At Evernow, we know that navigating perimenopause and menopause can come with a lot of questions—especially when it comes to managing symptoms like irregular bleeding, bloating, and mood changes. That’s why we sat down with Dr. Cindy Krause, Evernow’s Medical Director, to discuss Slynd, a progestin-only birth control pill that may be a good fit for some women in perimenopause.

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Evernow: What is Slynd, and how does it differ from traditional progestin-only birth control pills?

Dr. Krause: Slynd is a progestin-only birth control pill, but unlike traditional options, it contains drospirenone instead of norethindrone. This is significant because drospirenone has anti-androgenic and anti-mineralocorticoid properties, meaning it may help reduce acne, bloating, and mood swings. Another key difference is its dosing regimen—24 days on and 4 days off, similar to combination birth control pills, whereas traditional progestin-only pills require continuous daily use.

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Evernow: Who is Slynd best suited for?

Dr. Krause: Slynd is a great contraceptive option for any woman who needs to avoid the estrogen found in traditional combined oral contraceptive pills. It is also a great option for women in perimenopause who are still having periods, even if they don’t need contraception. It can help control irregular or heavy bleeding, which is a common issue during this stage. Additionally, because it has a longer half-life, it offers better ovulation suppression than traditional progestin-only pills, making it a more reliable option for birth control. Before starting Slynd, it is important to have any abnormal bleeding evaluated by your medical provider.

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Evernow: How does Slynd compare to traditional progestin-only pills when it comes to preventing pregnancy?

Dr. Krause: Slynd has a higher likelihood of inhibiting ovulation—about 80-90% of the time—compared to traditional progestin-only pills, which suppress ovulation in only about 50% of cycles. Most traditional progestin-only pills primarily work by thickening cervical mucus rather than consistently preventing ovulation. Additionally, Slynd has a 24-hour missed pill window, whereas older progestin-only pills must be taken within a very narrow 2-3 hour window to remain effective.

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Evernow: Can Slynd help with perimenopausal symptoms like mood swings and bloating?

Dr. Krause: Yes! Because drospirenone has anti-androgenic and anti-mineralocorticoid properties, it may help reduce bloating, acne, and mood swings—common concerns during perimenopause. Drospirenone-containing oral contraceptives are also FDA-approved to reduce symptoms of PMS and PMDD. Plus, unlike some hormonal contraceptives, it doesn’t increase blood pressure, making it a safer choice for women with hypertension.

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Evernow: Are there any risks or side effects associated with Slynd?

Dr. Krause: One consideration is that Slynd has the potential to increase potassium levels in women who are also taking potassium-sparing medications, such as spironolactone. In these cases, potassium levels should be monitored. Some women may also experience irregular bleeding while taking Slynd—if this occurs, it’s important to check in with your provider. Otherwise, it’s generally well tolerated and provides a good alternative for women who can’t or don’t want to take estrogen.

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Evernow: Can Slynd be used alongside estrogen therapy?

Dr. Krause: Yes! Slynd can be used with an estrogen patch, acting as the progestin component for women who need a short-term solution—typically for about six months to a year—before transitioning to bioidentical progesterone.

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Evernow: Why would you choose Slynd over other medications offered at Evernow?

Dr. Krause: Slynd is a great option for women who need a progestin-only birth control pill, especially those who can’t take estrogen due to health risks or personal preference. Unlike traditional progestin-only pills, Slynd offers a more forgiving dosing window, meaning it’s more effective if you miss a pill by a few hours. It also has a unique formulation that may help reduce common side effects like irregular bleeding, making it a well-tolerated choice for many.

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Evernow: What’s the bottom line on Slynd for women in perimenopause?

Dr. Krause: Slynd is a great option for women in perimenopause who need help managing irregular bleeding, mood swings, and bloating, even if they don’t need contraception. Its unique properties make it more forgiving in terms of missed doses, and it doesn’t carry the blood pressure risks associated with estrogen-containing birth control pills. If you’re still having periods and looking for a way to reduce bleeding while also easing perimenopausal symptoms, Slynd might be worth discussing with your doctor.

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Interested in learning more? Evernow’s medical team is here to help you find the best approach to managing perimenopause and menopause symptoms. Get started today to explore your options.

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