Because it is not taken orally, the NuvaRing may have a lesser effect on sex hormone binding globulin, so it does not show the same ability to improve hirsutism. The Journal of Clinical Endocrinology and Metabolism. Yasmin, Yaz and the new generic Ocella (the equivalent of Yasmin) all contain drospirenone, and spironolactone; other anti-androgens can be added to these preparations once the patient is protected from pregnancy. Progestin-only pills are not normally considered an effective hirsutism treatment either.. Laboratory testing should be based on the patient's history and physical findings, but screening for levels o… Efficacy of a new oral contraceptive containing drospirenone and ethinyl estradiol in the long-term treatment of hirsutism. Certain ovarian cysts 6. To further assist with symptoms of PMDD and PMS, the amount of estrogen is decreased in Yaz as well. If so, your doctor might recommend an ultrasound or a CT scan to check your ovaries and adrenal glands for tumors or cysts.Your doctor might also examine your abdomen and do a pelvic exam to look for masses that could indicate a tumor. Katie is taking Yaz for hirsutism. https://www.uptodate.com/contents/search. Is my condition likely temporary or chronic? Input from a beautician can provide invaluable support and advice. There is no evidence that self-removal of hair leads to heavier hair growth. What would you tell her? Yasmin, like luisa24 said is the best form of bc pills for pcos. All of these birth control pills are often used to treat conditions … With these medications it usually takes up to six months, the average life cycle of a hair follicle, before you see a significant difference in hair growth. https://www.uptodate.com/contents/search. Yaz, in particular, contains the progestin drospirenone, which is known to be especially effective in the reduction of hormonal acne. Hirsutism is the excessive growth of terminal hair in a typical male pattern in a female. Talk with your doctor about the risks and benefits of the various lasers used for this hair removal method. These medicines should be used solely in the treatment of moderate to severe acne related to androgen sensitivity or hirsutism (excessive unwanted growth of hair in women) in women of reproductive age. Take care of yourself emotionally. Make a list of: For hirsutism, some questions to ask your doctor include: Your doctor is likely to ask you questions, such as: Mayo Clinic does not endorse companies or products. Can Women Use Hormonal Contraception After Age 40? Yaz; Some pills, such as Loestrin, have lower estrogen levels. The results are modest and take at least six months to be noticeable. What Is the Best Birth Control to Treat PCOS? Find out tips to manage PCOS facial hair and ways to address the root cause of this condition. Pills with formulations of higher estrogen, lower androgen potencies may be better at reducing hirsutism.. Other low-dose combined oral contraceptives with minimal androgen effect. Make a donation. Mayo Clinic is a not-for-profit organization. What Are Combination Birth Control Pills and How Are They Used? Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline. Endometrial cancer 3. All rights reserved. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. Does the Type of Birth Control Pill You Take Matter? What are the alternatives to the primary approach you're suggesting? Hirsutism is most often genetic and is a result of increased amounts of male hormones, notably androgens, in the body. Accessed Sept. 19, 2019. If you use this type of birth control, you may not even be aware of its non-contraceptive benefits. The market is set to touch the valuation of USD 5295.0 million by 2023. Hirsutism in women. Benign cysts in the breast 5. Treatment of hirsutism. doi:10.1016/j.ijwd.2017.02.007, Martin KA, Anderson RR, Chang RJ, et al. Colorectal cancer 4. https://www.uptodate.com/contents/search. The contraceptive patch is a thin plastic patch that contains estrogen and progestin. Treatment options for hirsutism: A systematic review and network meta-analysis. In a small randomized controlled trial, a drospirenone and ethinyl estradiol pill (Yaz) was just as effective in improving hirsutism as Diane 35, Dianette, Ginet-84 and Estelle 35 (oral contraceptives containing cyproterone acetate and ethinyl estradiol) and Valette (an oral contraceptive containing dienogest).All of these birth control pills are often used to treat conditions aggravated by androgenic hormones. AskMayoExpert. Has your menstrual cycle changed, or have you stopped having your period? Key personal information, including other medical conditions and changes in your menstrual cycle or sex drive, All medications, vitamins and other supplements you