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Today we’re continuing Birth Control Week with a discussion around Drosiprenone pills.

Yaz and Yazmin (as well as Gianvi, Ocella, Syeda,Zarah, Beyaz, and Safyral) are popular birth control choices for women who have PCOS or other hyper-androgen disorders.

This is because the progesterone that comes in these pills is Drosiprenone.  Drosiprenone acts much in the same was the drug spironolactone does in the body, which is to say, as a testosterone blocker.  This is why women with PCOS and/or hormonal dysregulation love this pill.  However: blocking testosterone is not the primary intention of these pills.  They are, first and foremost, potassium sparing diuretics.

The drug Spironolactone is ordinarily proscribed to lower blood pressure while simultaneously preserving potassium levels.  This is good for people with kidney disease.  It also has, however, as I just mentioned, the “added benefit” of interfering with adolsterone production.  This, in turn, appears to have an anti-androgen, specifically an anti-testosterone effect.  For this reason, Spironolatone and Drosiprenone decrease and in many cases completely eliminate problems with acne, male-pattern hair growth, and male-pattern hair loss.

Drosiprenone has the same testosterone-fighting and potassium-sparing effects.

Women on these drugs must get their potassium levels regularly checked, and must make sure that they are not dehydrated while on these drugs.   And when they do, they are normally quite fine.

The level of Drosiprenone in the pill is less than women normally take when on Spironolactone, but that does not change the importance of this warning.

A build-up of potassium in the blood can lead to sudden death.  I am not joking.  Early warning signs include muscle weakness, shortness of breath, and heart palpitations. 

Dehydration can lead to a wide variety of medical problems, including

  • Dry, sticky mouth
  • Dry skin
  • Headache
  • Constipation
  • Dizziness or lightheadedness
  • Low blood pressure
  • Rapid heartbeat
  • Rapid breathing
  • Insomnia
  • Anxiety
  • Fever
  • In the most serious cases, delirium or unconsciousness
I took Spironolactone for five months and experienced anxiety, heart palpitations, and insomnia due to combined potassium-imbalance and dehydration, not just while on the drug, but for several months afterwards.  Unfortunately, I did not know it at the time, so I did not know how to fix it.  It continued to worsen until I checked myself into the ER with severe heart palpitations. I share this information with you NOT to scare you off of these drugs–millions of women use them every year to happy effect–but rather to share with you the reality of the situation, and to let you know that if you experience any changes or negative side effects once going on one of these pills, this may be why, and a reason for you to consider other options more appropriate to your personal biochemistry.

Potassium rich foods include avocado (the richest), banana, potato, sweet potato, tomatoes, all leafy greens, and salmon.  Most other vegetables and fruits are rich in potassium relative to the rest of foods.    It might be best to avoid these foods while on drosiprenone-containing birth control pills.

If you missed it, make sure to read the first post in this series, Birth Control Pills: How They Work, Benefits, and Risks. You can also find everything I find relevant to birth control here, in my Birth Control Unlocked guide.

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