Medication: Slinda (Drosperinone 4mg)
SLINDA, Drosperinone 4mg
Drospirenone is a synthetic progestogen (ie stops the endometrial thickening) with two special properties:
- Anti-androgenic → helps with acne, oily skin, and excess hair
- Anti-mineralocorticoid → acts like a mild diuretic, reducing bloating, fluid retention, and breast tenderness.
The Prescription
- Each pack contains 28 pills with 4 ‘sugar’ (inert) pills.
- Start on day 1 of your period.
- It is recommended to take the sugar pills, as they help maintain steady estrogen levels and minimise irregular bleeding.
- Skipping the sugar pills may lead to low estrogen, which is usually more significant if you are not taking estradiol as part of MHT.
- After 1 year, even if sugar pills are taken only 20% of users will menstruate
Why Slinda is Good in Perimenopause
Slinda has several advantages in perimenopause, especially when estrogen is also prescribed:
- Supports mood stability and can help those with progesterone intolerance.
- Useful in PMDD and for ongoing cyclical symptoms despite high-dose MHT.
- Provides endometrial protection (effective up to 50 mcg estradiol dose).
- Helps manage heavy or irregular periods.
- Can benefit women with PCOS by improving cycle control and reducing excess hair or acne.
- Suitable for women with migraine because it provides anovulation and stable hormone levels. AND we can add transdermal estrogen which is safer
- Can be combined with micronised progesterone (Utrogestan) and in some cases allows for continuous Utrogestan use.
💡 Note: The estrogen dose in Yasmin (30 mcg ethinyl estradiol) is significantly higher than even 100 mg of estradiol used in MHT, which shows why Slinda is likely to be safe at higher doses.
