--- title: Yaz vs Slynd: Differences and Which to Choose for PMDD description: Yaz vs Slynd compared: both contain drospirenone, but only Yaz has trial evidence for PMDD. Here's how regimens, side effects and suitability differ. url: https://niyora.com/treatments/yaz-vs-slynd/ --- - [Niyora](https://niyora.com/) - [Treatments](https://niyora.com/treatments/) - Yaz vs Slynd: how they compare for PMS and PMDD Treatments # Yaz vs Slynd: how they compare for PMS and PMDD Yaz and Slynd both contain the progestin drospirenone, but only Yaz pairs it with estrogen and has trial evidence for easing PMDD. Slynd is progestin-only and approved for contraception, not for mood symptoms. Which one fits you usually comes down to whether you can take estrogen and how much evidence you want behind the choice. Updated 14 October 2026 Niyora editorial Mixed evidence Strength of evidence Mixed Trials disagree, or the effect is small. - None - Limited - Mixed - Moderate - Strong ## At a glance - Yaz combines ethinyl estradiol and drospirenone and is one of the few treatments with trial evidence specifically for PMDD. - Slynd contains drospirenone alone, with no estrogen, and is approved for contraception rather than for treating PMDD. - Both pills' drospirenone can ease bloating and acne, because it blocks fluid retention and has mild anti-androgen activity. - Switching between Yaz and Slynd should go through your doctor, who can time it around your current pack and contraceptive needs. - If mood symptoms take over a week every month, bring two months of daily notes to a GP or gynecologist. ## Strength of evidence Mixed evidence - None - Limited - Mixed - Moderate - Strong Yaz has randomized trial evidence for PMDD and FDA approval for that use (The Journal of Reproductive Medicine, 2008). Slynd is a progestin-only pill approved for contraception. No trials here tested Slynd for PMS or PMDD, so its mood effects remain unproven even though it shares drospirenone with Yaz. Side by side Yaz and Slynd Hormones Yaz Ethinyl estradiol (20 mcg) plus drospirenone (3 mg) Slynd Drospirenone alone, no estrogen Also compared in the table below - Pill type - PMDD evidence - Estrogen-related risks - Extra approved uses | Compared on | Yaz | Slynd | | --- | --- | --- | | Hormones | Ethinyl estradiol (20 mcg) plus drospirenone (3 mg) | Drospirenone alone, no estrogen | | Pill type | Combined oral contraceptive | Progestin-only pill | | PMDD evidence | Two randomized trials, FDA approved for PMDD | No PMDD trials in current evidence; approved for contraception only | | Estrogen-related risks | Small clot risk, possible nausea or breast tenderness, tied to estrogen | None of these specific risks, since there is no estrogen | | Extra approved uses | Also approved for acne; a folate-added version (Beyaz) exists | Contraception only, no added approved uses in current evidence | ## How do Yaz and Slynd differ? Yaz and Slynd share one ingredient and differ in almost everything else. Yaz combines ethinyl estradiol with the progestin drospirenone, taken for 24 active days and 4 placebo days (The Journal of Reproductive Medicine, 2008). Slynd contains drospirenone alone, with no estrogen at all. That makes it a **progestin-only pill**, rather than a combined one. That difference in estrogen matters for who can safely take each one. Combined pills like Yaz carry a small clot risk tied to estrogen, so doctors often steer away from them for people who smoke, have migraine with aura, or have a personal or family history of blood clots. Slynd's lack of estrogen can make it an option when a combined pill is off the table for those reasons. Both pills also share drospirenone's two extra effects. It blocks the hormone that drives fluid retention, which eases the bloating many people feel before their period, and it has mild anti-androgen activity, part of why both pills are sometimes used for acne (Minerva Ginecologica, 2010). ## Which works better for PMS or PMDD? Yaz has the stronger evidence here. Two randomized trials found that the drospirenone and ethinyl estradiol combination eased the mood, physical and behavioral symptoms of PMDD, including food cravings, water retention and relationship strain (The Journal of Reproductive Medicine, 2008). That evidence is part of why Yaz is one of only four treatments the FDA has approved specifically for PMDD (The Journal of Reproductive Medicine, 2008). Shortening the hormone-free interval to 4 days, instead of the usual 7, also smooths out the hormone drop that can trigger withdrawal symptoms like headache, breast tenderness and mood dips (Minerva Ginecologica, 2010). A related version, Beyaz, adds folate to the same drospirenone and ethinyl estradiol combination and carries the same approved uses, including PMDD (Women's Health, 2012). Slynd doesn't have that kind of trial behind it for PMDD or PMS. It's studied and approved as a contraceptive, and its effect on premenstrual mood hasn't been tested