What is unique about drospirenone in some COCs?

• A. To reduce side effects such as bloating, PMS, and weight gain
• B. To increase estrogen exposure
• C. To promote hair loss
• D. To enhance iron absorption

Answer: (A)

Drospirenone is unique among some combined oral contraceptives because it has anti-mineralocorticoid activity, similar to spironolactone. This property counteracts water retention and edema, which helps reduce bloating, PMS-related symptoms, and perceived weight gain in many users. That anti-aldosterone effect is the key reason this progestin stands out. The other statements don’t reflect a specific feature of drospirenone: estrogen exposure is set by the estrogen component of the pill, not by the progestin; it does not promote hair loss (in fact it is antiandrogenic and can improve acne and hair outcomes in some people); and iron absorption is unrelated to the progestin's action.