Menopause Matters Forum
Menopause Discussion => Personal Experiences => Topic started by: Konijntje on August 06, 2025, 10:00:13 AM
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Just got my first 4 weeks (or rather 24 days, because of the 4 placebo pills, I’ll probably skip those) from the pharmacy and since I find the other diaries very helpful, I’ll start my own.
For people that don’t know it, because it is still quite new, Drovelis (Nextstellis in US) is a birth control pill with drospirenone as progestogen and estetrol (E4) as the estrogen. Estetrol is bio identical, but it’s only produced during pregnancy (by the liver of the foetus). It acts like a SERM and gives less breast cancer risk. It also doesn’t have a first pass effect on the liver and has potentially less clotting risk than estradiol. Next year, estetrol will become available as hrt under the brand name Donesta.
My reason for starting this birth controll pill at the age of 50 is twofold. 1 I’m progesterone intolerant and I’ve read good things about drospirenone. 2 My own cycle is giving me a lot of trouble, I’m feeling bad for most of my cycle now and only feel “good” (ok-ish) for about 10 days a month.
That sums up my diary introduction, I will start my first pill tonight.
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I took my first pill last night after dinner (around 18.30, about 5 hours before bedtime). No noticeable weird first effects. I slept ok, so that gives me hope the estrogen amount is adequate (estrogen makes me sleep through, otherwise I keep waking up). My neck hurts a bit, which I got from dydrogesterone and levenorgestrel (mirena), but I don’t feel as wired (yet). I have stomach cramps this morning, I have ibs and dyspepsia, so that is a side effect I usually get. Hopefully it goes away soon. Also minor headache.
Too soon to say anything about mood and I’m feeling pms-y anyway, so I can probably only say anything about that in a few weeks.
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Please keep posting about your experience, this is so interesting.
I really hope Donesta reaches the UK market and doesn't end up like duavee, duphaston or the testosterone patch - canned due to low use because nobody knew they existed!
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Day 2: slept ok again and didn’t have any hot flushes yesterday, so I think the estrogen is sufficient right now.
Still have a headache and intestinal issues, but hopefully that goes away after a few weeks (they are often initial side effects, so fingers crossed).
Mood is still uncertain, I’m not sure how that is going. I feel a bit weird, not really depressed or low mood, but not really great either. Better than progesterone, dydrogesterone or levonorgestrel, because with those I feel off within 2 days, so hopefully drospirenone will agree with me.
I haven’t noticed sore breasts yet, I know it’s only been 2 days, so might be too soon anyway, but my breasts have grown 3 sizes over the last 2 years (2 of those before I started hormones, so just from peri) and I really don’t need them to grow bigger (32GG), so this is an important side effect for me not to have. I understand that as long as I’m still in peri, they might grow more,but the fast growth I had 1.5 years ago seems to have stopped for now luckily.
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Day 3:
I was so very very tired yesterday and today again. I’ve read that can be an initial side effect from drospirenone along with the headache I have, so I’m hoping that will improve.
This morning I woke up with an incredible dry mouth, which can be a side effect too, that goes away for some, but not all. I do hope it doesn’t get worse at least.
I have aching legs and lower back pain, I’m hoping it’s from cramping and it will get better once my cycle is suppressed. Progesterone gave me lower back pain that just kept getting worse and worse, the longer I took it, so I’m really hoping this isn’t similar. The pain does feel more like cramps now, so fingers crossed I’ll just start bleeding soon and I’ll feel better after that.
I did a one month trial of tibolone before this and that seemed to have messed with my cycle, so I’ve been feeling PMS like mood and cramps for 3 weeks now. Tibolone also did nothing for my hot flushes after 4 weeks, but I’ve read i5 can take pretty long for it to start working, I’m not writing it off completely yet, but if I were to trial again, it would be post menopause.
I’ll probably not update daily, but will check in in a few days or earlier if anything changes.
