Birth Control Methods for Women: Limited or One-Time-Use

With so many different types of birth control for women, one of the first steps in figuring out which one is right for you is understanding the differences between each of them and their advantages and disadvantages. 

Some birth control methods are placed in the uterus, such as IUDs (intrauterine devices), while other contraceptives are taken orally (to be discussed in Part 2: Birth Control Methods for Women: Oral Contraceptives). The birth control methods that work best for you and fits your lifestyle will depend on a number of factors, including (but not exclusive to):

• Your current health and any medical conditions
• How often you engage in sexual activity
• How many partners you engage in sexual activity with
• How soon you and your partner wish to have children 
• Whether or not the birth control method will be correctly used on a consistent basis
• Side effect profile of the birth control method

In this article, we look at one-time-use birth control methods. Stay tuned for our future articles where we’ll also cover IUDs and oral contraceptives.

One-Time Use Birth Control Methods

Internal condom

A type of single-use condom, an internal condom for women is a polyurethane pouch that is placed inside the vagina. This may reduce the risk of STIs and pregnancy. While perfect use has a 95% effectiveness rating, typical use has a 79% effectiveness rating. 

Advantages

• Latex-free and suitable for those with allergies to other materials
• Suitable for those who cannot take a pill with hormones 
• Can be placed and left inside the vagina eight hours before intercourse

Disadvantages

• It may take time to learn how to use them perfectly in order to ensure higher effectiveness
• Much pricier than condoms for men with most internal condoms costing $2-4 each

Diaphragm

A round and flexible disk made of silicone is inserted into the vagina to block sperm from reaching the cervix. Before use, it is saturated with spermicide. This type of birth control requires a prescription from a doctor and may be covered by health insurance. In terms of the effectiveness rate for a diaphragm, perfect use has approximately 96% effectiveness, while typical use has approximately 88% effectiveness. 

Advantages

• Can be reusable as long as spermicide is reapplied before intercourse
• Replaced every two years, making it a cost-effective choice
• Similar to an internal condom, most diaphragms are hormone and latex-free
• Can be left in the vagina for 24 hours, provided more spermicide is reapplied every 6 hours

Disadvantages

• Spermicide is required for every use
• Requires careful timing with spermicide application—for those who are forgetful, this will reduce the effectiveness of a diaphragm 
• Not recommended for women who are at a higher risk of contracting a UTI (urinary tract infection)
• May shift out of place during intercourse

Sponge

If you’ve never heard of a sponge before as a type of birth control method, we understand that it might sound strange! While the name may throw you off, a sponge is a birth control method that is placed inside the vagina, blocking the cervix (similar to the diaphragm above). In terms of how effective a sponge is, perfect use is approximately 91% effective, while typical use is 80% effective. 

Advantages

• Similar to other birth control methods mentioned so far, sponges feature no latex, making it an option for women with allergies to other materials
• Can also be placed in the vagina for 24 hours ahead of intercourse

Disadvantages

• Similar to a diaphragm, sponges need to be saturated with spermicide and will have similar associated disadvantages, such as remembering to reapply
• Unlike a diaphragm, sponges are truly one-time use like an internal condom
• Can be harder to position
• After intercourse, the sponge must be left in the vagina for six hours 
• Slightly increased risk of toxic shock syndrome
• Pricy for a one-time use method at around $4-6 each

Cervical Cap

Placed inside the vagina, cervical caps prevent sperm from entering the uterus. Similar to a diaphragm, cervical caps are technically reusable but you will need to reapply it with spermicide. These do require a prescription from a doctor, which may be covered by your health insurance. 

In terms of effectiveness, perfect use of a cervical cap is approximately 86%, while typical use (including women who have given birth before) has a 71% effectiveness. Note that perfect use is for those who are not only using the cervical cap in the correct position and spermicide application but have also never given birth before.

Advantages

• Similar to other internal birth control methods mentioned above, cervical caps are an option for women with allergies to certain materials or who want to stay away from birth control with hormones
• Can be left in the vagina for 48 hours
• Spermicide does not need to be reapplied
• Can be replaced every year, making it a cost-effective option

Disadvantages

• Cervical caps must remain in the vagina for four hours after intercourse
• One of the lower effectiveness ratings in terms of birth control

Finding the right birth control method for you

In general, these one-time use birth control methods are a better choice for those who are looking to get pregnant in the near future. However, a lot of these options use spermicide, which means these are not for those with allergies to spermicide. 

We always recommend speaking to your doctor to learn more about effective birth control methods for you. In future articles, we’ll be covering IUDs and oral contraceptives, so check our blog!

Do not take Slynd® if you:

• have kidney disease or kidney failure
• have reduced adrenal gland function (adrenal insufficiency)
• have or have had cervical cancer or any cancer that is sensitive to female hormones
• have liver disease, including liver tumors
• have unexplained vaginal bleeding

If any of these conditions happen while you are taking Slynd®, stop taking Slynd® right away and talk to your healthcare provider. Use non-hormonal contraception when you stop taking Slynd®.

Click here to read more Important Risk Information and Full Prescribing Information.

Slynd® is a trademark of Chemo Research, S.L.

©2022 Exeltis USA, Inc. All rights reserved. EXP-21-0024 R00

9 Facts About Birth Control Pills

From different brands to different types of birth control pills, women today have many options when it comes to choosing an oral contraceptive that is right for their needs. 

Modern oral contraceptives have been around for decades and the industry has seen some unique innovations, such as pills that contain less estrogen to products like Slynd‘s estrogen-free pill featuring a 24-hour dosage window. 

