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Benefits of Slynd

A benefit of Slynd is there is a 24 hour window to take the tablet if missed at the usual time and it will still work as contraception.

Other POPs including Cerazette, Cerelle, Hana, and Lovima contain the hormone desogestrel 75mg. These have a shorter 12 hour window to take the tablet if you miss it at the usual time. The original POPs, Noriday and Norgeston, contain different progestogen hormones and have only a 3 hour window.

Additional benefits of drospirenone in Slynd are that it may:

• Reduce acne or hirsutism (abnormal hair growth).
• Reduce water retention.
• Reduce weight changes when it has occurred using other types of hormonal contraception.

Some women who cannot take 'combined' contraceptive pills (combining oestrogen and progestogen) may be able to take Slynd. If in doubt, discuss with your GP or a sexual health advisor.

How Slynd works

Slynd has 3 actions to prevent pregnancy:

1. Prevents ovulation (an egg being released from the ovaries).
2. Mucus at the neck of the womb (cervix) becomes thicker and more difficult for sperm to pass through.
3. Changes to the lining of the womb, making it thinner and more difficult for a fertilised egg to implant.

Slynd does not protect against HIV infection or any other sexually transmitted infection/disease. It is therefore important to use condoms if you are at risk of sexually transmitted infections.

Cautions and suitability

Dr cannot supply Slynd if any of the following apply:

• Allergy to drospirenone.
• Thrombosis (blood clot in a blood vessel), eg deep vein thrombosis (DVT) or pulmonary embolism (PE).
• History of breast, ovarian, or uterine (womb) cancer.
• Liver disease/abnormal liver function tests.
• Severe kidney disease.
• Diabetes.
• High blood pressure - treated or untreated.
• Unexplained vaginal bleeding.
• Lactose intolerance.
• Acute porphyria.

Other medicines and Slynd

Some medicines may prevent Slynd from working properly or need additional monitoring. These include the following conditions/treatments:

• Epilepsy.
• Tuberculosis.
• Medications that tend to increase blood potassium levels.
• HIV.
• St. John's Wort (herbal remedy for depression/low mood).
• Fungal infection tablets.
• Ischaemic heart disease or angina.
• Glucose lowering medications (eg insulin or gliclazide).
• Weight loss injections (eg Mounjaro).

If any of these apply, Slynd may not be suitable for you. Please consult with your GP surgery or sexual health advisor if you wish to take Slynd as Dr is unable to prescribe.

How to take Slynd

Slynd differs from other POPs as the pack contains:

• 24 white active pills which contain hormone.
• 4 green inactive (placebo) pills.

Because there are 2 different types of tablet it is important that you take the tablet marked 'start' when you begin a new blister pack.

Take one tablet daily with water if necessary. You can take the tablets with or without food (except grapefruit). Take the tablets around the same time of the day so that the interval between tablets is 24 hours.

If you are not using hormonal contraception at present (or in the past month)

• Start the pack on day 1 of your period and you will be protected against pregnancy immediately.
• If starting at any other time in your menstrual cycle contraceptive cover will not be active for 7 days, so you have the risk of pregnancy and should use condoms during this time.

Changing to Slynd from other hormonal contraceptives

Contraception will remain active if Slynd is started:

• The day after a different POP.
• The day after the last 'active' tablet of a combined oral contraceptive pill (COCP).
• The same day a progesterone implant, patch, vaginal ring, intrauterine system (hormonal coil), or copper coil (IUD) is removed.
• The day the depot injection is due.

Starting Slynd after giving birth

• Start Slynd between days 21-28 after giving birth and it will work immediately.
• If you start Slynd later than day 28, but before your periods have started, you must be sure that you are not pregnant and use a condom until you have taken the first 7 tablets of the pack.

Missed pill rules for Slynd

Less than 24 hours late: take the missed tablet as soon as you remember and take the next one at the usual time. Contraceptive protection remains active.

