Remember when the whole world started freaking out about the Oxford-AstraZeneca vaccine causing blood clots (one in 126,582 chances) while no one batted an eye at the National Blood Clot Alliance in the US, who estimated that one in 1,000 women per year who are taking birth control pills will develop a clot, putting the risk at 0.1 per cent?
Well, long story short, for years now, women have been taking this risk—knowingly for some, unknowingly for others—in order to live their lives the way they wish to; freely. Even if we forget about the whole blood clot controversy for a minute, different types of contraceptive pills are known to have some pretty worrying side effects. These can range from altering a woman’s body shape and causing metabolic issues to, in some cases, increasing the potential of suicidal behaviour.
But enough with the demoralising facts—at least for now—because I have good news for you! There’s a new contraceptive pill on the market (only approved in the US for the time being) that has the least side effects compared to all other oral birth control pills. Introducing Slynd, the first progestin-only pill (POP) with a 24-hour intake window and a 24+4 dosing regimen. Now let’s get into what that means exactly, and why this actually is good news.
Not every type of pill is a good fit for every woman—if you ask me, there is not a one-size (or pill) fits-all solution. That’s why you might have been offered different kinds of pills and changed from one to another. The first type of contraceptive pill you should know about are combination pills, which contain synthetic (meaning man-made) forms of the hormones estrogen and progestin. But that’s not the end of it: there are several types of combination pills, from monophasic pills and multiphasic pills to extended-cycle pills.
Progestin-only pills are different from combination pills because they contain progestin without estrogen, hence the name. POPs are also called ‘mini pills’. The success of progestin-only oral contraceptives in substantially decreasing, and controlling menstrual bleeding has led to the development of multiple progestin-only protocols for the sole purpose of bleeding control. In other words, POPs became the go-to pill for women suffering from heavy periods because it leads to either irregular monthly bleeding or none at all.
By taking it everyday without any break (unlike other oral contraceptives which use inactive pills during the last week of the cycle), period havers can ‘control’ when they bleed, among other things.
Okay, so what’s to say that this Slynd pill is so promising in comparison to other options? Well, according to a 2021 study conducted by Donna Shoupe, MD, Professor of Obstetrics & Gynecology at Keck School of Medicine, University of Southern California, Los Angeles, progestin-only contraceptives are the best form of hormonal contraception with the least side effects and only four days of bleeding. Sounds pretty dreamy.
First of all, older forms of contraceptives mixing estrogen and progestin, which are commonly used worldwide, cause widespread metabolic and inflammatory effects. If that isn’t enough, a 2020 study found that young women using oral contraceptives (both combination and progestin-only pills) may be at increased risk of suicidal behaviour, although it was noted that the risk declined with increased duration of use.
Last but not least, you’ve probably heard the rumour—and rumour is the key word here—that the pill can cause weight gain. While that isn’t exactly true, the BBC has confirmed that it can change body shape (and fat storage) in other surprising ways. Back in 2009, Steven Riechman, an exercise physiologist at Texas A&M University, discovered that when they worked out, women on a certain type of pill had less of the muscle-building hormone DHEA (and therefore less muscle gain) than those not on the pill.
“Another study found that women on pills with higher levels of oestrogen tended to have pear-shaped bodies and more subcutaneous fat, though not necessarily more fat overall,” added the BBC. Research also suggests that oestrogen can cause the body to retain more fluid, including the type used in the contraceptive pill, leading many women on the contraceptive pill to ‘bloat’.
Considering everything stated above, I completely understand why telling you that the Food and Drug Administration (FDA) has approved Slynd for use by women in the US is simply not enough. That being said, it does look like Slynd might be a lesser evil than all the other pills on the market.
Supplied in blister card packaging, each Slynd box holds 24 white tablets containing drospirenone 4 milligrams and 4 green inert tablets. These 4 inactive tablets represent the 4 days of period people on this contraceptive pill will be on.
In the ongoing evolution of contraception, the goal has always been to improve efficacy as well as minimising side effects. Estrogen dose reduction and shortening of hormone-free intervals have been helpful to meet these goals. “As a result, Slynd was developed with a 24/4 dose regimen, which provides a more stable hormonal timeframe compared to traditional 21/7 dose regimens, achieving greater pituitary and ovarian suppression,” writes Birth Control Pharmacist.
In simpler terms, Slynd’s 24/4 regimen has less hormone withdrawal effect and improves side effects such as pelvic pain, headaches, breast tenderness, and bloating symptoms that are reported during the hormone-free days with 21/7 regimens.
Furthermore, Slynd allows a 24-hour missed pill window (while other POPs tend to have very narrow windows), which improves reliability and bleeding profiles in the event of a missed dose. “One study compared two arms—one with four missed doses (four 24-hour delays) and the other with no missed dose during the cycle. Even with four missed doses in the cycle, there was adequate ovarian suppression and the same follicular size was observed in both arms,” continues Birth Control Pharmacist.
Of course, it would be daft to claim premature victory before we know the impact that this new option has on women in the long term, but what can be said after reading a variety of research on the matter is that Slynd has strong potential to change the oral contraceptive market for the better.