In this article, let’s take a look at some fun and interesting facts about birth control pills!

1. What’s the difference between a combination pill (combined oral contraceptive or COC) vs. a mini-pill?

A combination pill has both estrogen and progestin. These are hormones that prevent pregnancy. A mini-pill or “POP” are pills that only contain progestin. For some women who are at a higher risk of developing blood clots or are breastfeeding, an estrogen-free pill may be the better choice. Learn more in our article, What’s the difference between progestin and estrogen in birth control pills?

2. The effectiveness of a birth control pill may be impacted by your weight. 

Women with a higher BMI greater than 27.3 have a 60% higher chance of getting pregnant when taking the pill.² Of course, this doesn’t mean they can’t take oral contraceptives. Certain progestin-only pills may be a more effective option when compared to oral contraceptives that contain estrogen. For example, Slynd® is an estrogen-free pill that doesn’t have an upper BMI listed on its label and can be an effective choice for some women.

3. Did you know that the pill was approved by the FDA in 1960?

While an application was submitted in 1959, the FDA didn’t make a decision right away. The issue wasn’t about safety, but the revolutionary concept of the pill itself. If the pill was approved, this would make it the first case where the drug’s purpose wasn’t to target a health concern, but rather it was meant to be used in a more social context.³ Eventually, the first oral contraceptive was approved for use in 1960 but initially, it was only available for limited use of no longer than two years at a time. The reason for this limitation was because regulators didn’t yet fully understand the long-term safety of taking the pill.

4. How exactly does a morning-after pill work? 

The morning-after pill is another type of oral contraceptive. However, unlike combination pills and mini-pills, the morning-after pill isn’t meant to be taken as the primary birth control option. Instead, it’s used in emergencies as a backup when your primary birth control method has failed, such as a broken condom or forgetting to take your pill on time. The morning-after pill works by delaying or preventing ovulation but doesn’t stop a pregnancy if a fertilized egg has implanted.⁴

Common side effects of the morning-after pill include nausea, vomiting, dizziness, headaches, breast pain or tenderness, abdominal cramps, fatigue, and bleeding between periods.

5. For women, the pill is one of the most common forms of birth control.

In a 2017-2019 study that looked at popular forms of contraception in the U.S. among women aged 15-49, female sterilization ranked #1 at 18.1%, while oral contraceptives came in at #2 at 14%.⁵ The study found that as women get older, pill usage generally decreases while female sterilization increases. 

6. Oral contraceptives weren’t legally available to everyone until the 1970s.

Remember how we said the FDA approved the pill in 1960? Well, it was primarily available for married couples and laws were still in place that prevented the pill from being prescribed to single women. Eventually, a case arguing against this unequal treatment was brought before the U.S. Supreme Court, which paved the way for the pill to be available to everyone regardless of their marital status.⁶

7. Could oral contraceptives reduce the risk of cancer?

While the majority of research has come from observational studies which means a definitive link cannot be determined, they do provide consistent evidence that suggests women who take the pill have a 30% decreased risk of endometrial cancer, a 30-50% decreased risk of ovarian cancer, and a 15-20% decreased risk of colorectal cancer.⁷

To learn more, click here.

8. Just like other medication, birth control pills have an expiry date

When taking your pill, be sure to check the expiration date on the packaging. You should not take expired medication as it may be less effective at preventing pregnancy. After a certain period of time, the composition of the medicine may also change and may increase the risk of unwanted side effects.

9. How do you find the pill that’s right for you? 

When it comes to oral contraceptives, every pill is different. You may find that you experience side effects when taking one pill, but fewer side effects when taking a different brand. Some pill formulations might not fit what you’re looking for in terms of the hormones used, while another pill might offer more convenient features that fit your lifestyle. 

Be sure to talk to your doctor about what you’re looking for to find the fill that’s right for you. For a convenient way to speak to a healthcare professional, learn more about how you can connect with a doctor online.

Do not take Slynd® if you:

• have kidney disease or kidney failure
• have reduced adrenal gland function (adrenal insufficiency)
• have or have had cervical cancer or any cancer that is sensitive to female hormones
• have liver disease, including liver tumors
• have unexplained vaginal bleeding

If any of these conditions happen while you are taking Slynd®, stop taking Slynd® right away and talk to your healthcare provider. Use non-hormonal contraception when you stop taking Slynd®.

Click here to read more Important Risk Information and Full Prescribing Information.

Slynd® is a trademark of Chemo Research, S.L.

©2022 Exeltis USA, Inc. All rights reserved. EXP-21-0024 R00

Resources

1. McCarthy, S. (2011, September 25). Don’t worry, darling, I have giant fennel. Salon. Retrieved July 4, 2022, from https://www.salon.com/1999/07/01/fennel/
2. Stacey, D. (2021, December 30). Five must know facts before you start taking the pill. Verywell Health. Retrieved July 4, 2022, from https://www.verywellhealth.com/must-know-facts-about-the-pill-906934
3. Public Broadcasting Service. (n.d.). The FDA approves the pill. PBS. Retrieved July 4, 2022, from https://www.pbs.org/wgbh/americanexperience/features/pill-us-food-and-drug-administration-approves-pill/
4. Mayo Clinic Team. (2022, June 3). Morning-after pill. Mayo Clinic. Retrieved July 4, 2022, from https://www.mayoclinic.org/tests-procedures/morning-after-pill/about/pac-20394730
5. Daniels, K., & Abma, J. C. (2020, October 20). Current Contraceptive Status Among Women Aged 15–49: United States, 2017–2019. Centers for Disease Control and Prevention. Retrieved July 4, 2022, from https://www.cdc.gov/nchs/products/databriefs/db388.htm
6. Casebriefs. (n.d.). Eisenstadt v. Baird. Casebriefs. Retrieved July 4, 2022, from https://www.casebriefs.com/blog/law/family-law/family-law-keyed-to-weisberg/private-family-choices-constitutional-protection-for-the-family-and-its-members/eisenstadt-v-baird/
7. National Cancer Institute. (2018, February 22). Oral contraceptives (birth control pills) and cancer risk. National Cancer Institute. Retrieved July 4, 2022, from https://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/oral-contraceptives-fact-sheet
8. McDermott, A. (2016, December 18). Do birth control pills expire? Healthline. Retrieved July 4, 2022, from https://www.healthline.com/health/do-birth-control-pills-expire