If anyone has something to say about drospirenone (Slynd) and the initial and longterm side effects for you, I’d appreciate if you could share.
I do think the estetrol agrees with me very well, no hotflashes at all and also no nausea (I do get a bit of nausea (and a lot when I first started) from estradiol). It’s difficult to say if it does something for mood and other symptoms, because of the interference of drospirenone.
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This is really interesting. You posting on my thread has led me to investigate what you are doing.
I took can not tolerate my own cycle. But a chemical menopause nearly ended me. It was horrific.
I tried nearly ever pill available a few years ago. Bit never got huge success. And a ton of side affects to boot.
But, I will try again if I need to as I cannot tolerate my own cycle.
I'm doing cerazette and topping up with hrt now as my latest trial. Fwiw double cerazette completely supressed me - but it was far too strong and as my body reacts to all changes, I'd never have got enough hrt in to resolve the low E issues that supression caused.
Keep updating. This is very interesting.
P s I did trial slynd last year. But I found it much stronger than desogestral and I felt constantly dizzy.
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I will keep updating. Slynd has more drospirenone than drovelis and I think when in peri, it’s probably better to take estrogen too, as base levels (when suppressing a cycle) of estrogen are declining (I just realized you mention that in your post). One of my peri symptoms is dizziness and adding estrogen has helped a lot.
I’m still feeling quite PMS-y, but I’ve read this is a common side effect. My headache and fatigue are maybe slightly improving, but not enough to feel well. I’m not feeling very bad either though and progestins that don’t work for me, usually make me feel bad within a few days, so still keeping my hopes up that this one might work.
I have also not been sleeping great again, I might have had some hot flushes during sleep. First few nights were pretty good though, so I’m hoping one my own hormones settle, the estrogen level turns out to be enough for me.
I don’t think I’ve tried the progestin that is in cerazette (desogestrel I think?), it is on my list of progestins I might want to try, but only on 4th place, I had the 3 birth control pills with bio identical estrogens above that one, because those progestins are more often named for being tolerated by progesterone intolerant people.
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Still following - I'm actually really interested in this pill for my daughter even though a diuretic progestin is totally unsuitable for me.
I would like to know if Drovelis provides adequate menstrual suppression when taken continuously ie omitting the dummy pills.
Do you plan to run the active pills back to back?
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Yes, I’m planning to skip the inactive pills. If I don’t start bleeding during this first month, I might take them only after the first pack, because I haven’t bled for a month now and I’d feel more comfortable getting at least one bleed after the month of tibolone (I did get a bleed 1 week in on the tibolone). Considering the cramping I have, I do think I’ll probably start bleeding this week.
I’ve read a lot of reviews and it seems to work for quite a bit of women with endometriosis and PMDD, so I’m guessing it should suppress your cycle. It can take a few months. (Most seem to stop bleeding in 3 months, but for some it takes a bit longer).
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I’m now one week in, my mood isn’t great, I feel like I have PMS (light) all the time, but it also isn’t awful.
I’m still very tired and have that slight headache, hopefully those will subside soon (I’ve read mostly within 2 weeks, so fingers crossed).
Yesterday evening, my breasts were very sore, I’m really hoping they won’t start growing again. It took me pretty long to find some new favourite bra brands when my old brands weren’t working for me anymore in a bigger size, so I worry a bit about that.
Still no bleed, but still feeling it’s going to happen this week. I’m really hoping cramping is causing my lower back pain, it does feel a bit more crampy than the constant lower back pain on utrogestan, that just kept getting worse.
Sleeping: this is very estrogen related for me, I think for now the dose is sufficient on some days and not quite sufficient on other days, I’m hoping once my cycle is suppressed, the dosage will be high enough. I think I’ve seen they are planning to release Donesta in 2 dosages, 1 same as in Drovelis (15 mg) and the other a bit higher at 20 mg.
