Sprintec vs Yaz for PMS and PMDD

Yaz and Sprintec are both combined birth control pills, meaning they contain estrogen and a progestin, but the progestin and the dosing schedule are different.

• Yaz pairs 20 micrograms of ethinyl estradiol with 3 milligrams of drospirenone, a progestin with antiandrogenic and antimineralocorticoid effects [4].
• Yaz uses a 24/4 schedule: 24 active pills followed by 4 placebo days, shortening the hormone-free interval compared with the older 21/7 pattern [2].
• Sprintec pairs ethinyl estradiol with norgestimate, a progestin without drospirenone's antiandrogenic or water-shedding effects.
• Sprintec follows the standard 21/7 schedule: 21 active pills, then 7 placebo days.

The shorter hormone-free interval in Yaz's 24/4 regimen is meant to limit the hormone swings that can bring on headaches, breast tenderness and mood changes during the days off active pills [2]. Sprintec's longer break follows the older pattern most combined pills use. If you're new to how premenstrual hormone shifts work in general, see what is PMS before comparing pills.

PMS and PMDD can both drag down quality of life, especially the emotional side of daily routines, compared with women who don't have these symptoms [1]. That makes the choice between pills more than a preference question.

Yaz is the only one of the two with specific trial evidence for premenstrual dysphoric disorder. Two large randomized trials found Yaz eased the mood, physical and behavioral symptoms of PMDD, including the food cravings, water retention and relationship strain that often come with it [3]. That evidence is why the FDA approved Yaz specifically for PMDD, alongside three antidepressants [3].

Sprintec has not been tested for PMS or PMDD in trials. Like many combined pills, it may smooth out some physical premenstrual symptoms by limiting hormone swings across the cycle, but no study has measured that effect for this particular formulation.

If PMDD is why you're looking at either pill, read more on Yaz for PMDD and Yaz for PMS before you decide.

Yaz and Sprintec share some of the same early side effects, since both are combined estrogen and progestin pills.

• Both can cause nausea, breast tenderness, headache and breakthrough bleeding in the first cycle or two.
• Yaz's drospirenone has a small theoretical chance of raising potassium, because of its antimineralocorticoid effect.
• A 2008 review describing large noninterventional safety studies found no higher risk of raised potassium or blood clots with drospirenone pills compared with other progestins [4].
• Sprintec's norgestimate doesn't carry that same potassium watch, but it also doesn't offer drospirenone's acne or water-retention benefits.

Mood changes can happen on either pill, and they don't always go the way you'd expect. Some people feel steadier on one, others feel worse, especially while the body adjusts. If mood is what you're tracking, Yaz side effects and Yaz and mood go into more detail on what that can look like.

You can usually switch from one combined pill to the other without a hormone-free gap, but the timing matters.

Switching from one combined pill to another usually depends on where you are in your current pack, which sets the right starting day and whether you need backup contraception. Once you switch, track your symptoms daily for a few cycles so you and your doctor can judge whether the new pill is working.

Hormone levels take a few weeks to settle after starting a new pill, and premenstrual symptoms already vary from cycle to cycle. Judging too early is a common reason people give up on a pill that might have worked. See how long does Yaz take to work for a cycle-by-cycle sense of that timeline.

The pill that fits you depends on what you're treating and your own health history.

• If premenstrual mood symptoms take up most of the week before your period, ask about Yaz by name, since it's the one with trial data and FDA approval for PMDD [3].
• If acne is part of the picture, ask about drospirenone's antiandrogenic effect, which Sprintec's norgestimate doesn't share [2].
• Mention any history of raised potassium, kidney problems or blood clots, since that affects which progestin is safer for you [4].
• If you mainly need contraception and don't have diagnosed PMDD, either pill is a reasonable starting point.

Mostly, the right pill comes down to why you're taking it in the first place. For how birth control fits into PMDD care more broadly, see birth control for PMDD.