What you need to know about starting birth control pills

When can women start using birth control pills? What are some of the risks involved?

Here are seven quick things you need to know before starting birth control pills!

Questions to ask your doctor about birth control pills

For many women, speaking to their doctor is the first step to finding a birth control option that’s right for them. While it can be easy to feel overwhelmed learning about different types of pregnancy prevention methods, consider writing a list of important questions you want to ask your doctor about birth control pills. Some examples include:

• Are birth control pills a safe option for me?
• What is the difference between combined oral contraceptives (COCs) and progestin-only pills (POPs, also known as the mini-pill)?
• Based on my medical history and lifestyle, do I have a higher risk of blood clots or other cardiovascular issues?
• What happens if I forget to take a pill one day?
• How effective are oral contraceptives?
• If I’m currently taking medication for another health issue, can I still take birth control pills?

Birth control pills can fit your needs and lifestyle

Long gone are the days when women had a limited selection of birth control pills to choose from. Innovations in the industry have led to new products that offer more flexibility and freedom. With Slynd®, we believe your birth control pill should fit your needs and your lifestyle, not the other way around!

An important distinction to make when it comes to oral contraceptives is COCs (combined oral contraceptives) versus POPs (progestin-only pills). COCs contain two types of hormones—estrogen and progestin—that prevent pregnancy. On the other hand, POPs only contain progestin and are safer for women who smoke and those who may be at risk of adverse side effects when taking a pill with estrogen.

For some women, such as those who are overweight or smoke, COCs may be less effective and may lead to increased risks of side effects. COCs contain a boxed warning regarding increased risk of blood clots in women over the age of 35 who smoke. POPs, which do not contain estrogen, do not have a boxed warning and are a safer option.

Who is at a higher risk of side effects?

When speaking to your doctor about starting birth control pills, they will ask about your medical history. Certain health conditions (i.e. liver cancer, serious cardiovascular risk such as heart attacks) and lifestyle choices may lead to a woman having a higher risk of side effects when taking birth control pills. These include:

• Women who are smokers and are 35 years old or older
• Women who have a history of breast cancer, heart disease, or stroke
• Women with high blood pressure or have a history of blood clotting
• Women who have had diabetes for more than 10 years
• Women who suffer from migraine headaches

When can teenage girls start birth control pills?

In addition to preventing pregnancy, some young women may also want to take oral contraceptives as a way to control their acne. Slynd® contains drospirenone, which is a more appropriate birth control hormone for those suffering from skin-related problems, like acne.

In addition to the list above about certain health conditions, girls who have unexplained vaginal bleeding or think they may be pregnant should not start or take oral contraceptives. Before prescribing oral contraceptives, doctors or registered nurses may also conduct a physical exam (including a pelvic exam).

The most common age for teenage girls to start birth control pills is 16 since, at this age, most will have an established menstrual cycle. We recommend speaking to your doctor to learn more about whether or not oral contraceptives are the best option for you.

One question younger women might be asked by their doctor is whether or not they can reliably take the pill at the same time every day. This is because a pill must be taken in a short window of time every day in order to be effective.

After getting your first pack of pills, when should you start them?

Consult with your doctor on when you should take your pills. In many cases, women will start taking their birth control pills as soon as they have them, even during their period. Visit our FAQ section to learn when to start taking Slynd® pills if:

• You haven’t been taking any other form of hormonal birth control
• You’re switching from another birth control pill
• You’re switching from a vaginal ring or transdermal patch
• You’re switching from a different progestin-only method, such as an implant or injection
• Or you’re switching from an intrauterine device or system (IUD or IUS)

Slynd® Day 1 Start: You will use a Day 1 Start if your healthcare provider told you to take your first pill (Day 1) on the first day of your period.

• Take 1 pill every day in the order of the blister pack, at the same time each day, for 28 days. After taking the last pill on Day 28 from the blister pack, start taking the first pill from a new pack, on the same day of the week as the first pack. Take the first pill in the new pack whether or not you are having your period.

What should I do if I miss any Slynd® pills?

If you miss 1 white pill (active pills):

• Take it as soon as you remember. Take the next pill at your regular time. This means you may take 2 pills in 1 day.
• Then continue taking 1 pill every day until you finish the pack.
• You do not need to use a back-up birth control method if you have sex.

If you miss 2 or more white pills (active pills), follow these steps:

• Take a pill as soon as you remember. Take the next pill at your regular time. This means you may take 2 pills in 1 day.
• Then continue to take 1 pill every day until you finish the pack (this will mean one or more missed white pills will remain in the blister pack).
• Use a non-hormonal birth control method (such as a condom or spermicide) as a back-up if you have sex during the first 7 days after missing your pills.

