Yasmin: what it is used for, dosage and side effects
Yasmin is a combined oral contraceptive with two active substances: drospirenone and ethinylestradiol. It is taken by mouth and is used for contraception. It is prescription only, because before it is started a doctor has to weigh up blood pressure, the risk of blood clots and everything else you take. This page explains how it works, what a doctor checks, what needs watching, and what we can and cannot do about a prescription.
What Yasmin is and which active substances it contains
Yasmin contains two active substances: drospirenone, a progestogen, and ethinylestradiol, an oestrogen. Because it contains both, it belongs to the combined hormonal contraceptives, and that is what separates it from products containing a progestogen alone.
In the European Medicines Agency data for the Maltese market the medicine is listed with the active substances drospirenone and ethinylestradiol and the route of administration: oral. A product with the same pair of substances in a lower strength is on the Maltese list under the name Yasminelle, which is one reason why swapping packs on your own is not appropriate.
Combined contraception also comes in forms that are not tablets. A vaginal ring is described on /medicines/nuvaring/ and a skin patch on /medicines/evra/; the substances differ, but the class of risk they carry is the same. An overview of the whole group is in /contraceptive-pill/.
The strengths, the composition of the pack and the excipients are in the patient information leaflet in your pack. The list of medicines authorised in Malta is kept by the Medicines Authority, the body that authorises medicines here and monitors their safety.
What it is used for
The authorised use is contraception in women who choose an oral hormonal method. Used as directed, combined oral contraception is a reliable method, but no method is absolutely certain, and how reliable it is in practice depends on taking it consistently.
Doctors sometimes also use combined contraception for complaints linked to the cycle or to hormones, such as heavy or painful periods or acne. Whether that applies to you, and whether this particular product is the right one, is a judgement for a doctor who knows your history, not something a questionnaire settles.
This medicine does not protect against sexually transmitted infections. Only barrier methods do that, and they can be used alongside hormonal contraception.
It is not emergency contraception and it does not replace it. If a risk has already occurred, the timing of what you do matters and the route is different; what to do after a missed pill is set out in /health-guide/missed-contraceptive-pill/.
How it works
The two substances act together in three ways. They suppress the release of an egg from the ovary, they change the mucus at the entrance to the womb so that sperm pass less easily, and they change the lining of the womb.
Suppressing ovulation is the main mechanism, and it is also why regular taking matters so much: the effect depends on a steady level of both substances. A gap in taking allows the ovary to resume activity, and that is when the method becomes less reliable.
Drospirenone has a weak anti-mineralocorticoid effect, which is why some women notice less fluid retention on this product than on others. That is a difference between products, not a reason to choose one without a doctor.
Bleeding during the break in a pack is not the same as a natural period; it is a withdrawal bleed caused by the fall in hormone levels. Its absence does not automatically mean pregnancy, but it is a reason to check, especially if pills were missed.
The risk of blood clots and what the doctor assesses
Combined hormonal contraception raises the risk of venous thromboembolism, that is a clot in a vein, most often in the leg, which can travel to the lungs. The risk is small in absolute terms in healthy young women, but it is real and it is the main reason why this medicine is not available without a prescription.
The risk is not the same for everyone. It is higher in the first months after starting or restarting, after a long period without hormonal contraception, in smokers, with rising age, with obesity, after childbirth, after major surgery or long immobility, and where there is a personal or family history of clots or a known clotting disorder. Migraine with aura, uncontrolled high blood pressure and some diseases of the liver, heart or blood vessels make combined contraception unsuitable rather than merely something to be careful about.
That is exactly what a doctor weighs up before prescribing, together with blood pressure, and that is why blood pressure measured recently is a reasonable thing to have to hand. These are not formalities: they are the facts that decide whether combined contraception is safe for you or whether a progestogen only method is more appropriate.
Learn to recognise the warning signs and act on them: swelling, pain or heat in one calf; sudden breathlessness or chest pain; coughing up blood; sudden severe headache, disturbed vision or speech, weakness or numbness on one side. Seek urgent medical help, and in an emergency in Malta call 112.
How it is taken and what needs watching
The tablets are taken by mouth, one at a time, in the order shown on the pack, at roughly the same point in the day. The pack layout and whether it includes a break or inactive tablets differ between products, so follow the leaflet for the pack you actually have.
What to do about a missed tablet depends on how much time has passed and on where you are in the pack, and the rules are not the same for every product. Follow the leaflet for your own pack, and where it tells you to use additional protection, use it. Do not work from advice written for a different product; /health-guide/missed-contraceptive-pill/ explains why that distinction matters.
Vomiting or severe diarrhoea soon after taking a tablet can mean it was not absorbed, and the leaflet treats that in the same way as a missed tablet. It is worth reading that section before you need it rather than during a stomach upset.
Planned surgery, a long period of immobility and a long journey are situations to discuss with a doctor in advance, because they add to the risk of clots. Tell any doctor or dentist treating you that you use combined hormonal contraception.