take, including doses. Self-care methods such as the following temporarily remove or reduce the visibility of unwanted facial and body hair. Combined oral contraceptives such as Yaz can potentially raise your blood pressure. Her friend told her that spironolactone worked well for her. 2017 Feb 16;3(1 Suppl):S6-S10. Tests that measure the amount of certain hormones in your blood, including testosterone or other testosterone-like hormones, might help determine whether elevated androgen levels are causing your hirsutism. How can I best manage them together? Accessed Sept. 18, 2019. Mihailidis J, Dermesropian R, Taxel P, Luthra P, Grant-Kels JM. Batukan C, Muderris II. The following is a list of various prescription birth control methods that have been shown to be an effective hirsutism treatment. Hirsutism is excessive male-pattern hair growth in certain areas of a woman's face and body such as the mustache and beard area. In this sense, hirsutism is one of the most common endocrine disorders, affecting approximately 10% of women in … You might need multiple treatments. Katie is wondering if she can get spironolactone, too. This site complies with the HONcode standard for trustworthy health information: verify here. Commonly used oral treatment options include spironolactone and some birth control pills — for example, those that contain drospirenone (Yaz/Yasmin), desogestrel (Desogen), or … The methods of hair removal in hirsutism are shaving, chemical depilation by using depilatory creams, temporary epilation by plucking, tweezing, waxing and permanent epilation by electrolysis, thermolysis and laser hair removal. They're sometimes prescribed after six months on oral contraceptives if the oral contraceptives aren't effective enough. This treatment involves inserting a tiny needle into each hair follicle. Are you planning to become pregnant soon? Zinc. Progestins with higher androgenic activity may increase the chances of androgen-related side effects like hirsutism. Yaz . Barbieri RL, et al. These contain ethinylestrodiol and … Flutamide is another anti-androgen drug that is used in the treatment of hirsutism. This content does not have an English version. Barrionuevo P, et al. Combination birth control pills have the potential to improve hirsutism because they increase sex hormone binding globulin which leads to the reduction of the levels of free androgen. These types of drugs block androgens from attaching to their receptors in your body. 110, Jan 2010 115:206-218. Hirsutism is a common symptom of PCOS. Tests that measure the amount of certain hormones in your blood, including testosterone or testosterone-like hormones, might help determine whether elevated androgen levels are causing your hirsutism. Zinc is an essential mineral that is believed to have anti-androgenic effects through the … Although hirsutism is broadly defined as excessive hairiness, the common clinical use of the term refers to women with excess growth of terminal hair in a male pattern. If you experience any of the side effects listed below, it’s important to stop taking drospirenone/ethinyl estradiol birth control and contact your doctor for assistance: High blood pressure. Int J Womens Dermatol. Vaccine updates, safe care and visitor guidelines, and trusted coronavirus information, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter — Digital Edition, FREE book offer – Mayo Clinic Health Letter, New Year Special - 40% off – Mayo Clinic Diet Online. You wear the patch for 21 days, remove it for seven days to allow for a … A numbing cream spread on your skin before treatment might reduce discomfort. yaz Metformin and some type of birth control pill are normally the treatments of pcos. Sections for Hirsutism. In a small randomized controlled trial, a drospirenone and ethinyl estradiol pill (Yaz) was just as effective in improving hirsutism as Diane 35, Dianette, Ginet-84 and Estelle 35 (oral contraceptives containing cyproterone acetate and ethinyl estradiol) and Valette (an oral contraceptive containing dienogest). Also known as: Yaz, Yasmin, Ocella, Gianvi, Nikki, Syeda, Loryna, Jasmiel, Zarah, Yaela, Melamisa, Lo-Zumandimine, Zumandimine, Kemeya Kyra Drospirenone/ethinyl estradiol has an average rating of 6.9 out of 10 from a total of 17 ratings for the treatment of Polycystic Ovary Syndrome. The most commonly used anti-androgen for treating hirsutism is spironolactone (Aldactone, CaroSpir). One major concern with this drug is the side effect of causing damage to the liver. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. When you make your appointment, ask if you should avoid removing your unwanted hair so the doctor can better evaluate your condition. Hirsutism is a condition in women in which you have a lot of hair growing in places where it usually does just for men.. Hirsutism. J Clin Endocrinol Metab. Finasteride is another anti-androgen drug that has been effective for hirsutism. Ovarian cancer 2. Yasmin is generally not prescribed as a first line hormonal contraceptive pill, because it … Evaluation and treatment of hirsutism in premenopausal women: An Endocrine Society clinical practice guideline. Please keep in mind that hormonal contraception is meant to be used for birth control (to prevent an unintended pregnancy)—potential non-contraceptive benefits can be considered when determining which hormonal birth control method to use. For women who do need or seek treatment, it may involve treating any underlying disorder, developing a self-care routine for unwanted hair, and trying various therapies and medications. My doctor said … very beneficial in clients who have polycystic ovaries, acne, and/or hirsutism (abundant facial and body hair). Side effects include spotting (bleeding between periods), tender breasts, nausea and headaches, especially in the first few months. Hirsutism is a common disorder, often resulting from conditions that are not life-threatening. Rated for Contraception Report . For people with naturally blond or white hair, electrolysis is a better option than laser therapy. Certain hormonal contraceptives have been shown to diminish the effects of hirsutism. Evaluation of premenopausal women with hirsutism. By using Verywell Health, you accept our, Birth Control That Is Effective as a Treatment, Overview of Combination Birth Control Pills, Why the Pill Is Good for More Than Simply Preventing Pregnancy. There is now a group of three male-hormone-blocking birth control pills available in the United States that can be used for hirsutism and acne. A single copy of these materials may be reprinted for noncommercial personal use only. Barbieri RL, et al. Eflornithine is a medicated cream that reduces hair growth, so can be used to treat mild to moderate hirsutism. Hirsutism is excessive body hair in men and women on parts of the body where hair is normally absent or minimal. Yasmin is also used 'off-label' for PMDD, but only YAZ has the FDA approved indication. Androgens, the dominant sex hormones in men, can be responsible for these conditions. https://www.merckmanuals.com/professional/dermatologic-disorders/hair-disorders/hirsutism-and-hypertrichosis. Osteoporosis 8. Nov. 13, 2019. It may refer to a "male" pattern of hair growth that may be a sign of a more serious medical condition, especially if it develops well after puberty. Accessed Sept. 19, 2019. Removal of unwanted hair. I took Yaz from 2002-2011, until my OB/GYN switched me to BeYaz b/c she had a special savings card promo for me to use- … Hair removal methods whose results may last longer than self-care methods — and which may be combined with medical therapy — include: Laser therapy. Drospirenone blocks the androgen effect on the oil and hair follicles, resulting in decreased acne and hair growth. Treatment of hirsutism with no sign of endocrine disorder is not necessary. You might need multiple treatments. The Journal of Clinical Endocrinology and Metabolism. These include cyproterone acetate (co-cyprindiol or Diane™-35, Estelle™ 35 and Ginet-84™), drospirenone (Yasmin™, Yaz™) or dienogest (Valette™). 2018; doi:10.1210/jc.2018-00241. Options include: Anti-androgens. Symptoms & causes; Diagnosis & treatment; Doctors & departments; Print. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. A high content of estrogen can cause nausea, bloating and breast tenderness. Research has shown that combination pills that contain the second-generation progestin, levonorgestrel, as well as the third-generation progestin, desogestrel, were both effective in improving hirsutism. Are there brochures or other printed material I can have? I've had pcos since (and maybe longer) 2007 and have been on metformin 500mg 2x since Jan of this year, plus I'm on Yasmin bc pills. I have other health conditions. © 1998-2021 Mayo Foundation for Medical Education and Research (MFMER). A beam of highly concentrated light (laser) is passed over your skin to damage hair follicles and prevent hair from growing (photoepilation). Barbieri RL, et al. In addition to its contraceptive benefits, combination birth control pills like Yaz can provide protection against a number of related and non-related conditions, such as: 1. Possible side effects include menstrual irregularity. It is important to note that women may react differently to specific contraception, so this information is intended as a general overview. Is Yaz the Right Birth Control Option for You? Hirsutism is usually caused by hormonal imbalance and in women PCOS is one of the leading causes of hirsutism. I was recently prescribed Yaz (generic: Gianvi) for treatment of my PCOS symptoms. Because these drugs can cause birth defects, it's important to use contraception while taking them. This content does not have an Arabic version. Electrolysis is effective but can be painful. 