A Guide to the Different Types of Drospirenone

October 9, 2025 •

4 min read

Over 60% of women in the US have used oral contraceptives containing synthetic progestins at some point in their lives. Drospirenone is one such progestin, but there are several different types of drospirenone medications, each formulated for specific therapeutic purposes, from contraception to managing menopausal symptoms. This guide will explain what are the different types of drospirenone available today.

Quick Summary

Drospirenone medications are available as combination oral contraceptives, progestin-only pills, and hormone replacement therapy. Formulations like Yasmin, Yaz, and Slynd differ in their estrogen content, dosing, and additional medical indications such as treating PMDD, acne, or menopause symptoms.

Key Points

Variety of Formulations: Drospirenone is available in combination with different estrogens (ethinyl estradiol, estradiol, estetrol) or as a progestin-only pill (Slynd).
Diverse Medical Uses: These formulations are used for contraception, treating premenstrual dysphoric disorder (PMDD), managing acne, and providing hormone replacement therapy during menopause.
Anti-Mineralocorticoid Activity: Drospirenone's unique properties, similar to the diuretic spironolactone, can help reduce water retention and bloating, but also increase the risk of hyperkalemia.
Dosing Regimen Varies: Drospirenone products feature different dosing schedules, such as the 24/4 regimen of Yaz and Slynd versus the 21/7 regimen of Yasmin, which affects menstrual patterns.
Specific Indications for Combination Pills: While Yasmin is primarily for contraception, Yaz is also approved for PMDD and acne, and Beyaz includes folic acid supplementation.
Consideration for Estrogen Avoidance: Slynd, the progestin-only option, is suitable for women who need to avoid estrogen, such as those who smoke or are breastfeeding.

What is Drospirenone?

Drospirenone is a synthetic hormone known as a progestin, often categorized as a "fourth-generation" progestin. It was originally developed as a component of oral contraceptives and is also a spironolactone analogue, which means it has diuretic and anti-mineralocorticoid properties. This unique characteristic can help mitigate side effects like bloating and water retention that are sometimes associated with other hormonal birth control methods. Due to its antiandrogenic properties, it can also be beneficial in reducing symptoms of acne. Drospirenone is used alone or in combination with an estrogen, such as ethinyl estradiol, estradiol, or estetrol, to prevent pregnancy, treat severe premenstrual syndrome (PMDD), clear acne, or manage menopausal symptoms.

Combination Oral Contraceptives (COCs) with Drospirenone

Most drospirenone products are combined with an estrogen in an oral contraceptive pill. The amount of estrogen and the dosing regimen are the primary differences among these formulations, which can influence their approved uses and side effect profiles. The most common estrogen combined with drospirenone is ethinyl estradiol (EE).

Yasmin (Drospirenone/Ethinyl Estradiol)

Yasmin is a monophasic combination oral contraceptive that contains 3 mg of drospirenone and 30 mcg of EE. Its regimen typically consists of 21 active tablets, each with the same hormone dose, followed by 7 placebo tablets, over a 28-day cycle. This formulation is primarily approved for the prevention of pregnancy. Yasmin contains a higher dose of estrogen compared to some other drospirenone products, which might lead to a different profile of side effects for some users. Generics for Yasmin include Ocella, Syeda, and Zarah.

Yaz (Drospirenone/Ethinyl Estradiol)

Yaz is a lower-estrogen COC compared to Yasmin, with a dosage of 3 mg drospirenone and 20 mcg of EE. A key difference is its dosing regimen: 24 active tablets followed by 4 placebo tablets. In addition to contraception, Yaz is FDA-approved to treat moderate acne and the symptoms of premenstrual dysphoric disorder (PMDD). The shorter placebo interval of Yaz can contribute to a shorter menstrual period compared to Yasmin. Generics for Yaz include Gianvi, Nikki, and Loryna.

Beyaz and Safyral (COCs with Folic Acid)

Beyaz and Safyral are unique COCs that combine drospirenone and ethinyl estradiol with levomefolate calcium, a form of folic acid. Folic acid supplementation is included to reduce the risk of neural tube defects should pregnancy occur accidentally. Beyaz uses a 24/4 dosing regimen, while Safyral is a 21/7 regimen. These are also indicated for contraception and may also be used for PMDD and acne.

Progestin-Only Pill (POP) with Drospirenone

For individuals who cannot take estrogen-containing birth control due to medical conditions or personal preference, drospirenone is also available as a progestin-only pill.