If you are more than 24 hours late taking any of the white active tablets, contraceptive protection may be reduced. The missed tablet should be taken as soon as possible. It is OK to take 2 tablets on the same day at the same time - then continue to take the tablets at the usual time. Barrier contraception/condoms should be used for the next 7 days.

Missed pills in the third week: follow advice above but do not take the 4 green inactive tablets - throw these away and start the next blister pack immediately.

Missed green inactive tablet: this can be thrown away and contraception remains active.

If you vomit or have severe diarrhoea

If you vomit or have severe diarrhoea within 3-4 hours of taking a white active tablet, the hormone may not have been completely absorbed. Take another white tablet as soon as possible and within 24 hours of the usual time. If vomiting or diarrhoea continues, or it is more than 24 hours, follow the missed pill rules above.

Possible side effects of Slynd

Bleeding patterns may be unpredictable when using Slynd. Scheduled bleeding may occur when taking the green (inactive) tablets (known as the hormone free interval). 1 trial showed that fewer than 20% of women had 'scheduled' bleeding at 9 months. Users may have bleeding/spotting at other times. Unpredictable/irregular bleeding is common when taking all types of POP including Slynd, but this usually settles the longer they are taken.

The following side effects may affect up to 1 in 10 women: headache, nausea, abdominal pain, acne, breast tenderness, painful or irregular periods, weight gain, and loss of sex drive.

Grapefruit or grapefruit juice should be avoided as it may increase the chance of side effects when taking Slynd. For a full list of side effects and details of interacting medicines see the patient information leaflet supplied with pills.

Cautions when taking Slynd

• High potassium - in rare cases the progestogen in Slynd can cause high potassium levels in your body, usually when taken with certain medicines or particular medical conditions. Symptoms can include chest pain, palpitations, weakness or tingling in the arms or legs, nausea, or vomiting. Seek urgent medical review if these develop.
• Thrombosis - there is a slightly increased risk of developing a clot in a blood vessel when taking a POP, however this is a lower risk than when taking a combined oral contraceptive pill.
• Breast or cervical cancer - there could be a small increase in the risk of developing breast or cervical cancer when using a POP (whereas the risks of endometrial, ovarian, and colorectal cancers are reduced).
• Ectopic pregnancy - there is a small increased risk of ectopic pregnancy when taking a POP, but the risk is lower than when not using contraception.
• Depression - if you experience low mood or thoughts of self harm shortly after starting Slynd, you should contact your usual GP for advice as soon as possible.

Breastfeeding and pregnancy

Women who are breastfeeding can safely take Slynd. It is recommended to start at least a week after giving birth once milk flow has been established. It does not usually affect milk production but should be stopped if this is noted.

Women who are exclusively breastfeeding an infant under 6 months of age and have not had a period since giving birth, have what is called lactational amenorrhoea (LAM). LAM is over 98% effective at preventing pregnancy, therefore these women may not consider it necessary to take contraception.

Slynd should not be taken when pregnant. If pregnancy occurs while taking Slynd, you should stop taking the pill and consult a doctor or sexual health advisor. Slynd has not been shown to cause harm if taken when pregnant.

Requesting Slynd POP online

Dr Fox can supply 1-12 months of Slynd to eligible women over 18 who wish to start or continue Slynd Dr birht control for contraception.

There is a short online medical questionnaire to ensure treatment is suitable for you.

Women ordering from Dr Fox are recommended to provide their GP details and consent to a notification letter being sent, which will inform their GP.

Most contraception can be obtained free through the NHS from GPs and sexual health clinics. Girls under the age of 16 years can obtain contraception without their parents or guardians being informed, providing they are competent, informed, and following assessment, not considered to be vulnerable to exploitation or abuse.

Alternatives to progestogen-only pills

• Combined oral contraception
• Long-acting reversible contraception such as injections, implants, and intrauterine devices or systems.

Further information

• Slynd manufacturer's website
• NHS - Your contraception guide
• NHS - Progestogen-only pill
• NIHR/UCL - Contraception Choices
• Frequently Asked Questions: Progestogen-only pill