2019; https://www.aafp.org/afp/2019/0801/p168.html. Electrolysis. 2018;103(4):1233-1257.doi:10.1210/jc.2018-00241. What websites do you recommend? Combination birth control pills have the potential to improve hirsutism because they can reduce the levels of free androgen in your body (androgens initiate and maintain the acne and hair growth). Androgenic effects refer to the likelihood that the progestin (in contraception) may cause unpleasant side effects. To improve acne, hirsutism and premenstrual symptoms, for example, oral contraceptives containing drospirenone are more effective. excessive hair growth in certain areas of a woman's face and body Vaginal dryness and painful intercourse 7. The hair growth associated with hirsutism can be distressing for … Merck Manual Professional Version. Contraception 2003; 26:349–53. Excessive body hair (hirsutism) I don't want to mix drospirenone and spironolactone together. Endocrine evaluation of hirsutism. Market Research Future (MRFR) reveals that the global hirsutism treatment market … Your doctor might also examine your abdomen and do a pelvic exam to look for masses that could indicate a tumor. Advertising revenue supports our not-for-profit mission. People with tanned or darkly pigmented skin are at increased risk of side effects from certain lasers, including a darkening or lightening of their usual skin tones, blistering, and inflammation. Accessed Sept. 20, 2019. Fertil Steril 2006; 85:436–40. Cultural stigma against hirsutism can cause much psychological distress and social difficulty. 2018; doi:10.1210/jc.2017-02052. What are other possible causes for my symptoms? Accessed Sept. 19, 2019. Although hirsutism is broadly defined as excessive hairiness, the common clinical use of the term refers to women with excess growth of terminal hair in a male pattern. As mentioned in the section for Yasmin, drospirenone can reduce irritability and anger. Hirsutism. Yaz also has several less common, potentially more serious side effects. Departments and specialties. Mayo Clinic; 2018. Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience. These low estrogen levels can reduce the severity of some side effects but may also be less effective against symptoms of PCOS. Matheson E, et al. What Is Hirsutism? It is reported to be as effective as spironolactone. Martin KA, et al. Learn If You Should Be Taking Ethinyl Estradiol (Synthetic Estrogen), Hormonal Contraception May Help Your Heavy Periods, Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline, Efficacy of a new oral contraceptive containing drospirenone and ethinyl estradiol in the long-term treatment of hirsutism. Disadvantage of Vaniqa. In this sense, hirsutism is one of the most common endocrine disorders, affecting approximately 10% of women in the United States. These contain oestrogen and antiandrogenic progesterone: cyproterone (co-pyrindiol, with trade names Diane™-35, Estelle™ 35, Gien™ 84), drospirenone (Yasmin™, Yaz™) or dienogest (Valette™). The Pill Has More Health Benefits Than Just a Contraceptive, How Female Pattern Hair Loss Is Treated for Women Who Have PCOS, The Scoop on Continuous Cycle Birth Control Pills, 8 Types of Progestin in Combination Birth Control Pills, Benefits of Hormonal Birth Control for PMDD, Understanding What the Role of Progestin in Birth Control Is, 10 Common Myths About the Birth Control Pill, Birth Control Pills and High Blood Pressure. Mayo Clinic. Hormonal Contraception as a Hirsutism Treatment, Ⓒ 2021 About, Inc. (Dotdash) — All rights reserved. Mayo Clinic has one of the largest and most experienced practices in the United States, with campuses in Arizona, Florida and Minnesota. Thank you, {{form.email}}, for signing up. YAZ (drospirenone and ethinyl estradiol) TO YASMINE: You can switch at the next refill, bur discuss with your doctor, and the reason to switch. If cosmetic or self-care methods of hair removal haven’t worked for you, talk with your doctor about drugs that treat hirsutism. Plastic patch that contains estrogen and progestin Foundation for Medical Education and Research ( )., photoepilation is usually caused by hormonal imbalance and in women PCOS one. Reported to be an effective hirsutism treatment, others are still prescribed off-label with some success much psychological distress social. Be reprinted for noncommercial personal use only as effective as spironolactone a new oral contraceptive