Slynd

Slynd is a POP containing only 4 mg of drospirenone. It is taken in a 28-day cycle consisting of 24 active tablets and 4 inactive tablets. Unlike traditional POPs with a very strict 3-hour missed-pill window, Slynd offers a more forgiving 24-hour window. It is a suitable option for women who are breastfeeding, over 35 and smoke, or have a history of blood clots, as it carries a lower risk of thrombosis compared to COCs.

Hormone Replacement Therapy (HRT) with Drospirenone

Drospirenone is also used in a hormone therapy context for postmenopausal women.

Angeliq

Angeliq is a medication that combines drospirenone with estradiol to treat menopausal symptoms. It is available in different strengths (e.g., 0.25 mg drospirenone/0.5 mg estradiol or 0.5 mg drospirenone/1 mg estradiol) for managing vasomotor symptoms like hot flashes and symptoms of vulvar and vaginal atrophy. The drospirenone component helps to protect the uterine lining from overgrowth caused by estrogen.

Comparison of Key Drospirenone Products


Feature	Yasmin	Yaz	Slynd	Angeliq
Hormones	Drospirenone + Ethinyl Estradiol	Drospirenone + Ethinyl Estradiol	Drospirenone only	Drospirenone + Estradiol
Hormone Type	Combination Oral Contraceptive	Combination Oral Contraceptive	Progestin-Only Pill	Hormone Replacement Therapy
Dosing Cycle	21 active, 7 inactive	24 active, 4 inactive	24 active, 4 inactive	Continuous, once daily
Primary Use	Contraception	Contraception, PMDD, Acne	Contraception	Menopause Symptoms
Unique Feature	Higher estrogen dose	Lower estrogen dose, PMDD/acne indications	Estrogen-free, 24-hour missed pill window	Continuous dose for menopause

Important Considerations and Risks

All medications containing drospirenone carry certain risks and require medical supervision. One of the most critical is the potential for elevated potassium levels (hyperkalemia), especially in individuals with kidney, liver, or adrenal issues, or those taking other medications that increase potassium. Due to its anti-mineralocorticoid properties, drospirenone can affect potassium balance, similar to the diuretic spironolactone. In combination pills, the estrogen component can slightly increase the risk of blood clots, heart attack, and stroke, with this risk being elevated in smokers over 35.

Always consult a healthcare provider to determine the most suitable type of drospirenone medication based on individual medical history, health goals, and risk factors. They can provide a comprehensive overview of the benefits and risks associated with each product. The FDA provides detailed labeling for all drospirenone products, which can be found via the agency's website for authoritative information.

Conclusion

Drospirenone is a versatile synthetic progestin used in a range of medications for contraception, PMDD, acne, and menopausal hormone therapy. The different types of drospirenone products are distinguished by their combination with various estrogens, the dosing regimen, and their specific therapeutic indications. Whether a progestin-only pill like Slynd, a combined contraceptive like Yaz, or an HRT option like Angeliq, understanding these differences is crucial for making an informed healthcare decision with a medical professional. Due to the potential for serious side effects like hyperkalemia and blood clots, careful medical evaluation and monitoring are essential for anyone considering drospirenone therapy.

Frequently Asked Questions

The main differences are the estrogen dosage and the dosing schedule. Yaz contains a lower dose of ethinyl estradiol (20 mcg) and has 24 active pills per cycle, while Yasmin has a higher dose (30 mcg) and 21 active pills. Yaz is also approved for PMDD and moderate acne, which Yasmin is not.

Slynd is a progestin-only pill containing no estrogen, making it an option for women who need to avoid estrogen for health reasons. It also features a more forgiving 24-hour missed pill window compared to older progestin-only pills.

Yes, drospirenone has anti-mineralocorticoid activity and can increase serum potassium levels, a condition known as hyperkalemia. This is a particular risk for individuals with kidney or adrenal problems or those taking other potassium-raising medications.

Some formulations, such as Beyaz and Safyral, include levomefolate calcium (a form of folic acid). This is intended to lower the risk of neural tube defects in the fetus should an unexpected pregnancy occur while taking the medication.

Angeliq is the drospirenone-containing medication used for menopause symptoms. It combines drospirenone with estradiol to manage hot flashes and vaginal atrophy in postmenopausal women with a uterus.

Yes, some drospirenone products combined with ethinyl estradiol, such as Yaz, are specifically approved to treat moderate acne vulgaris in women, leveraging drospirenone's antiandrogenic effects.

Yes, women over 35 who smoke are at an increased risk of blood clots, heart attack, and stroke when taking drospirenone-containing combination pills. Estrogen-free options like Slynd are generally safer in this population.