Interactions with other medicines
Some medicines speed up the breakdown of the hormones in the liver and can make contraception less reliable. The group includes certain medicines used in epilepsy, certain medicines used in tuberculosis and some antiretrovirals, as well as the herbal preparation St John's wort, which is sold without a prescription.
This is why a complete list of what you take belongs in the assessment, including supplements and herbal products that people often do not think of as medicines. Where an interaction of this kind exists, a doctor will say whether additional protection is needed, for how long, and whether another method is a better answer.
In the other direction, contraception can affect the level of other medicines, such as some used in mental health or in transplantation. That is another reason not to change anything on your own.
Drospirenone can raise potassium slightly, which matters where you take medicines that also raise it. Severe vomiting and diarrhoea, whatever the cause, can reduce absorption and therefore reliability.
Side effects
The side effects described most often are headache, nausea, breast tenderness, mood changes, spotting between periods and reduced desire. Spotting is most common in the first months and usually settles; if it persists, a doctor should look into it rather than you simply waiting.
A change in blood pressure can occur, which is why it is measured before and during treatment. Some women notice changes in weight or in skin, and those go in both directions depending on the product.
Serious events are much rarer but they are the reason for the prescription requirement: clots in veins or arteries, serious liver disorders and, where high blood pressure is uncontrolled, cardiovascular events. A new migraine, or a migraine that becomes different or comes with aura, is a reason to contact a doctor promptly.
How often each effect occurs is in the patient information leaflet for your pack, and we deliberately do not repeat those figures here: they belong to the specific product you hold.
Prescription status and what we can do
Yasmin is prescription only, so a pharmacy does not supply it without a prescription. The decision to prescribe belongs to a doctor after an assessment of your medical information, which for combined contraception includes blood pressure and the risk of clots. We do not sell medicines and we do not ship them.
Whether contraception is covered by the public health service in Malta, and on what terms, is decided by the health authorities and not by us. Our service is private and is not covered by them, so the pharmacy price of the pack and our fee are two separate items.
Our model is a medical questionnaire that a doctor reviews asynchronously, from your answers and any records you attach. There is no video call, no phone call and no live chat with a doctor. If contraception has already been started by a doctor and this is a continuation of the same method, you can ask for an assessment at /contraception/ for 24,90 €. Priority handling is available for an extra 9,90 €, which is not a promise of a deadline. A first start, a change of method or new symptoms need a doctor who can examine you.
If the doctor issues a prescription, you receive the document by email as a PDF in the standard EU cross-border format set out in Directive 2012/52/EU; its recognition in another member state is governed by Directive 2011/24/EU. There is no code and the document is not entered in any Maltese state health record, so you go to the pharmacy with a printout or with the PDF on screen, together with photo identification. A pharmacy in Malta may dispense it; the decision rests with the pharmacist, who can refuse, for example where the pack is not available locally. The fee covers the doctor's assessment, not the issuing of a document. If the doctor declines on medical or legal grounds, we refund the fee. If we ask you for medical records, you have at least 7 days to reply. We then send a reminder and extend the deadline on request, and where the assessment still cannot be completed we close the request and refund the fee. The assessment is carried out by Damian Wojno, a doctor registered in Poland, licence no. 3211301, MEDINOW Sp. z o.o. He is not registered with the Medical Council of Malta, which keeps the register of doctors practising here.
Is Yasmin prescription only in Malta?
Yes. It is supplied on prescription only, because combined hormonal contraception raises the risk of blood clots and a doctor has to weigh up blood pressure, your history and everything else you take before it is started. A pharmacy will not supply it without a prescription, and an assessment can end in a refusal or in a recommendation of a different method.
How quickly does it work?
That depends on where in the cycle you start, and the rule for your own pack is in its patient information leaflet. Some starting points give protection at once, others need additional protection at the beginning. Read that section of the leaflet before the first tablet, not afterwards, and where it tells you to use additional protection, use it.
Which side effects are common?
Headache, nausea, breast tenderness, mood changes, spotting between periods and reduced desire are the most commonly described. Spotting is most common in the first months and usually settles. Warning signs of a clot, such as pain or swelling in one calf, sudden breathlessness, chest pain or a sudden severe headache with disturbed vision, mean urgent medical help.
What happens if a pill is missed?
It depends on how much time has passed and on where you are in the pack, and the rules differ between products, so follow the leaflet for your own pack rather than general advice. Where the leaflet tells you to use additional protection, use it, and if a risk has already occurred consider whether emergency contraception is needed. More on this in /health-guide/missed-contraceptive-pill/.
Does it protect against sexually transmitted infections?
No. Hormonal contraception acts on the possibility of pregnancy and does nothing against infections. Only barrier methods reduce that risk, and they can be used together with a hormonal method. Testing after a risk episode is a separate matter and is worth discussing with a doctor.
How is a repeat prescription arranged?
If a doctor has already started your contraception and this is a continuation of the same method, fill in the medical questionnaire at /contraception/. The medical assessment costs 24,90 €. Blood pressure measured recently is worth having to hand, because for combined contraception it is part of the assessment. We do not promise a deadline, because it depends on the completeness of your answers and on the doctor's assessment.