--- title: Yaz vs Junel: ingredient, PMS and PMDD differences description: Yaz pairs drospirenone with estrogen and is FDA-approved for PMDD. Junel uses norethindrone acetate, with far less evidence for premenstrual symptoms. url: https://niyora.com/treatments/yaz-vs-junel/ --- - [Niyora](https://niyora.com/) - [Treatments](https://niyora.com/treatments/) - Yaz vs Junel: how they compare for PMS and PMDD Treatments # Yaz vs Junel: how they compare for PMS and PMDD Yaz and Junel are both combined birth control pills, but their progestins differ: Yaz contains drospirenone and is FDA-approved to treat PMDD, while Junel's norethindrone acetate hasn't been studied for premenstrual symptoms. If PMDD or PMS is your main reason for choosing a pill, the trial evidence favors Yaz. For contraception alone, either can work, and your doctor decides what's safest for you. 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 pairs ethinyl estradiol with drospirenone in a 24 active, 4 placebo day pack, and it's one of four FDA-approved treatments for PMDD. - Junel pairs ethinyl estradiol with norethindrone acetate, usually in a 21 active, 7 placebo day pack, and hasn't been tested for PMDD or PMS. - Two key trials back Yaz's drospirenone combination for easing PMDD's mood, physical and behavioral symptoms. - Yaz's drospirenone hasn't shown extra clotting or potassium risk compared with other combined pills in large safety studies. - Switching between the two pills is common. Your doctor decides timing based on your health history and current pack. ## Strength of evidence Mixed evidence - None - Limited - Mixed - Moderate - Strong Two key trials support Yaz's drospirenone and ethinyl estradiol combination for PMDD, and large safety studies found no added clotting or potassium risk. No trials in this comparison tested Junel's norethindrone acetate for PMS or PMDD, so the evidence is one-sided toward Yaz for premenstrual symptoms. Side by side Yaz and Junel Active ingredients Yaz Ethinyl estradiol 20 mcg + drospirenone 3 mg Junel Ethinyl estradiol + norethindrone acetate Also compared in the table below - Pill regimen - FDA indication for PMDD - Trial evidence for premenstrual symptoms - Potassium and clotting risk - Folate-fortified option | Compared on | Yaz | Junel | | --- | --- | --- | | Active ingredients | Ethinyl estradiol 20 mcg + drospirenone 3 mg | Ethinyl estradiol + norethindrone acetate | | Pill regimen | 24 active days, 4 placebo days | 21 active days, 7 placebo days (iron in placebo for Junel Fe) | | FDA indication for PMDD | Yes, one of four approved PMDD treatments | No published indication for PMDD | | Trial evidence for premenstrual symptoms | Two key trials showed improvement in PMDD mood, physical and behavioral symptoms | No trials identified evaluating PMDD or PMS specifically | | Potassium and clotting risk | Large safety studies found no increased hyperkalemia or clot risk versus other combined pills | Not raised by norethindrone acetate; no comparable safety signal to monitor | | Folate-fortified option | Available as Beyaz, same contraception and PMDD indications | No folate-fortified version | ## How do Yaz and Junel differ? Yaz and Junel are both combined birth control pills, but they pair ethinyl estradiol with different progestins. Yaz combines 20 mcg of ethinyl estradiol with 3 mg of drospirenone, taken for 24 active days followed by 4 placebo days [4]. Drospirenone is unusual among progestins because it has **antimineralocorticoid and antiandrogenic** effects that most other progestins don't share [4]. Junel pairs ethinyl estradiol with norethindrone acetate, an older progestin without those extra effects. Most Junel formulas, including Junel Fe 1/20, follow the standard 21 active days and 7 placebo days, with iron added to the placebo pills in the Fe version. That shortened hormone-free interval in Yaz isn't incidental. A shorter gap between hormone doses smooths out the swings in estrogen and progesterone that can bring on headaches, breast tenderness and mood changes before a period [1]. - Yaz: ethinyl estradiol 20 mcg plus drospirenone 3 mg, 24 active days and 4 placebo days. - Junel: ethinyl estradiol plus norethindrone acetate, usually 21 active days and 7 placebo days. For more on how Yaz's formula works, see [Yaz: what it is and whether it helps PMS](https://niyora.com/treatments/yaz/). ## Which works better for PMS or PMDD? The trial evidence here isn't balanced between the two pills. Two key trials found that Yaz's drospirenone and ethinyl estradiol combination eased the mood, physical and behavioral symptoms of PMDD, including symptoms tied to food cravings, water retention and conflict with people close to you [3]. That evidence is why the FDA approved it as one of four treatments for PMDD, alongside three SSRIs [3]. The shortened hormone-free interval is thought to matter too. Reducing hormone fluctuation across the cycle is linked to fewer withdrawal symptoms, like mood swings and breast tenderness, both in PMDD and in premenstrual symptoms more broadly [1]. Beyaz, a folate-fortified version of the same drospirenone and ethinyl estradiol combination, carries the same contraception and PMDD indications, which suggests the benefit sits with the hormone combination itself [2]. Junel hasn't been tested this way. None of the trials behind this comparison evaluated norethindrone acetate pills for PMS or PMDD specifically, and norethindrone acetate doesn't share drospirenone's antiandrogenic activity. If premenstrual mood symptoms are why you're looking at birth control, the current evidence points toward **drospirenone-containing pills** like Yaz, not Junel. Read more