How long should oral contraceptives be taken?

Healthy women can take the pill on an ongoing basis as long as they require birth control or until they experience menopause. For older women who haven’t had a menstrual cycle for at least a year, this signals that they have reached menopause. At this stage, the changing hormone levels within the body means the ovaries aren’t releasing any eggs so women can’t get pregnant naturally.

Women who are trying to get pregnant should speak to their doctors about stopping their oral contraceptives. This is also an opportunity to get a pre-pregnancy check-up to ensure you are in full health before getting pregnant.

For older women who haven’t had a menstrual cycle for at least a year, this signals that they have reached menopause. At this stage, the changing hormone levels within the body means the ovaries aren’t releasing any eggs so women can’t get pregnant naturally.

Taking your pill every day

Birth control pills are most effective when they’re taken at the same time every day so the important question to ask yourself is whether or not this is realistic based on your schedule and lifestyle. For progestin-only pills (POPs), until recently, all of them offer a short 3-hour missed pill window. Slynd® now offers a much more generous and flexible 24-hour missed pill window.

Maintaining a schedule to take the pill on time can be a breeze for some women, but may be difficult and stressful for other women. Talk to your doctor about ways you can help yourself remember to take the pill on time and whether it’s the right option for you.

Your pill, your way

It’s important to speak to your doctor about how birth control pills can support your health and lifestyle. While some of the terminologies can get confusing, don’t worry—we can help! Here are some educational resources to help get you started:

• What’s the difference between progestin and estrogen in birth control pills?
• What are “POPs”?

Do not take Slynd® if you:

• have kidney disease or kidney failure
• have reduced adrenal gland function (adrenal insufficiency)
• have or have had cervical cancer or any cancer that is sensitive to female hormones
• have liver disease, including liver tumors
• have unexplained vaginal bleeding

If any of these conditions happen while you are taking Slynd®, stop taking Slynd® right away and talk to your healthcare provider. Use non-hormonal contraception when you stop taking Slynd®.

Click here to read more Important Risk Information and Full Prescribing Information.

Slynd® is a trademark of Chemo Research, S.L.

©2022 Exeltis USA, Inc. All rights reserved. EXP-21-0024 R00

Resources

1. The Healthline Editorial Team , & Boyers, L. (2022, June 29). Your guide to birth control pills: Types, effectiveness, and safety. Healthline. Retrieved July 4, 2022, from https://www.healthline.com/health/birth-control/birth-control-pills
2. Gordon, L. P. (Ed.). (2022, January). Birth control pill (for teens) – Nemours KidsHealth. KidsHealth. Retrieved July 4, 2022, from https://kidshealth.org/en/teens/contraception-birth.html
3. Kramer, R. (2021, February 8). 4 essential questions about teen birth control. Virtua Health System: South Jersey Healthcare & Hospitals. Retrieved July 4, 2022, from https://www.virtua.org/articles/4-essential-questions-about-teen-birth-control
4. Roland, J. (2022, March 23). How long is too long to be on birth control pills? Healthline. Retrieved July 4, 2022, from https://www.healthline.com/health/birth-control/how-long-is-too-long-to-be-on-birth-control
5. Pietrangelo, A. (2017, May 4). Menopause and pregnancy: What you should know. Healthline. Retrieved July 4, 2022, from https://www.healthline.com/health/menopause/menopause-pregnancy
6. Planned Parenthood. (n.d.). How do I use the birth control pill? Planned Parenthood. Retrieved July 4, 2022, from https://www.plannedparenthood.org/learn/birth-control/birth-control-pill/how-do-i-use-the-birth-control-pill
7. Mayo Clinic Team. (2021, June 12). Birth control pill FAQ: Benefits, risks and choices. Mayo Clinic. Retrieved July 4, 2022, from https://www.mayoclinic.org/healthy-lifestyle/birth-control/in-depth/birth-control-pill/art-20045136

What are “POPs”?

When considering oral contraceptives, two common options include combination oral contraceptives (COCs), which contain both estrogen and progestin, and progestin-only pills (POPs). In our What’s the difference between progestin and estrogen in birth control pills?, we looked at the major differences between these hormones and the benefits and drawbacks of COCs versus POPs.

Keep reading to learn more about progestin-only pills, how effective POPs are, potential side effects of this type of oral contraceptive, and women who may want to consider a POP over a pill that uses estrogen.

How do progestin-only pills work?

The key difference between POPs and COCs is that POPs do not contain estrogen. Instead, progestin is the primary hormone used to prevent pregnancy.

Progestin-only birth control pills prevent pregnancy by thickening the mucus of the cervix. This makes it harder for sperm to enter the uterus to fertilize an egg. As a synthetic form of progesterone (which is naturally produced in the body), progestin stops ovulation but this process is not always consistent.

Studies show that roughly four out of ten women who use progestin-only pills will still ovulate. Another way POPs prevent pregnancy is that it thins the lining of the uterus. This means any egg that is fertilized will have a harder time implanting itself to the wall of the uterus. Similar to other oral contraceptives, POPs do not prevent STDs (sexually transmitted diseases) or HIV. Because certain birth control methods do not provide skin-to-skin protection (oral contraceptives and IUDs), use a barrier method to protect against STDs, such as condoms.

POPs are taken orally and in order to be effective, must be taken once per day at the same time every day. Typical progestin-only pills come in a pack of 28 tablets, all of which contain active hormones with no placebo. However, Slynd®, a newer progestin-only pill, features 24 white active pills and four green inactive or placebo pills which helps to provide a scheduled withdrawal bleed that can be planned and anticipated.

