help women with PMDD?

Continuous birth control pills reduced PMDD symptoms more than placebo. About 52% of women on the pill improved by at least half, compared to 40% on placebo.

Systematic review, 2012

Does the oral contraceptive drospirenone help women with premenstrual symptoms?

Yes, drospirenone 3 mg plus ethinyl estradiol 20 micrograms reduced premenstrual symptoms more than placebo and improved daily functioning, but it causes more nausea, intermenstrual bleeding, and breast pain.

Systematic review, 2012

What medications work best for PMDD?

The abstract does not include findings or results, so no conclusion can be drawn from it.

Randomised trial, 2012

Do hysterectomy or hormonal IUDs reduce premenstrual symptoms in women with heavy periods?

Both treatments significantly reduced premenstrual symptoms by 6 months with similar effectiveness. However, the study involved women treated for heavy periods, not those specifically diagnosed with PMS.

Randomised trial, 2011

Does a 24/4 birth control pill help women with PMDD improve work, relationship, and social functioning?

Yes. The pill significantly improved problems at work, in relationships, and in social activities compared to placebo, with the greatest improvements appearing in the first cycle.

Randomised trial, 2011

Does a birth control pill reduce negative emotions, food cravings, and water retention in women with PMDD?

Yes, the pill significantly reduced all three symptom clusters compared to placebo in all three treatment cycles. The greatest improvements happened in the first cycle.

Survey study, 2011

Is premenstrual syndrome related to major depression?

Yes. Women with moderate to severe PMS are significantly more likely to have depression (11.3% to 24.6% depending on PMS severity). Women with both conditions are more severely impaired than those with either alone.

Randomised trial, 2010

What treatments work for premenstrual syndrome?

Several treatments reduce PMS symptoms according to controlled studies: SSRIs, some birth control pills, hormone injections, calcium, chasteberry, and cognitive-behavioral therapy. However, about 40% of women don't respond to current treatments.

Randomised trial, 2009

Does Yasmin birth control reduce PMS symptoms better than another pill?

Yes. Yasmin reduced water retention, improved breast tenderness, and improved skin problems more than desogestrel pill. Both prevented pregnancy well.

Review, 2009

What causes PMDD and what are the treatment options?

PMDD affects an estimated 5-8% of women and causes severe mood and physical symptoms. The cause involves individual sensitivity to hormonal changes. Treatments include serotonin antidepressants, medications that stop ovulation, and certain newer birth control pills.

Randomised trial, 2008

Does drospirenone with ethinyl estradiol birth control help PMDD?

This birth control formulation is the only hormone-based option with large randomized controlled trials proving it works for PMDD and has FDA approval for this use.

Systematic review, 2008

Does birth control with drospirenone help premenstrual symptoms?

Birth control containing drospirenone plus low-dose estrogen may reduce PMDD symptoms after 3 months, but the improvement is modest and the placebo also helped significantly.

Randomised trial, 2008

How well do SSRIs and birth control pills actually work for severe PMS?

SSRIs and birth control pills help some women but not as many as commonly reported. After accounting for placebo effect, approximately 40% of women with severe PMS still don't respond to SSRIs.

Review, 2008

What medications are FDA-approved for treating PMDD?

Three selective serotonin reuptake inhibitors (SSRIs, a type of antidepressant) and a low-dose birth control pill containing drospirenone are FDA-approved for PMDD. SSRIs can be taken just during the two weeks before menstruation.

Systematic review, 2007

What treatments work for premenstrual syndrome?

Many treatments have been studied for PMS, but researchers face a major challenge: there is no standard way to measure symptom severity, making it difficult to know which treatments truly work.

Randomised trial, 2005

Does a low-dose birth control pill with drospirenone help PMDD?

Yes, the pill reduced symptoms significantly more than placebo. On average, 8 women need to take it for 1 to experience major improvement (50% symptom reduction).

Randomised trial, 2004

Which low-dose birth control pill has better cycle control and fewer side effects?

Both pills equally reduced period pain and PMS. One type (with desogestrel) had more stable bleeding patterns and less acne than the other (with levonorgestrel). Both were well tolerated overall.

Randomised trial, 2003

What treatments work for PMS and PMDD?

Several treatments work. Non-drug options include cognitive behavioral therapy, exercise, and supplements like calcium and magnesium. Many studies support SSRIs (taken daily or only before menstruation). Hormonal treatments that stop ovulation also help.

Study, 2002

Which PMS treatments have good scientific evidence?

Calcium at 1200 mg daily and certain antidepressants have good evidence of working. Many popular treatments like vitamin B6, evening primrose oil, and birth control pills lack strong evidence. Some treatments like progesterone do not work.

Randomised trial, 1999

Does calcium reduce PMS symptoms?

Yes, this large study of 497 women found that calcium supplementation reduced PMS symptoms during the luteal and menstrual phases. This is strong evidence from a well-designed trial.

Review, 1999

Does vitamin B6 supplement help treat PMS symptoms?

Yes, vitamin B6 is beneficial for treating premenstrual syndrome according to a systematic review of published studies. However, the abstract does not provide specific details about the magnitude of benefit.

Randomised trial, 1998

Does taking calcium supplements reduce PMS symptoms?

Yes. In this large trial, women who took calcium carbonate had much lower PMS symptom scores than women who took a placebo, with symptoms down 48% versus 30% by the third month.

Cohort study, 1993

How common are premenstrual and menstrual symptoms in women?

Menstrual symptoms are very common in women in the community and increase with age. Women with anxiety are more likely to report menstrual problems.

Randomised trial, 1981

Do oral contraceptives help reduce premenstrual symptoms?

Yes. Birth control pills reduced premenstrual tension symptoms in most age groups, except in 18-year-olds where they showed little or no benefit.

Survey study, 2026

What are the causes, diagnosis, and treatments for PMS and PMDD?

This review consolidates what doctors know about PMS and PMDD. PMS affects 12-98% of reproductive-age women and PMDD affects 2-5%. Treatments range from lifestyle changes, therapy, and vitamins to medications like SSRIs and oral contraceptives.

Review, 2026

How should doctors diagnose and treat PMDD?

Doctors can treat PMDD with antidepressants (SSRIs) or birth control pills. The main challenge is that diagnosis is often difficult and delayed, especially for women with other mental health conditions.

Case-control study, 2026

Are women with PMS history more likely to experience side-effects from birth control pills?

Women with a history of PMS were 2.5 times more likely to stop the birth control pill due to side-effects, and those with anxiety or mood disorders were also at higher risk. Mood disorders were the most common reported side-effect.

Survey study, 2026

Are women who feel mood changes from birth control pills at higher risk for PMDD and postpartum depression?

Yes. Women who reported mood problems from the pill were 3.78 times more likely to have PMDD and 1.66 times more likely to have depression after childbirth, though genetic factors and depression history also matter.

Study, 2026

What treatments work for PMDD?

SSRIs (a type of antidepressant) and certain types of birth control are the main first-line treatments. New treatments targeting brain chemistry are being developed.

Survey study, 2026

How common is PMS in female medical students and how much does it affect their daily life?

About two-thirds experience common symptoms like fatigue and mood swings. PMS affects emotional well-being in 34.5%, social interactions in 22.3%, and school performance in 21.5%, but most students avoid seeing doctors.