the same way. Any pill that reduces hormone swings might ease some symptoms anyway, but without trial data, your doctor has far less to go on if you ask about Slynd specifically for PMDD. If PMDD or significant PMS is the main reason you're considering a pill, **Yaz is the one with evidence behind it** (see [Yaz for PMDD](https://niyora.com/treatments/yaz-for-pmdd/) and Yaz and mood). Slynd's track record so far is for contraception. ## How do the side effects compare? Both pills' side effects start from the same place: drospirenone's effect on fluid and androgen levels. Beyond that, **estrogen is the main thing that sets them apart**. | Side effect | Yaz | Slynd | | --- | --- | --- | | Bloating | Often eased, from drospirenone's anti-fluid-retention effect | Same effect, from the same progestin | | Nausea, breast tenderness | Can happen, especially in the first few cycles, tied to estrogen | Less common, since there's no estrogen | | Breakthrough bleeding | Less common once your body adjusts | More common, as with most progestin-only pills | | Clot risk | Small but real, tied to estrogen. Several large studies have found drospirenone-containing pills like Yaz carry a somewhat higher clot risk than pills with older progestins such as levonorgestrel (FDA Drug Safety Communication, 2012; Lidegaard et al., 2011, BMJ), though the absolute risk stays low for healthy nonsmokers | Not a concern in the same way, since there's no estrogen | | Potassium levels | Doctors may check this in people with kidney issues, since drospirenone affects the hormone that regulates potassium | Same consideration applies | For the fuller list of what Yaz can cause, see [Yaz side effects, including mood](https://niyora.com/treatments/yaz-side-effects/). ## Can you switch from one to the other? Yes, people switch between combined pills and progestin-only pills fairly often, and a doctor can tell you how to do it safely for your cycle and health history. The right timing usually depends on which pack day you're on and whether you need backup contraception while your body adjusts. A few practical notes: - Don't stop one pill and start the other without a plan. A gap between them can mean a gap in contraception too. - Expect a short adjustment period. Breakthrough bleeding or mood changes in those first weeks don't necessarily mean the new pill is wrong for you. - Keep daily notes through the switch. If you're switching because of mood symptoms, you'll want to compare how you felt before and after, not rely on memory. Niyora is a PMS and PMDD support app. Its estimated PMS window can help you see whether how you feel lines up with the week before your period, useful context for this kind of medication decision. ## Which should you ask your doctor about? Bring the specifics of what you're dealing with, not just the drug names. That's what helps a doctor match a pill to your actual symptoms and health history. Ask about Yaz if: - PMDD or significant premenstrual mood symptoms are the main problem, and you want the option with trial evidence behind it. - You don't have a history of blood clots, migraine with aura, or uncontrolled high blood pressure, the usual reasons doctors avoid estrogen. Ask about Slynd if: - You need or want a progestin-only option, because of migraine with aura, a clotting history, or a preference to avoid estrogen. - Contraception is your main goal, and mood relief is a secondary hope rather than the reason you're there. Either way, your doctor decides what's safe given your full history. If your mood symptoms take a week of every month, or you have thoughts of hurting yourself, see a GP or gynecologist and bring two months of daily notes. For hormonal and non-hormonal options side by side, see [birth control for PMDD](https://niyora.com/treatments/birth-control-for-pmdd/) and [PMS treatment: what actually helps](https://niyora.com/treatments/pms-treatment/). Before that appointment, write down which week of your cycle your symptoms peak. That's the detail that helps a doctor choose between these two pills. From the research library ## Research on the pill 502 studies in the library look at the pill in PMS and PMDD. They were published from 1970 to 2026, and each one has a short summary of what was tested and found. 