in [Yaz for PMDD: does it work?](https://niyora.com/treatments/yaz-for-pmdd/) and [Yaz for PMS: does it work?](https://niyora.com/treatments/yaz-for-pms/). What the research says These findings come from trials of Yaz itself, not head-to-head studies against Junel or other norethindrone acetate pills [3]. ## How do the side effects compare? Both pills carry the side effects typical of combined hormonal birth control: nausea, breast tenderness and breakthrough bleeding in the first few cycles. Where they differ is in a few risks tied to the progestin itself. | Side effect | Yaz (drospirenone) | Junel (norethindrone acetate) | | --- | --- | --- | | Potassium levels | Can raise potassium slightly; studies of drospirenone-containing pills (including the 30 mcg formulation) found no extra hyperkalemia risk versus other progestins [4] | Not affected by this progestin, so no potassium monitoring needed | | Blood clot risk | Non-interventional studies found no increased clotting risk versus other progestin types [4] | Established safety profile, similar baseline risk to other combined pills | | Mood changes | Possible; individual response varies | Possible; individual response varies | | Acne and hirsutism | Antiandrogenic effect can improve both [1] | Less consistent effect on acne or hair growth | For a fuller list, see [Yaz side effects, including mood](https://niyora.com/treatments/yaz-side-effects/). When to see a doctor If you have kidney problems, adrenal issues, or take potassium-sparing medicines, tell your doctor before starting a drospirenone pill like Yaz. ## Can you switch from one to the other? Switching between combined pills is common, and most people can move from Junel to Yaz or back without a break in protection. A few things matter more than the switch itself: - Your doctor or pharmacist decides exactly when to start the new pack based on where you are in your current one. - If you're switching because of premenstrual mood symptoms, give the new pill a few cycles before judging whether it's helping. See [how long does Yaz take to work](https://niyora.com/treatments/how-long-does-yaz-take-to-work/) for what that timeline usually looks like. - Tell your prescriber about any side effects from your current pill, including mood changes, so they can factor those in. - Mention any other medicines or health conditions again, even if you listed them before, since the progestin is changing. None of this requires guessing on your own. A short conversation with whoever prescribes your pill covers it. ## What should you discuss with your doctor? What you ask depends on what you're trying to solve. - Is my main goal contraception, acne control, or easing premenstrual mood symptoms? - Do I have a condition, like kidney problems or long-term NSAID use, that makes drospirenone riskier for me? - How many cycles should I expect to wait before judging if a pill is helping? - What should I be tracking day to day to show you what's changing? If your premenstrual mood symptoms take over a week of most months, or make it hard to function at work or with people you care about, see a GP or gynecologist and bring two months of daily notes. That record, more than a brand name, usually decides which pill makes sense. Writing down what a day before your period actually looked like can make that record easier to put together. Niyora is a PMS and PMDD support app. Its Moon feature lets you write down what happened, see it from another angle, and draft how you want to respond. That gives you real examples to bring to an appointment, instead of a vague memory of your premenstrual week. For more on options beyond Yaz and Junel, see [Birth control for PMDD: does it work?](https://niyora.com/treatments/birth-control-for-pmdd/). 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 Yaz or Junel better for PMDD? + Yaz has trial evidence for easing PMDD symptoms and FDA approval for that use. Junel hasn't been tested the same way, so there's no published evidence it helps PMDD specifically. If PMDD is your main concern, talk with your doctor about drospirenone-containing pills like Yaz. What's the difference between Yaz and Junel Fe 1/20? + Yaz pairs ethinyl estradiol with drospirenone over a 24 active, 4 placebo day cycle. Junel Fe 1/20 pairs ethinyl estradiol with norethindrone acetate over 21 active days, with iron added to the 7 placebo days. The progestins work differently in the body. Can switching from Junel to Yaz help PMS? + Switching might help if Junel hasn't eased your premenstrual symptoms, since Yaz's drospirenone has trial evidence Junel's progestin doesn't. Give a new pill a few cycles before judging it, and tell your doctor what symptoms you're hoping to change. Does Yaz cause more side effects than Junel? + Yaz can raise potassium slightly, though large safety studies found no extra clotting or hyperkalemia risk compared with other pills. Junel's norethindrone acetate doesn't carry that potassium effect. Both share common combined pill side effects like nausea and breakthrough bleeding early on. When should I see a doctor about premenstrual symptoms? + A doctor or gynecologist visit makes sense if premenstrual symptoms take over a week of most months or disrupt work or relationships. Bring two months of daily notes on what you feel and when, since that pattern matters more than which pill name you're asking about. ## 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 Junel differ?](#how-do-yaz-and-junel-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) - [What should you discuss with your doctor?](#what-should-you-discuss-with-your-doctor) - [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