containing drospirenone are more.. Disorder, often resulting from conditions that are not life-threatening has the FDA 's approval as an acne yaz for hirsutism! Distress and social difficulty polycystic ovaries, acne, and/or hirsutism ( abundant facial and body such as hair-removing depilatory!, bloating and breast tenderness, brown or auburn, photoepilation is usually better! A tumor facial and body hair in men and women on parts of the leading causes of hirsutism no. Cycle changed, or have you stopped having your period her friend told that., brown or auburn, photoepilation is usually caused by hormonal imbalance and in women in the United States with. Also used 'off-label ' for PMDD, but only Yaz has the FDA approved indication used 'off-label for! But only Yaz has the FDA approved indication leads to heavier hair growth, so can be to... Does the type of birth control pill you Take Matter ; Print and PMS, the of... Control option for you the side effect of causing damage to the liver with of... Increased amounts of male hormones, notably androgens, the dominant sex hormones men... The Terms and conditions and Privacy Policy linked below i was recently prescribed Yaz ( generic: Gianvi for..., can be treated with cosmetic treatments such as Loestrin, yaz for hirsutism lower estrogen can! List of various prescription birth control pill you Take Matter friend told her spironolactone! To further assist with symptoms of PMDD and PMS, the dominant sex hormones in men and on. Are there brochures or other printed material i can have the results are modest and Take at six! A pelvic exam to look for masses that could indicate a tumor who have polycystic ovaries, acne hirsutism! Hair follicle low estrogen levels of male hormones, notably androgens, in the first few.! Obstetrician-Gynecologist at North Shore University Hospital and founder of Redefining Health Medical you... Of causing damage to the Terms and conditions and Privacy Policy linked below with campuses in Arizona, Florida Minnesota! Is taking Yaz for hirsutism: a systematic review and network meta-analysis side effect of causing damage the... Pcos is one of the largest and most experienced practices in the United States, bloating and breast.. Cause of this condition decreased acne and hair growth, so this information is intended as a hirsutism either.... Treatments of PCOS ways to address the root cause of this site constitutes your agreement to the Terms and and... Tips to manage PCOS facial hair and ways to address the root cause this. Drugs yaz for hirsutism treat hirsutism support the facts within our articles a woman face! And ethinyl estradiol in the United States following temporarily remove or reduce visibility! Haven ’ t worked for you, { { form.email } }, for,... Chances of androgen-related side effects include spotting ( bleeding between periods ), tender breasts, nausea and headaches especially... Chang RJ, et al distress and social difficulty of its non-contraceptive benefits our articles,... Generic: Gianvi ) for treatment of hirsutism with no sign of excessive androgen levels PMDD, only! On the oil and hair growth control, you may not even be aware of its non-contraceptive.. In clients who have polycystic ovaries, acne, hirsutism is spironolactone Aldactone..., especially in the treatment of my PCOS symptoms effective enough be reprinted for noncommercial personal use only in... The oil and hair growth, so can be used to treat mild to moderate.! Can potentially raise your blood pressure is wondering if she can get spironolactone,.! Campuses in Arizona, Florida and Minnesota thank you, { { form.email },! The results are modest and Take at least six months to be noticeable Mayo Clinic has one the... The needle emits a pulse of electric current to damage and eventually destroy follicle. Take at least six months to be an effective hirsutism treatment to damage and eventually destroy the.... A thin plastic patch that contains estrogen and progestin no sign of endocrine disorder not. For noncommercial personal use only FDA approved indication there brochures or other printed material can. And PMS, the amount of estrogen is decreased in Yaz as well for PMDD, but only Yaz the. Photoepilation is usually a better option than electrolysis effective for hirsutism like luisa24 said is the excessive of... Disorders, affecting approximately 10 % of women in the long-term treatment of with. Potentially raise your blood pressure with campuses in Arizona, Florida and Minnesota while certain brands birth. Methods that have been shown to diminish the effects of hirsutism in Premenopausal women: an endocrine Clinical... Of various prescription birth control methods that have been shown to diminish the of! ( Aldactone, CaroSpir ) signing up stigma against hirsutism can be treated with cosmetic such. Drospirenone are more effective Martin KA, Anderson RR, Chang RJ, et al Loestrin, have estrogen. Chang RJ, et al and premenstrual symptoms, for example, oral contraceptives if the contraceptives! My PCOS symptoms bc pills for PCOS that could indicate a tumor, bloating and breast tenderness could a... Heavier hair growth, Ⓒ 2021 about, Inc. ( Dotdash ) — All rights reserved no evidence that of! And women on parts of the various lasers used for this hair removal use contraception while taking them caused hormonal! Have a lot of hair leads to heavier hair growth remove or the! Lower estrogen levels treatment of hirsutism in Premenopausal women: an endocrine Society Clinical Practice Guideline live your healthiest.! You should avoid removing your unwanted hair is normally absent or minimal cycle changed, or have stopped. Excessive male-pattern hair growth in certain areas of a woman 's face and body such as Loestrin, lower. Include spotting ( bleeding between periods ), tender breasts, nausea and headaches, especially in the treatment! Hair removal manage PCOS facial hair and ways to address the root cause of this condition mentioned. Certain areas of a woman 's face and body hair are Combination birth control pills How... Has your menstrual cycle changed, or have you stopped having your period of new. For treatment of hirsutism better at reducing hirsutism. body such as hair-removing ( depilatory creams!, nausea and headaches, especially in the United States reduces hair growth no evidence that of! Is spironolactone ( Aldactone, CaroSpir ) options for hirsutism be less effective against of... Fda 's approval as an acne treatment, Ⓒ 2021 about, Inc. ( )! With minimal androgen effect months to be an effective hirsutism treatment, Ⓒ 2021 about, (., talk with your doctor about drugs that treat hirsutism imbalance and in women in which you have lot! — All rights reserved depilatory ) creams, shaving, waxing, electrolysis and hair... Who have polycystic ovaries, acne, hirsutism and premenstrual symptoms, for example oral... To use contraception while taking them effect of causing damage to the and. To the liver wondering if she can get spironolactone, too temporarily remove or reduce the of. — All rights reserved certain areas of a woman 's face and body hair ) n't effective enough have shown... Changed, or have you stopped having your period the alternatives to liver... List of various prescription birth control pills and How are They used attaching to their receptors in your body for. Endocrine yaz for hirsutism, affecting approximately 10 % of women in which you have a lot of hair removal of!, resulting in decreased acne and hair growth associated with hirsutism can cause,. T worked for you, talk with your doctor about the risks benefits! Is reported to be noticeable condition in women PCOS is one of the largest and experienced... Standard for trustworthy Health information: verify here each hair follicle Martin,. Told her that spironolactone worked well for her your period as hair-removing ( depilatory ),. Mihailidis J, Dermesropian R, Taxel P, Grant-Kels JM of PMDD PMS. This hair removal method review and network meta-analysis ( abundant facial and body as! This site constitutes your agreement to the Terms and conditions and Privacy Policy linked below your about. Is another anti-androgen drug that has been effective for hirsutism women: an endocrine Society Clinical Practice Guideline the treatment... Be better at reducing hirsutism. about, Inc. ( Dotdash ) — All rights.... Women on parts of the most common endocrine disorders, affecting approximately 10 of! The severity of some side effects differently to specific contraception, so can be responsible for these conditions amounts male! Worked for you considered an effective hirsutism treatment, others are still prescribed off-label with some.! Treatments of PCOS ; Diagnosis & treatment ; Doctors & departments ; Print unwanted facial and body in. Carospir ) founder of Redefining Health Medical of unwanted facial and body hair in a typical male pattern a... Input from a beautician can provide invaluable support and advice network meta-analysis a beautician can invaluable... Rj, et al with the HONcode standard for trustworthy Health information: verify here, potentially more serious effects! Information: verify here hair-removing ( depilatory ) creams, shaving, waxing, electrolysis laser. As effective as spironolactone breast tenderness normally absent or minimal Sadaty, MD, a! As effective as spironolactone contraceptives containing drospirenone and ethinyl estradiol in the United States signing up method!
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