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I just took my 10th pill and not feeling great. The diuretic effect of drospirenone has clearly kicked in (with a vengeance) and I’m incredibly thirsty and have a dry mouth all the time. It started with a bit of a dry mouth when I woke up since day 5 probably? But today, ugh. I also have some eczema on my hip and that is dehydration driven for me and I normally only get it during cold winters (and we are in a heatwave right now!). I also have had dry eyes for years and gel drops for those, but I’ve been needing to take those more often. I’m hoping this dry mouth thing will lessen soon (I’ve read that it often does, but not for everyone).
I’ve also been having hot flushes for the past few days, but there is a heatwave and I’m really feeling I’m about to get a bleed (and I always have more hot flushes before my period), so still hoping that once my own hormones settle down, the estrogen will be sufficient. Otherwise I might ask if I can supplement with a small amount of transdermal estrogen.
Still am very tired, have a headache (that is slightly less than a week ago) and have cramps and feel moody. I also still think this progestin might work out for me, since mood issues seem to be of a different (better) quality than with progesterone and other progestins, more mood swings and not overall anxiety/low mood.
Lots of people seem to start bleeding in their second week and I’m really hoping I will too, because that might get rid of some of the side effects (that feel like PMS).
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I just took my 14th pill, so 2 weeks in. Dry mouth improved a little, but still annoying. Also still have a headache, fatigue and cramps. I’ve been a bit dizzy too, not as much as pre hrt, but just enough to worry me if it gets worse.
Still no bleed, so if it doesn’t come next week, I’ll probably will take the placebos to force one, I’m hoping it will reduce my cramping, since I already had it on the tibolone.
I also still have some hot flashes and my nights are ranging from just ok - pretty bad, so I’m thinking estrogen is not sufficient still.
Mood wise, not great, but not very low either. I’m not sure drospirenone will be the best progestin for me, but it’s certainly better than the ones I’ve tried so far.
I’m probably going to try for multiple months with how things are going (if things don’t get worse), at least until my next phone appointment (in 2 months, so would be 2.5 months on Drovelis). If the diuretic properties of drospirenone keep bothering me so much, I might ask to try Qlaira, as I think dienogest is a bit similar to drospirenone, except without the diuretic effect.
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If you are looking into a non diuretic pill with 17 beta estradiol I would recommend Zoely over Qlaira because it's monophasic, providing much better hormonal stability and better suited to continuous use for menstrual suppression.
The chaotic dosing of Qlaira is designed to replicate a menstrual cycle, which to me is the definition of madness when you are taking something that can eradicate menstruation and hormonal cyclicity.
I am very happy with Zoely and find the progestin very tolerable, I don't even feel like I'm taking a progestin.
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I wouldn’t mind Zoely either. I’d prefer to try Qlaira first for a few reasons. Most important one is that the progestin seems available seperately, so I could switch to transdermal estrogen at some point (oral does give me some nausea, so might not be my preference in the long run).
The mimicing a cycle isn’t my preference either, but I’m sure it wouldn’t be as bad as my own cycle. I wouldn’t mind a bleed as long as it isn’t heavy (like my periods).
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2.5 weeks in.
Last Friday my cramps were very bad, I was sure I would start bleeding, but I didn’t. So, I’ll probably take the placebo’s this month to force a bleed. I’m also wondering if my neck pain is from the drospirenone, it isn’t as bad as on other progestins, but it is there. I do sometimes have some neck pain without progestins, so it can be coincidence. When my mirena got removed, my neck pain just vanished in a few days, so the placebo break will probably give me an answer.
Fatigue has lightened a bit and so has the headache (it comes and goes). The thirst/dry mouth hasn’t really unfortunately, still annoying.
Mood wise still the same, a bit moody like pms, but not really depressed. So drospirenone definitely agrees better with me than anything I’ve tried.