As with all medical products, read the patient package insert or ask your doctor to learn how to properly store your pills to ensure product stability and shelf-life.

How effective are progestin-only pills?

Clinical studies are performed to evaluate the effectiveness of POP products. These trials often look at both typical use and perfect use. When looking at typical use, approximately nine out of 100 women will become pregnant during the first year of using a POP. It’s important to keep in mind that these findings are based on other POPs that offer a 3-hour missed pill window. As the only POP with a more flexible 24-hour missed pill window, Slynd® has a Pearl Index of just 4.0 Pearl Index (2.3, 6.4; 95% CI).

Even if you’re taking your progestin-only birth control pills on schedule and ensure it’s safely stored, there are certain medications that may impact how effective the pill is in preventing pregnancy. Certain medications, such as Rifampin, some barbiturates, and griseofulvin, may make POPs less effective. Before taking birth control pills, inform your doctor of any other medication you may be taking.

The effectiveness of POPs may also be negatively impacted if you experience vomiting or diarrhea, resulting in your body not properly absorbing the pill. In this situation, women should use another method of birth control, such as a condom, for at least 48 hours.

Progestin products like Micronor® that use norethindrone offer a 3-hour window during which women must take the pill for it to be effective. Instead of using norethindrone, Slynd® uses drospirenone, another form of progestin. Slynd® is the only progestin-only pill that offers a 24-hour missed pill window. This means that you can be up to 24 hours late in taking your next Slynd® pill without compromising its effectiveness. However, it is still recommended that you take your pill at the same time every day for maximum effectiveness.

What are common side effects when taking progestin-only pills?

When using progestin-only pills, women may experience a lighter period with less blood flow and cramping. Certain women may also experience no periods at all when taking the pill. POPs have also been linked to a reduced risk of pelvic inflammatory infection, anemia, and endometrial cancer.

One adverse side effect when taking progestin-only pills, particularly those that use norethindrone, include erratic or unscheduled bleeding. Slynd®, unlike typical progestin-only pills, has a tolerable bleeding profile comparable to combined oral contraceptives. In clinical studies, there was as little as <1% (0.4%) discontinuation rate due to bleeding irregularities.

Other side effects of POPs may include headaches, acne, nausea, breast tenderness, lower sex drive, and weight gain.

Who should or shouldn’t take progestin-only pills?

Certain women who are more sensitive to estrogen may want to consider a progestin-only pill in order to avoid introducing additional hormones to their bodies.

Who should consider taking progestin-only pills?

Increased levels of estrogen may impact breast milk production during the postpartum period, so women who are breastfeeding will want to consider a POP instead of a combined pill.

Progestin-only pills are considered safe for older women (35 years old and older) who experience high blood pressure, blood clots, or migraine headaches with aura. Women who smoke should also avoid estrogen-based oral contraceptives, but POPs are a viable and safe alternative.

Who should not take any birth control pills, including progestin-only pills?

Women who have had breast cancer in the past or have a history of breast cancer in their family should not take a progestin-only pill. Additionally, those who experience severe cirrhosis, acute liver disease, abnormal uterine bleeding, or have benign or malignant liver tumors should not take POPs.

What are some common side effects of POP products?

With progestin-only pills, some of the common side effects include headaches, nausea, breast pain and tenderness, weight gain, decreased sexual drive, menstrual cramps, and acne. Speak to your doctor if side effects persist or worsen.

Choosing the progestin-only pill that’s right for you

When considering a progestin-only pill or combination birth control pill, always speak to a doctor to learn more about which product is right for you and your needs.

Do not take Slynd® if you:

• have kidney disease or kidney failure
• have reduced adrenal gland function (adrenal insufficiency)
• have or have had cervical cancer or any cancer that is sensitive to female hormones
• have liver disease, including liver tumors
• have unexplained vaginal bleeding

If any of these conditions happen while you are taking Slynd®, stop taking Slynd® right away and talk to your healthcare provider. Use non-hormonal contraception when you stop taking Slynd®.

Click here to read more Important Risk Information and Full Prescribing Information.

Slynd® is a trademark of Chemo Research, S.L.

©2022 Exeltis USA, Inc. All rights reserved. EXP-21-0024 R00

Resources

• Progestin-only hormonal birth control: Pill and injection. ACOG. (2020, October). Retrieved July 4, 2022, from https://www.acog.org/womens-health/faqs/progestin-only-hormonal-birth-control-pill-and-injection
• Edwards, M., & Can, A. S. (2021). Progestin. StatPearls. Retrieved July 4, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK563211/ 
• Centers for Disease Control and Prevention. (2017, February 1). CDC – progestin-only pills – US SPR – Reproductive Health. Centers for Disease Control and Prevention. Retrieved July 4, 2022, from https://www.cdc.gov/reproductivehealth/contraception/mmwr/spr/progestin.html
• U.S. National Library of Medicine. (2021, March 15). Progestin-only (norethindrone) oral contraceptives: Medlineplus drug information. MedlinePlus. Retrieved July 4, 2022, from https://medlineplus.gov/druginfo/meds/a602008.html
• Progestin Only Birth Control Pills. Florida State University Health Services. (2017, July). Retrieved July 4, 2022, from https://uhs.fsu.edu/sites/g/files/upcbnu1651/files/docs/Progestin%20Only%20Pills_a.pdf
• Progestin-Only Contraception Pill (POPs). UC Berkeley University Health Services. (n.d.). Retrieved July 4, 2022, from https://uhs.berkeley.edu/sites/default/files/pops.pdf
• Stanborough, R. J. (2020, May 28). Birth control without estrogen: Minipill and other options. Healthline. Retrieved July 4, 2022, from https://www.healthline.com/health/birth-control-without-estrogen
• Am Fam Physician. (2000, October 15). Progestin-only contraceptives. American Family Physician. Retrieved July 4, 2022, from https://www.aafp.org/pubs/afp/issues/2000/1015/p1849.html

What’s the difference between progestin and estrogen in birth control pills?

