Thomas Dudley Kimble, MD, discusses drospirenone

June 3, 2019

Dr. Kimble discusses a new progestin hormone that can be used for birth control and identifies which patients could benefit from it.

 

DR. KIMBLE: So drospirenone is a fairly new progestin hormone that can be used for contraception.  It is a metabolites spironolactone and the benefit of that is it gives it antiandrogenic activity and antimineralocorticoid activity.  

Well as far as antiandrogenic activity, it means that it can reduce some symptoms of things like acne and hirsutism and then for the antimineralocorticoid effect, it may have some blood pressure-lowering potential and also lose some water weight for women which is popular. 

Drospirenone has been around for several years in combined forms of birth control.  But now this will be the first progestin-only drospirenone pill in the United States.  

So drospirenone is progestin-only, meaning there is no estrogen component to it and the Pearl Index was 2.9. That is very similar to another very common and popular on the market, Lo Loestrin, which had a Pearl Index of 2.92.

There is no estrogen so it is safe in breastfeeding mothers.  It is progestin-only and was shown to be safe in both the mom and the baby. 

A patient who is going to start drospirenone should, if she has a history of hypertension and is taking blood pressure medications, she should just discuss it with her primary care doctor to make sure that she’s not on any other agents that could raise potassium levels. Although we want to clarify that it is not standard of care to screen people’s potassium level in order to start this medication.  

So the takeaway is we’ve got a great new progestin-only form of birth control, which really widens the options for women.  It is an oral contraceptive and there are women who still want to an oral contraceptive as their method of birth control.  It’s progestin-only, so it’s safe.  It’s safe in women who have migraines, women who smoke, women who have hypertension and women at the higher end of the reproductive age spectrum. And so it’s got a wide offering of people who it would be efficacious for.

Disclosures:

Dr. Kimble receives research funding from Exeltis.