A Cochrane review «Oral contraceptives containing drospirenone for premenstrual syndrome»1 «...»1 included 5 trials with a total of 858 women.Drospirenone (plus ethinyl estradiol 20μg) improved overall premenstrual symptoms (standardised mean difference (SMD) -0.41, 95% CI -0.59 to -0.24; 2 RCTs, n=514; I²=64%); productivity (WMD -0.31; 95% CI -0.55 to -0.08), social activities (WMD --0.29; 95% CI -0.54 to -0.04), and relationships (WMD -0.30; 95% CI -0.54 to -0.06). Side effects more common with oral contraceptive (COC) use were nausea, intermenstrual bleeding, and breast pain.
Comment: The quality of evidence is downgraded by study quality (high losses to follow-up and several other limitations), by inconsistency (heterogeneity and marked placebo effect), by indirectness (short follow-up), by imprecise results (limited study size), and by potential publication bias.