Drospirenone (Slynd)<i>—</i>A New Progestin-Only Oral Contraceptive

doi:10.1001/jama.2020.1603

Cited by 7 publications

(3 citation statements)

References 5 publications

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“…Drospirenone’s unique pharmacological properties ( Fuhrmann et al, 1996 ; Schindler et al, 2003 ; Kuhl, 2005 ; Bitzer and Paoletti, 2009 ) and its continued popularity in the clinic ( The Medical Letter on Drugs Therapeutics, 2020 ) merited investigation into its impact on the brain and behavior. Collectively, we showed dose-dependent cognitive benefits of drospirenone in young Ovx rats, which were modified by the addition of the synthetic estrogen EE.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Cognitive Impacts of Drospirenone, a Spironolactone-Derived Progestin, Independently and in Combination With Ethinyl Estradiol in Ovariectomized Adult Rats

et al. 2022

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Oral contraceptives and hormone therapies require a progestogen component to prevent ovulation, curtail uterine hyperplasia, and reduce gynecological cancer risk. Diverse classes of synthetic progestogens, called progestins, are used as natural progesterone alternatives due to progesterone’s low oral bioavailability. Progesterone and several synthetic analogs can negatively impact cognition and reverse some neuroprotective estrogen effects. Here, we investigate drospirenone, a spironolactone-derived progestin, which has unique pharmacological properties compared to other clinically-available progestins and natural progesterone, for its impact on spatial memory, anxiety-like behavior, and brain regions crucial to these cognitive tasks. Experiment 1 assessed three drospirenone doses in young adult, ovariectomized rats, and found that a moderate drospirenone dose benefited spatial memory. Experiment 2 investigated this moderate drospirenone dose with and without concomitant ethinyl estradiol (EE) treatment, the most common synthetic estrogen in oral contraceptives. Results demonstrate that the addition of EE to drospirenone administration reversed the beneficial working memory effects of drospirenone. The hippocampus, entorhinal cortex, and perirhinal cortex were then probed for proteins known to elicit estrogen- and progestin- mediated effects on learning and memory, including glutamate decarboxylase (GAD)65, GAD67, and insulin-like growth factor receptor protein expression, using western blot. EE increased GAD expression in the perirhinal cortex. Taken together, results underscore the necessity to consider the distinct cognitive and neural impacts of clinically-available synthetic estrogen and progesterone analogs, and why they produce unique cognitive profiles when administered together compared to those observed when each hormone is administered separately.

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Section: Discussionmentioning

confidence: 99%

Evaluating the Cognitive Impacts of Drospirenone, a Spironolactone-Derived Progestin, Independently and in Combination With Ethinyl Estradiol in Ovariectomized Adult Rats

et al. 2022

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“…(10) Isolated drospirenone, in turn, in addition to gonadotropic blockade, has an antiandrogenic effect, which may promote improvement in acne. (11) Other relevant aspect refers to the way POPs are used. Norethisterone and desogestrel are used continuously, while drospirenone is used in a cyclic regimen, with 24 active pills followed by four days of placebo.…”

Section: What Are the Main Differences Betweenmentioning

confidence: 99%

“…Norethisterone and desogestrel are used continuously, while drospirenone is used in a cyclic regimen, with 24 active pills followed by four days of placebo. 10 11 The effectiveness of POPs depends on the mechanism of action. As norethisterone alone has the main effect on cervical mucus, it depends on high motivation for daily use at the same time (with a maximum delay of three hours).…”

Section: What Are the Main Differences Between Pops? What Are The Eff...mentioning

confidence: 99%

Progestogen-only oral contraceptives

Machado

Politano

2022

Rev Bras Ginecol Obstet

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Special Considerations for Women of Reproductive Age on Anticoagulation

Azenkot

Schwarz

2022

J GEN INTERN MED

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Anticoagulation poses unique challenges for women of reproductive age. Clinicians prescribing anticoagulants must counsel patients on issues ranging from menstruation and the possibility of developing a hemorrhagic ovarian cyst to teratogenic risks and safety with breastfeeding. Abnormal uterine bleeding affects up to 70% of young women who are treated with anticoagulation. As such, thoughtful clinical guidance is required to avoid having young women who are troubled by their menses, dose reduce, or prematurely discontinue their anticoagulation, leaving them at increased risk of recurrent thrombosis. Informed by a review of the medical literature, we present current recommendations for assisting patients requiring anticoagulation with menstrual management, prevention of hemorrhagic ovarian cysts, and avoiding unintended pregnancy. The subdermal implant may be considered a first-line option for those requiring anticoagulation, given its superior contraceptive effectiveness and ability to reliably reduce risk of hemorrhagic ovarian cysts. All progestin-only formulations—such as the subdermal implant, intrauterine device, injection, or pills—are generally preferred over combined hormonal pills, patch, or ring. Tranexamic acid, and in rare cases endometrial ablation, may also be useful in managing menorrhagia and dysmenorrhea. During pregnancy, enoxaparin remains the preferred anticoagulant and warfarin is contraindicated. Breastfeeding women may use warfarin, but direct oral anticoagulants are not recommended given their limited safety data. This practical guide for clinicians is designed to inform discussions of risks and benefits of anticoagulation therapy for women of reproductive age.

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Drospirenone (Slynd)—A New Progestin-Only Oral Contraceptive

Abstract: This Medical Letter review summarizes the mechanism of action and drug interactions of drospirenone, a new progestin-only oral contraceptive, and compares it with norethindrone, its competitor.

Cited by 7 publications

References 5 publications

Evaluating the Cognitive Impacts of Drospirenone, a Spironolactone-Derived Progestin, Independently and in Combination With Ethinyl Estradiol in Ovariectomized Adult Rats

Evaluating the Cognitive Impacts of Drospirenone, a Spironolactone-Derived Progestin, Independently and in Combination With Ethinyl Estradiol in Ovariectomized Adult Rats

Progestogen-only oral contraceptives

Special Considerations for Women of Reproductive Age on Anticoagulation

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