When considering which oral contraceptive is right for you, two medical terms you might come across are progestin (a synthetic form of progesterone) and estrogen. These refer to two female sex hormones that are used in birth control products. Outside of their use in contraceptives, estrogen and progesterone are naturally produced in the female body and play key roles in regulating certain body functions in women throughout puberty, pregnancy, and menopause.

As two common hormones found in oral contraceptives, understanding the differences between combination pills and progestin-only pills can help you select one that fits your needs and lifestyle. In this article, we will look at the major differences between progestin and  estrogen as it relates to birth control, and why the pill is not “one size fits all.”

What you need to know about progestin

Progestin is a synthetic form of progesterone, which is a female hormone found in a woman’s body. As a naturally occurring hormone, progesterone is released from the ovaries to prepare the body for pregnancy. Progesterone also plays an important role during pregnancy. It contributes to maternal breast tissue growth while also preventing lactation, and prepares the body for labor by strengthening the wall muscles around the pelvic area.

Some common uses for progestin in products outside of contraception include treating abnormal uterine bleeding, severe premenstrual syndrome (PMS), and postmenopausal hormone replacement therapy.

Do progestin products have any adverse side effects? When taking oral contraceptives that contain progestin, some women may experience side effects including ovarian cysts, breast tenderness, headaches, fatigue, nausea, and hair thinning.

Other studies analyzing other side effects, such as the impact on sex drive and development of mood disturbances, are limited in terms of evidence and may offer conflicting views.

If you’re experiencing any adverse side effects when taking oral contraceptives, make sure to talk to your doctor.

What you need to know about estrogen

Like progesterone, estrogen is a sex hormone naturally produced in the body and is responsible for developing female sexual characteristics. For example, during puberty, estrogen contributes to the development of mammary ducts. During pregnancy, it supports functions that secrete breast milk.

Estrogen is commonly found in birth control products, such as oral contraceptives and vaginal rings. It is also found in products that treat symptoms during menopause, such as hot flashes, vaginal dryness, and itching.

Some side effects of taking estrogen products include nausea, cramps, headaches, weight gain, and abnormal uterine bleeding.

If you’re experiencing any adverse side effects when taking oral contraceptives, make sure to talk to your doctor.

Combination birth control pills or progestin-only pills?

Combination Oral Contraceptives (COCs)

Combination birth control pills contain both estrogen and progestin. When used in birth control pills, progestin and estrogen thicken the mucus inside the cervix, making it harder for sperm to travel to the egg. They also work to thin the lining of the uterine wall so that if an egg is fertilized, it is more difficult to implant.

COCs are most effective when the pills are taken correctly according to the instructions. Most products on the market use a one-phase dosing cycle, or monophasic. In other words, tablets of one strength are taken for 21 days. A monophasic dosing cycle with 28 days will include seven inactive or placebo pills that are another color.

Other dosing schedules include biphasic (two-phase), triphasic (three-phase), and even quadriphasic (four-phase). The differences between these phases are the number of different colored pills formulated with different strengths. The benefit of a monophasic dosing cycle is that it’s much more straightforward and easier for patients to remember—they don’t have to remember what color pill corresponds to what formulation strength. Learn more about dosing schedules in this Mayo Clinic article.

Combined birth control pills typically have a tight 3-hour dosage window. They contain varying levels of estrogen and also in different forms (chewables, soft gels, tablets).

Chewables or soft gels have similar side effects as other traditional combined pills, including headaches, breakthrough bleeding, nausea, and weight gain. However, similar to other COC products, side effects may vary from person to person.

A benefit of chewable birth control is that it may be easier to swallow, especially for women who are experiencing nausea. While not chewable, soft gel capsules are more flexible and easier to swallow than traditional pills.

It is important to note that all combined oral contraceptives contain a boxed warning about the increased risk of heart and blood vessel problems as well as death from blood clots, heart attack, or stroke in females that smoke and are over 35, which increases with age and the number of cigarettes smoked and is therefore not recommended in this group.

Progestin Only Pills (POPs)

Progestin-only pills (POPs) only contain progestin (no estrogen) and typically have a lower dose of progestin compared to a combination pill with both progestin and estrogen. Progestin-only birth control pills also prevent pregnancy by thickening the mucus of the cervix and thinning the lining of the uterine wall.

For women who are breastfeeding and want to take oral contraception, doctors may recommend a progestin-only pill since estrogen may interfere with the production of breastmilk.

POPs are also a more suitable option for women who smoke and are over the age of 35 because they do not contain estrogen. Patients with a history of blood clots or high blood pressure are better off taking a POP due to the increased cardiovascular risk seen with combined oral contraceptives.

Doctors may not recommend POPs for women who have had breast cancer, have liver disease, serious cardiovascular risk, have had cardiovascular surgery or other issues, or take other drugs that may interfere with the effectiveness of the pill.

