The Drospirenone progesterone only pill
The progesterone only pill ("POP" or “mini pill”) is recommended for women who cannot use oestrogen containing pills e.g. those with migraine with aura, history of thrombosis, and overweight women who smoke.
This article details information about the drospirenone progesterone-only-pill and not older levonorgestrel or norethisterone progesterone-only-pills.
The drospirenone progesterone only pill (Slinda) works in a different way to the older POPs and usually gives a more acceptable bleeding pattern.
It works in a similar way to the combined oral contraceptive pill by suppressing ovulation as well as thickening the cervical mucous and thinning the uterus lining.
It has a contraceptive efficacy of 99% (with perfect pill use), 91% with typical pill use and there is a larger window of opportunity to remember a missed pill compared to older POPs (24 hours instead of 3 hours).
As Slinda does not contain oestrogen, it can be used with more reliability in women who cannot tolerate oestrogen, or for whom oestrogen is considered too risky.
A pack of drospirenone pills (Slinda) contains 24 white hormone pills and 4 green, inactive “placebo” pills. It is available as a private prescription only as it is currently not on the PBS.
Starting Slinda for the first time
If you have not used a hormonal contraceptive in the last month, and you have a natural cycle, take the first tablet of Slinda on the first day of your normal period. If you do this, you will be covered for contraception straight away.
If you don't start the Slinda pills on the first day of your period, you will need to take 7 days of active (white) pills, before you can rely on it as a form of contraception. If this happens, you should use an additional form of barrier contraception (eg. condom) to prevent pregnancy.
If you are switching from a combined pill (i.e. one which contains oestrogen) or a vaginal ring;
If you start Slinda on the next day after your last active pill, or on the day you remove your vaginal ring, you can rely on it as a form of contraceptive straight away.
If there is longer than a day after you stop taking your active pill, or after you remove your vaginal ring, then you will need to take an active white Slinda pill for seven days before you can rely on it for contraception. If this happens, you should use an additional form of barrier contraception (eg. condom) to prevent pregnancy.
If you have been using another progesterone only pill (one that contains levonorgestrel), you can stop that pill and start the next day with Slinda, and you should be covered immediately for contraception.
If you have a device removed eg IUD, implanon etc. take Slinda on the day that you have your device removed.
If you have been having depot injections, take a Slinda tablet on the day you were due for your injection. If you start Slinda straight away, on the same day after stopping these long acting forms of contraception, you should be covered straight away.
After having a baby you can take Slinda on day 21-28 of having a baby, and it will cover you for contraception. If it is longer than 28 days, you must take 7 days of white active pills, use a barrier method such as a condom and take a urinary pregnancy test before you can rely on Slinda as a contraceptive.
Missed pill rules
Less than 24 hrs late
Take the late pill as soon as you realise you have missed it. You will still be covered for contraception. Keep on taking pills regularly, at the same time, in the usual way.
If it is more than 24 hrs late
There is a higher chance of failure. Missed pill rules should be followed, depending on when in the packet you forgot to take the pill.
If you have severe vomiting or diarrhoea
You should apply missed pill rules as you may not have absorbed the tablets.
Frequently Asked Questions about Slinda
Q. Is Slinda safe for breastfeeding mothers ?
Q. Can all women take Slinda?
A. Most women can take Slinda, but not if you have an active blood clot in your body. Slinda is safe for women with other risk factors eg smoking, obesity, family history of blood clots.
Q. Is it reversible?
A. Yes, Slinda is immediately reversible if you stop taking it
Q. What will happen to my periods?
A. Like most hormonal contraceptives, periods will be lighter and may stop when taking Slinda (50% change of periods stopping within one year of use). You may also experience some light breakthrough bleeding, which can usually be managed with a liner. Periods return to usual pattern on ceasing Slinda.