How should a healthy, non‑pregnant woman of reproductive age take Slynd (drospirenone) progestin‑only oral contraceptive?

How to Take Slynd (Drospirenone) Progestin-Only Pill

Slynd is taken as one 4 mg tablet daily for 24 consecutive days, followed by 4 placebo (inactive) tablets, creating a 28-day cycle that repeats continuously without interruption. 1, 2

Daily Dosing Regimen

• Take one active 4 mg drospirenone tablet at approximately the same time each day for the first 24 days of each 28-day cycle 2
• Follow the 24 active tablets with 4 placebo tablets (days 25-28) 1, 2
• Start the next pack immediately after finishing the placebo tablets, with no break between packs 2

Timing Flexibility: A Key Advantage

Unlike traditional progestin-only pills that require strict 3-hour timing windows, Slynd maintains contraceptive efficacy even with 24-hour delays in pill intake. 3, 1

• Research demonstrates that ovulation inhibition is maintained despite four scheduled 24-hour delays in tablet intake during a single cycle 3
• This provides the same "safety window" as combined oral contraceptives, distinguishing Slynd from traditional progestin-only pills 3, 1
• The overall ovulation rate remained only 0.8% even with multiple intentional 24-hour delays 3

Starting Slynd

Slynd can be started at any time if you are reasonably certain you are not pregnant. 4

• If started within the first 5 days of menstrual bleeding: No backup contraception is needed 4
• If started more than 5 days after menstrual bleeding began: Use backup contraception or abstain from intercourse for the next 2 days 4
• Can be started immediately postpartum (≥21 days), including in breastfeeding women 4

Pre-Initiation Requirements

• No physical examination, blood pressure measurement, pelvic exam, cervical cytology, or laboratory tests are required before starting Slynd in healthy women 4

Expected Bleeding Patterns

• Unscheduled bleeding (intermenstrual bleeding) is very common, occurring in approximately 90-92% of users across all cycles 2
• This irregular bleeding is the most common side effect but does not indicate treatment failure 2
• Slynd provides a more favorable bleeding profile compared to traditional progestin-only pills 1

Safety Profile

• All adverse events in clinical trials were mild or moderate, with no severe events reported 2
• No venous thromboembolism (VTE) events occurred even in subjects with VTE risk factors (31.9% of participants) 2
• This makes Slynd an appropriate option for women at risk of VTE for whom combined oral contraceptives are contraindicated 2

Critical Counseling Points

• Slynd does not protect against sexually transmitted diseases; consistent condom use is necessary for STD/HIV prevention 4
• The 4-day placebo interval and robust ovulation suppression distinguish Slynd from traditional progestin-only pills that require continuous daily dosing without breaks 3, 1
• Contraceptive efficacy: Pearl Index of 0.39 (95% CI 0.01-2.18) with a cumulative pregnancy rate of 0.40% 2

Common Pitfalls to Avoid

• Do not confuse Slynd's 24-hour flexibility with traditional progestin-only pills, which have much stricter timing requirements (3-hour window) 5, 3
• Unlike combined oral contraceptives, progestin-only formulations may worsen acne rather than improve it 4
• Do not discontinue due to irregular bleeding in the first several cycles, as this is expected and does not compromise contraceptive effectiveness 2