For a very long time, progestin-only pills only offered a tight 3-hour dosage window during which a woman must take her pill for maximum effectiveness in pregnancy prevention. However, that changed when Slynd® entered the market. Slynd® is the first and only POP with a 24-hour missed pill window, comparable to COCs.

When deciding between a combination oral contractive or a progestin-only pill, consult your healthcare provider to learn more about which option best suits you.

Click here to learn more about how Slynd® may fit your needs.

Do not take Slynd® if you:

• have kidney disease or kidney failure
• have reduced adrenal gland function (adrenal insufficiency)
• have or have had cervical cancer or any cancer that is sensitive to female hormones
• have liver disease, including liver tumors
• have unexplained vaginal bleeding

If any of these conditions happen while you are taking Slynd®, stop taking Slynd® right away and talk to your healthcare provider. Use non-hormonal contraception when you stop taking Slynd®.

Click here to read more Important Risk Information and Full Prescribing Information.

Slynd® is a trademark of Chemo Research, S.L.

©2022 Exeltis USA, Inc. All rights reserved. EXP-21-0024 R0

Resources

• U.S. National Library of Medicine. (2015, September 15). Estrogen and progestin (oral contraceptives): Medlineplus Drug Information. MedlinePlus. Retrieved July 4, 2022, from https://medlineplus.gov/druginfo/meds/a601050.html
• WebMD Team. (2020). Progesterone: Overview, uses, side effects, precautions, interactions, dosing and reviews. WebMD. Retrieved July 4, 2022, from https://www.webmd.com/vitamins/ai/ingredientmono-760/progesterone
• Progesterone. You and Your Hormones. (2021, July). Retrieved July 4, 2022, from https://www.yourhormones.info/hormones/progesterone/
• Delgado, B. J., & Lopez-Ojeda, W. (2021). Estrogen. In StatPearls [Internet]. StatPearls Publishing. Retrieved July 4, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK538260/
• Ginta, D. (2021, June 17). What are the symptoms of low estrogen in women and how are they treated? Healthline. Retrieved July 4, 2022, from https://www.healthline.com/health/womens-health/low-estrogen-symptoms
• Gebel Berg E. (2015). The Chemistry of the Pill. ACS central science, 1(1), 5–7. Retrieved July 4, 2022, from https://doi.org/10.1021/acscentsci.5b00066 
• Mayo Clinic Team. (2020, December 17). Combination Birth Control Pills. Mayo Clinic. Retrieved July 4, 2022, from https://www.mayoclinic.org/tests-procedures/combination-birth-control-pills/about/pac-20385282
• Mayo Clinic Team. (2022, February 1). Estrogen and progestin oral contraceptives (oral route) proper use. Mayo Clinic. Retrieved July 4, 2022, from https://www.mayoclinic.org/drugs-supplements/estrogen-and-progestin-oral-contraceptives-oral-route/proper-use/drg-20069422

Two New Publications Support the Safety and Efficacy of Slynd™ (drospirenone) tablets, 4 mg

FLORHAM PARK, N.J. July 7, 2020 – Exeltis USA, Inc., a division of Insud Pharma, today communicated that 2 new articles published in Contraception and The European Journal of Contraception & Reproductive Health Care,  reviewed the US Phase III clinical study involving Slynd™ (drospirenone) tablets 4 mg, a novel estrogen-free oral contraceptive in a physician and patient communication letter.

The publications highlighted the safety and efficacy of drospirenone 4 mg, similarly to the FDA which approved the Slynd™ NDA in May 2019.The first in Contraception, “A one-year prospective, open-label, single arm, multicenter phase 3 trial of the contraceptive efficacy and safety of the oral progestin-only drospirenone 4 mg using a 24/4 daily regimen” (Kimble et al; February 21, 2020), indicated that drospirenone provides a contraceptive option for the majority of women regardless of blood pressure and BMI. The second, “Estrogen-free oral contraception with a 4 mg drospirenone-only pill: new data and review of the literature” (Palacios et al; April 21, 2020), published in The European Journal of Contraception & Reproductive Healthcare-, concluded that drospirenone 4mg has shown contraceptive effectiveness similar to that of currently available COCs (combined oral contraceptives), very low cardiovascular side effects and a favorable bleeding pattern.

“We are pleased to see the Slynd™ clinical study  results being reported in renowned journals,” said  Randi Rievman, Senior Director, Marketing and Sales Training for Exeltis. “The data validates what we have known for some time: Slynd™ is an attractive option for many women who want or need an estrogen-free oral contraceptive. It offers  the right balance of safety and efficacy to address the needs of many women, especially for those who may not be good candidates for other  currently available oral contraceptive options.”

In addition to these findings, Exeltis USA President Salustiano Perez added, “Slynd™ is further differentiated in the market because it is an estrogen-free oral contraceptive product that provides a 24 active plus 4 inactive tablet dosing regimen and allows a 24-hour missed pill window.”

Slynd™ is indicated to prevent pregnancy among females of reproductive potential. Slynd™ is contraindicated in females with conditions that predispose to hyperkalemia (e.g. renal impairment, hepatic impairment, and adrenal insufficiency). Other contraindications include presence or history of progestin sensitive cancers, liver tumors, benign or malignant, or undiagnosed abnormal uterine bleeding. Slynd™ may cause side effects including hyperkalemia, thromboembolism, bone loss, cervical cancer, liver problems, ectopic pregnancy, high blood sugar, changes in menstrual bleeding or depression. Discontinue Slynd™ if a thromboembolic event occurs or there are acute or chronic changes in liver function. For full important risk and use information about Slynd™ please see full  Slynd™ Prescribing Information.