I’ve read a bit more about qlaira and Zoely. If the thirst doesn’t stop, I’m going to ask to try qlaira, because dienogest and drospirenone are the only progestins (besides dydrogesterone) that don’t seem to increase cancer risks (which is a big deal to me, as I have 2 aunts that got breast cancer around age 50 and multiple other relatives that got breast cancer later in life. No brca gene). There is also an option to take dienogest as Climodien (hrt with 2mg/2mg estradiol/dienogest) or standalone 2 mg with transdermal estrogen, should the multiphasic qlaira not agree with me. Dienogest works extremely well in keeping the lining thin (it’s often prescribed for endometriosis), so it should be a good option for longtime hrt.
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That's a good thought, I took think about what progestogen will suit me best when I graduate from OCP to hormone therapy, and both dydrogesterone and dienogest are on my shortlist.
I'm lucky enough to be breast free due to my family history but still keen to minimise the long term progestogen burden for cardiometabolic, cognitive and quality of life reasons.
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I tried dydrogesterone (duphaston) last year, but maybe too short of a time. It made me very anxious, it felt similar to levonorgestrel (I tried microgynon 30 some years ago) for me. But I’m very sensitive to progestins and since dydrogesterone is first choice here in the guidelines, I know plenty of people that do well on it. (My neighbour has been on femoston for almost 15 years, her GP (same as mine) advices her to stop every few years, but she just says no and continues to take them ;D).
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3 weeks (+1 day). Almost finished with the active pills. Last week was very rough, on Friday, my lower back pain was through the roof and I thought that I was either going to have a bleed or my lower back pain just kept building up like on progesterone. However, it was neither of the 2. Still no blood and I still have the pain, but it is a bit lighter again.
So, I am going to take the placebos this first month to force a bleed, since I’m hoping the cramping will get less afterwards.
Headache and neck pain is still there, but definitely slightly less. Thirst/dry mouth/dry skin isn’t getting less and is driving me kind of crazy. I did order some products to stimulate saliva production, hopefully that will at least help with the dry mouth. I’m very moody, but I’m not sure if it is the pain (haven’t been working out either) and dry mouth or the drospirenone.
I still have the occasional hot flush or night sweat, but I think less than the second week, so the estetrol might turn out to be just the right dose or just slightly too low.
I’m still planning to take the Drovelis until my appointment, as I read everywhere it takes a few months for mood to settle, but I’m pretty sure I’m going to ask to switch to qlaira then if the dry mouth continues. The dry skin is also a problem, because my hands are already pretty bad (bleeding knuckles) despite using creme, usually that is only a thing in winter when it’s cold. I wasn’t expecting this side effect being so bad for me, but I’m happy to know, so I can also take Slynd of my list of options if it doesn’t get less.
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I’m now 2 days in on the placebo’s and started very light spotting. I still feel like my lining needs to be shed, although it could be very thin from the tibolone and now Drovelis and the severe cramping could be just a side effect. Who knows?
Anyway, if the bleed isn’t any heavier tonight, I don’t want to start a new pack yet, but I do want to take estrogen (I have estradiol tablets), because I’m experiencing hotflushes and night sweats (I think the estrogen is too low in Drovelis, I was still having the occasional hot flush and night sweats on the active pills, so it was to be expected that those symptoms would reoccur fast on placebo). Would taking just estrogen stop my bleed (I don’t want that)? If it would, I guess I’m settling for nothing another day.
I’m really hoping things will get better on my next pack, because this month has been rough.
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I would absolutely take either the estradiol tablets or at least start the next active pill pack rather than suffering.
Anyone who can make a prediction about your bleed in this situation is probably off spending their lottery winnings, however there's no medical advantage to withdrawal bleeding on birth control pills.
It is a relic from a very paternalistic era in women's health care built in for no other reason than so we wouldn't think we were pregnant, being such untintelligent creatures that we couldn't understand amenorrhea as a side effect.