502 studies, 1970 to 2026 How strong the studies are Strong study design 54 Moderate study design 170 Early or limited evidence 278 - [Systematic review, 2026Does 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.Strong study design](https://niyora.com/research/papers/comparison-of-premenstrual-dysphoric-disorder-treatment-with-antidepressants-and-2026/) - [Cohort study, 2026Does 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.Strong study design](https://niyora.com/research/papers/sleep-duration-impact-on-sleep-quality-mood-and-fitness-in-elite-athletes-with-a-2026/) - [Randomised trial, 2025Does 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.Strong study design](https://niyora.com/research/papers/associations-between-menstrual-cycle-phases-and-sexuality-well-being-and-mood-in-2025/) - [Cohort study, 2025Are 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.Strong study design](https://niyora.com/research/papers/menstrual-cycle-characteristics-across-the-reproductive-lifespan-and-cognitive-2025/) - [Randomised trial, 2024Does 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.Strong study design](https://niyora.com/research/papers/effects-of-e4-drsp-on-self-reported-physical-and-emotional-premenstrual-and-2024/) - [Systematic review, 2024What 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.Strong study design](https://niyora.com/research/papers/management-of-premenstrual-dysphoric-disorder-a-scoping-review-2024/) ### Clinical trials - [Oral Contraceptives for Treating Premenstrual Dysphoric Disorder in Bipolar DisorderCompleted, Canada](https://niyora.com/research/trials/oral-contraceptives-for-treating-premenstrual-dysphoric-nct05098574/) - [Different Does of Acupuncture on Premenstrual Syndrome Efficacy AnalysisStatus unknown, Taiwan](https://niyora.com/research/trials/different-does-of-acupuncture-on-premenstrual-syndrome-nct04296422/) - [Does Adding Oral Contraceptives to Fluoxetine Improve the Management of Premenstrual Syndrome?Status unknown, Egypt](https://niyora.com/research/trials/does-adding-oral-contraceptives-to-fluoxetine-improve-the-nct02562053/) [See all 502 studies on oral contraceptives and drospirenone](https://niyora.com/research/topics/treatment-hormonal-contraceptives/) ## Questions people ask Is Slynd as well studied as Yaz for PMDD? + No. Yaz has two randomized trials showing it eases PMDD's mood, physical and behavioral symptoms, part of why the FDA approved it specifically for PMDD. Slynd is studied and approved as a contraceptive, and researchers haven't tested its effect on PMDD symptoms the same way, so there's far less evidence to point to. Does Slynd ease bloating the same way Yaz does? + Slynd and Yaz both contain drospirenone, which blocks the hormone that causes fluid retention, so both can ease bloating before your period. The difference is estrogen. Yaz pairs drospirenone with ethinyl estradiol, which can cause nausea or breast tenderness in the first few cycles. Slynd, with no estrogen, tends to skip those specific side effects. Can you take Slynd just for birth control, not for PMDD? + Yes. Slynd is approved and prescribed as a contraceptive on its own, with no requirement that you have PMS or PMDD symptoms. Some people notice steadier moods on any hormonal pill, simply because it reduces hormone swings before a period, but that's a possible side benefit, not Slynd's studied use. How long does it take Yaz to help PMDD symptoms? + Yaz's trials tracked symptom change over full cycles, and doctors usually want you to try it for a few cycles before deciding whether it's working. Premenstrual symptoms already vary from month to month on their own, so one good or bad cycle doesn't tell you much either way. Could Slynd treat PMDD if Yaz doesn't work for you? + There's no trial evidence either way, since Slynd hasn't been studied for PMDD specifically. Some doctors try a different hormonal option, including a progestin-only pill, when a first treatment doesn't help enough, but that's an individual decision, not something current evidence confirms will work for PMDD. ## Sources - 1. [[Extracontraceptive benefits of EE/DRSP (Yaz) in 24+4 day regimen]](https://pubmed.ncbi.nlm.nih.gov/20595950/), Minerva ginecologica, 2010 - 2. [Beyaz®: an oral contraceptive fortified with folate](https://doi.org/10.2217/whe.11.68), Women's health (London, England), 2012 - 3. [YAZ in the treatment of premenstrual dysphoric disorder](https://pubmed.ncbi.nlm.nih.gov/18980045/), The Journal of reproductive medicine, 2008 - 4. [YAZ and the novel progestin drospirenone](https://pubmed.ncbi.nlm.nih.gov/18980044/), The Journal of reproductive medicine, 2008 Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗ On this page - [How do Yaz and Slynd differ?](#how-do-yaz-and-slynd-differ) - [Which works better for PMS or PMDD?](#which-works-better-for-pms-or-pmdd) - [How do the side effects compare?](#how-do-the-side-effects-compare) - [Can you switch from one to the other?](#can-you-switch-from-one-to-the-other) - [Which should you ask your doctor about?](#which-should-you-ask-your-doctor-about) - [Research](#research) - [Questions](#faq) Niyora PMS & PMDD support For the hard moment before your period. Private, no account. [Get it on iPhone](https://apps.apple.com/app/niyora-pms-emotions/id6764561688) ## Keep reading Treatment Yaz birth control: what it is and whether it helps PMS Treatment Yaz for PMS: does it work? Treatment Yaz for PMDD: does it work? Treatment Yaz side effects, including mood Treatment How long does Yaz take to work? Treatment PMS treatment: what actually helps Condition What is PMS? Premenstrual syndrome, explained