Slynd™ (Drospirenone) tablets, 4 mg Updated Website Launches for Patients and Physicians

FLORHAM PARK, N.J, June 23, 2020 – Exeltis USA, Inc, a division of Insud Pharma, today announced the launch of the updated slynd.com, the website for Slynd™ (drospirenone) tablets 4 mg, a novel estrogen-free oral contraceptive, in a physician and patient communication letter.

The updated Slynd™ website provides patients and healthcare professionals a rich array of information in a user-friendly format to familiarize visitors with this new progestin-only pill and educate them on Slynd™ safety and efficacy while pointing out the unique aspects that differentiate Slynd™ from other birth control options.

The website offers information about patients for whom Slynd™ is an option, with educational videos for each patient type. The website also includes video commentary from three well-respected obstetricians and gynecologists who, with their endorsement,  share their perspective on Slynd™ and why they perceive it as a meaningful contraceptive option for their patients.

Slynd™, a progestin-only pill (POP) is a novel estrogen-free oral contraceptive with a 24 active and 4 inactive tablet dosing regimen and also allows a 24-hour missed pill window.  This not only can mean favorable safety and efficacy but an improved bleeding profile and contraceptive efficacy for up to a 24-hour window in the event of a delayed or missed dose, which is particularly beneficial for breastfeeding mothers.

“We are excited to share the website with patients and physicians.  Slynd™ is an appealing option for women who can’t or don’t wish to take oral contracptives with estrogen,” said Salustiano Perez, president of Exeltis USA. “It is a good option for women who are breastfeeding, overweight, smokers or those who want estrogen-free oral contraceptive choices. It also has a less rigid dosing schedule than other progestin-only oral contraceptives on the market.”

Slynd™ is indicated to prevent pregnancy among females of reproductive potential. Slynd™ is contraindicated in females with conditions that predispose to hyperkalemia (e.g. renal impairment, hepatic impairment, and adrenal insufficiency). Other contraindications include presence or history of progestin sensitive cancers, liver tumors, benign or malignant, or undiagnosed abnormal uterine bleeding. Slynd™ may cause side effects including hyperkalemia, thromboembolism, bone loss, cervical cancer, liver problems, ectopic pregnancy, high blood sugar, changes in menstrual bleeding or depression. Discontinue Slynd™ if a thromboembolic event occurs or there are acute or chronic changes in liver function. For full important risk and use information about Slynd™ please see full Slynd™ Prescribing Information.

Peer-Reviewed Publication Reinforces Safety and Efficacy of Slynd™ (Drospirenone) tablets, 4 mg

FLORHAM PARK, N.J., June 11, 2020 — Exeltis USA, Inc, a division of Insud Pharma, today released a physician and patient communication letter announcing a recent publication in Drugs of Today 2020 that highlights the Slynd™ safety data and the efficacy of drospirenone to inhibit ovulation, reinforcing the features and benefits of Slynd™ (drospirenone) tablets 4 mg, a novel estrogen-free oral contraceptive.

The published article, “Drospirenone: a novel progesterone used as an oral contraceptive without an estrogen component” (D.M. Paton, 56(5): 321-328) reviews two phase III clinical studies of Slynd. The paper concludes that “it was a logical development to determine the efficacy of a tablet that only included [drospirenone] DRSP as an oral contraceptive” which gained approval by the Food & Drug Administration in May, 2019.

“There is an important place in the market for this next generation progestin-only pill for prevention of pregnancy”, notes Randi Rievman, Senior Director, Marketing and Sales Training at Exeltis USA. “Slynd, which is proven safe and effective for contraception, is truly fitting a patient need in today’s environment. Using telemedicine service providers, it can be prescribed without an office visit.  It doesn’t require a blood pressure check before prescribing as the CDC guidance stipulates for other estrogen-containing oral contraceptives or need to be inserted like the IUDs.”

Exeltis, the license holder of Slynd™, has taken additional measures during the current COVID-19 environment to make the progestin-only pill easily available to women in need of an oral contraceptive. The company has made sampling delivery safe and convenient for physicians and patients by enabling physicians to order samples sent directly to their offices or direct shipments to patient homes to further facilitate their ability to start their patients on Slynd™.

“In the current COVID-19 environment, where there are many women physically distancing and unable to go to physician offices for visits, our program enables their doctors to help them access oral contraceptives without an office visit,” said Rievman.

Slynd™, a progestin-only pill (POP), is a novel estrogen-free oral contraceptive that has a 24 active with 4 inactive tablet dosing regimen and also allows a 24-hour missed pill window.  This not only can mean favorable safety and efficacy but an improved bleeding profile and contraceptive efficacy for up to a 24-hour window in the event of a delayed or missed dose, which is also very beneficial for breastfeeding mothers.

Slynd is indicated to prevent pregnancy among females of reproductive potential. Slynd is contraindicated in females with conditions that predispose to hyperkalemia (e.g. renal impairment, hepatic impairment, and adrenal insufficiency). Other contraindications include presence or history of progestin sensitive cancers, liver tumors, benign or malignant, or undiagnosed abnormal uterine bleeding. Slynd may cause side effects including hyperkalemia, thromboembolism, bone loss, cervical cancer, liver problems, ectopic pregnancy, high blood sugar, changes in menstrual bleeding or depression. Discontinue Slynd if a thromboembolic event occurs or there are acute or chronic changes in liver function. For full important risk and use information about Slynd please see full Slynd Prescribing Information.