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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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Obstetrics and Gynegology2026№3

Combined oral contraceptives in the treatment of premenstrual syndrome: a modern approach

DOI
https://dx.doi.org/10.18565/aig.2026.57

Bakhtiyarov K.R., Ignatko I.V., Zueva A.S., Saizhanov A.R., Sinyakova E.V.

1) I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia; 2) Peoples’ Friendship University of Russia named after Patrice Lumumba, Moscow, Russia

Premenstrual syndrome is a condition characterized by mental and/or physical discomfort that occurs during the last five days of the luteal phase of the menstrual cycle and resolves within the first four days of the next menstrual period. The main mechanism underlying the condition is thought to be an inappropriate response of the central nervous system to fluctuations in sex hormones during the menstrual cycle. It is well known that the first step in alleviating the clinical manifestations of premenstrual syndrome is non-pharmacological treatment, the main components of which are lifestyle changes, a balanced diet, treatment for obesity and the use of calcium supplements. In severe cases, or if the non-pharmacological methods described above prove ineffective, it is recommended to consider pharmacological treatment options, namely, selective serotonin reuptake inhibitors or combined oral contraceptives (COCs). It has been established that COCs containing drospirenone and ethinyl estradiol (Vidora micro) have a positive effect on alleviating the main symptoms of premenstrual syndrome, such as swelling, mood swings, and social withdrawal. Ethinyl estradiol improves the pharmacokinetics of drospirenone by interacting with CYP enzymes. Compared with other progestogens, drospirenone-containing preparations offer certain advantages due to their antimineralocorticoid activity (which not only prevents fluid retention and the development of edema-related symptoms, but also allows this progression to be used in patients with fluctuating blood pressure) and antiandrogenic activity (which has a positive effect on alleviating irritability and aggressiveness, as well as on prevention of weight gain). The analysis of the scientific literature revealed that the use of drospirenone-containing COCs demonstrated efficacy compared with the placebo group. It has been shown that long-term continuous use of this medicine is more effective than its periodic use. In addition, combined treatment is recommended, alongside with lifestyle changes, moderate physical activity and a healthy, balanced diet. The possibility of combining drospirenone-containing COCs and selective serotonin reuptake inhibitors shows promise.
Conclusion: There is a need for further large-scale studies involving a large sample of patients and control groups in order to obtain new data and establish an evidence base for using this type of therapy in clinical practice.

Authors’ contributions: Bakhtiyarov K.R., Ignatko I.V., Zueva A.S. – developing the concept of the study; Sinyakova E.V., Saizhanov A.R. – collecting and processing the material; Zueva A.S., Sinyakova E.V. – literature analysis; Sinyakova E.V., Zueva A.S. – writing the text; Bakhtiyarov K.R., Ignatko I.V. – editing the article.
Conflicts of interest: Authors declare lack of the possible conflicts of interest.
Funding: The work was carried out with the financial support from Sopharma LLC.
For citation: Bakhtiyarov K.R., Ignatko I.V., Zueva A.S., Saizhanov A.R., Sinyakova E.V. 
Combined oral contraceptives in the treatment of premenstrual syndrome: a modern approach. 
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (3): 176-182 (in Russian)
https://dx.doi.org/10.18565/aig.2026.57

Keywords

Vidora micro
drospirenone
combined oral contraceptives
levonorgestrel
premenstrual syndrome
premenstrual dysphoric disorder
ethinyl estradiol
Full text (in Russian)

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Received 16.02.2025

Accepted 25.03.2026

About the Authors

Kamil R. Bakhtiyarov, Dr. Med. Sci., Professor at the Department of Obstetrics, Gynecology, and Perinatology, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), 119048, Russia, Moscow, Trubetskaya str., 8, bldg. 2, +7(910)440-30-39, bakhtiyarov_k_r@staff.sechenov.ru, https://orcid.org/0000-0001-7114-4050
Irina V. Ignatko, Corresponding Member of the RAS, Dr. Med. Sci., Professor, Head of the Department of Obstetrics, Gynecology, and Perinatology, N.V. Sklifosovsky
Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University),
119048, Russia, Moscow, Trubetskaya str., 8, bldg. 2, ignatko_i_v@staff.sechenov.ru, https://orcid.org/0000-0002-9945-3848
Alina S. Zueva, student at the N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), 119048, Russia, Moscow, Trubetskaya str., 8, bldg. 2, +7(962)902-33-31, alina-zueva02@mail.ru, https://orcid.org/0009-0001-9755-2201
Ayrat R. Saizhanov, student, Peoples’ Friendship University of Russia named after Patrice Lumumba,
117198, Russia, Moscow, Miklukho-Maklaya str., 6, +7(985)465-81-82, ayrat06.06@mail.ru, https://orcid.org/0009-0003-5645-1011
Elizaveta V. Sinyakova, student at the N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), 119048, Russia, Moscow, Trubetskaya str., 8, bldg. 2, +7(985)191-00-23, sinyakova_e_v@student.sechenov.ru, https://orcid.org/0009-0009-7469-2971
Corresponding author: Alina S. Zueva, alina-zueva02@mail.ru

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