Glossary · Treatments

Drospirenone

Definition: Drospirenone is a fourth-generation progestin with antiandrogenic and antimineralocorticoid activity. It is the progestin in the combination HRT product Angeliq (estradiol + drospirenone) and in several oral contraceptives. It carries a slightly higher VTE risk than older progestins.

Detailed definition

Drospirenone is a spironolactone-derived synthetic progestin with antiandrogenic and antimineralocorticoid (potassium-sparing) properties. The combination product Angeliq pairs 0.5 mg drospirenone with 1 mg estradiol for combined HRT in postmenopausal women with a uterus. Drospirenone-containing oral contraceptives (Yaz, Yasmin) have been extensively studied; meta-analyses suggest a modestly higher VTE risk than levonorgestrel-containing OCs. The antimineralocorticoid effect can mildly raise serum potassium, which is generally clinically insignificant in healthy women but may be relevant in women on potassium-sparing diuretics, ACE inhibitors, or with renal dysfunction.

Why it matters in menopause

Angeliq is one of the few combined HRT options containing drospirenone in the US and may appeal to women who specifically benefit from the antiandrogenic effect (e.g., for acne or hirsutism). For most women, transdermal estradiol plus bedtime micronized progesterone remains the cleaner default.

Sources

External references: Wikipedia.

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