Some people who prefer birth control pills can’t use estrogen. Drospirenone is a new progestin-only pill (POP) that differs from the other available POP in some key ways.
Until recently in the United States, the only available POP was norethindrone. Due to its short half-life, the norethindrone POP should be taken at nearly the same time every day.
The drospirenone POP has a longer half-life than the norethindrone POP. This newer option may cause less breakthrough bleeding. It also has more flexible dosing, with a 24-hour missed pill window, similar to that of combined oral contraceptive pills. Drospirenone’s anti-androgenic effects may appeal to some patients and bother others. Drospirenone also has anti-mineralocorticoid effects that may cause slight decreases in blood pressure in some people. While Drospirenone rarely causes hyperkalemia, the FDA recommends checking potassium levels for patients taking other medications that can raise potassium.
Kimble T, Burke AE, Barnhart KT, Archer DF, Colli E, Westhoff CL. A 1-year prospective, open-label, single-arm, multicenter, phase 3 trial of the contraceptive efficacy and safety of the oral progrestin-only pill drospirenone 4 mg using a 24/4-day regimen. Contraception: X. 2020;2,100020. https://doi.org/10.1016/j.conx.2020.100020.
Palacios S, Regidor PA, Colli E, Skouby SO, Apter D, Egarter C, Nappi RE, Skrivanek A, Jakimiuk AJ, Weyers S, Acs N, Elia D, Danielsson KG, Bitzer J. Oestrogen-free oral contraception with a 4 mg drospirenone-only pill: New data and a review of the literature. The European Journal of Contraception & Reproductive Health Care. 2020;25(3): 221-227. doi: 10.1080/13625187.2020.1743828.
The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.