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Yes, I understand about the bleed not being neccessary and am planning to skip the placebo’s on the next months. It’s just that I’ve been having cramps for the last 6 weeks (the last 2 weeks of tibolone and the whole pack of Drovelis) and I’m just hoping a bleed might help (sort of a reset). Maybe I should have waited before starting Drovelis when I stopped the tibolone, because now I don’t really know if it a drospirenone side effect or my body just still trying to bleed (and the drospirenone might be suppressing that, as it’s supposed to do). I’m probably overthinking, but since I’m getting side effects from everything I’m trying and have a horendous cycle at this point, I’m second guessing everything.
I think I’m going to take estradiol tonight (is 1 or 2 mg a medium dose? My tablets are 1 mg I think) and start the new pack tomorrow, besides the spotting this morning, I haven’t seen any more blood. Still have cramps though.
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I'd probably take the 2mg if you are symptomatic.
There's 1.5mg in Zoely but I have high ovarian reserve and even shut down I have some endogenous estradiol release.
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I did sleep better after taking 2 mg of estradiol (no night sweats and no hot flushes this morning), but pretty nauseous today. I have been taking estetrol instead of estradiol in Drovelis and while it is a bit too low of a dose, I do like that I don’t get any nausea at all from it. With estradiol, it takes a few weeks for the nausea to subside (doesn’t matter if it is oral or transdermal), when I first started, I had to start really low because of that.
So, still no bleeding other than maybe very light spotting, so I’ll just start my new pack tonight. I’m just going to treat the cramping as a side effect from Drovelis (which is reported often in the first month) and not as a sign that I have a thick lining that needs to be shed (because that would have happened by now I think).
I’ll update again once I have new things to report.
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If you can afford it you could always book a private ultrasound to check your lining for peace of mind.
I have one regularly for ovarian screening.
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I’m in the Netherlands, so things work a bit different. I am planning to ask for a physical, because things don’t feel completely right in my vagina. My GP said I don’t have a prolapse, but I have doubts. At the specialist, I’ve had 1 appointment at the clinic, but didn’t think to discuss it then (they only checked my blood pressure) and my next appointment will be by phone, so I’ll ask for the next appointment to be at the clinic then. I could ask for an ultrasound too probably.
I’m not really worried about a thickened lining, because I have had a bleed 1 week into the tibolone, which was similar to a (for me) light period, which would probably be a normal-heavy period for a lot of others (mine are usually very heavy). I was just hoping the whole cramping would subside after a bleed. I did read many more reports on a lot of cramping the first month on Drovelis and for most this did seem to resolve somewhere during the second pack, so fingers crossed it’s the same for me.
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Small update: For the last few days I’ve been supplementing with estradiol (1 mg tablets), because the estetrol dose in Drovelis is obviously too low for me. Or maybe the estetrol is just not working well for me, I’m not sure without comparison or a way to up that specific dose.
I’m nauseous, which is a temporary side effect from estradiol (both oral and transdermal) for me, so that will probably subside in 2 weeks. (Estetrol doesn’t make me nauseous at all, which was a big plus). I’m having less hot flushes and sleeping slightly better, hopefully this will get better after longer. My dizziness is not gone, but I think it is a bit better. My dry mouth has improved considerily, so besides the diuretic effect from drospirenone, it was probably caused partly by low estrogen. It’s not gone, but tolerable now, I wanted to know if drospirenone could work for me as a progestin, because Slynd/Slinda with estrogen is another option. My back pain also might have improved slightly, but still pretty bad, so still not sure if that is caused by the progestin or low estrogen or something else.
So, I think my adding estrogen experiment is working well, although I’m still not feeling great. Drospirenone might turn out to be an option for me. I still think I’ll probably ask to try qlaira first, before considering Slinda/Slynd (I think it’s called Slinda in EU and Slynd in UK?) with estrogen, because I do find the diuretic effect very annoying, so I’m hoping dienogest might work better for me. I’d still prefer to not to have to take a progestin at all, so I might look into getting Duavive abroad at some point. It is still available in Belgium, but I’m not sure if I could get it there, how that works with getting prescriptions and so on.