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Is Nextstellis a Combination Pill?

Key Takeaways

  • Yes, Nextstellis is a combination birth control pill containing two hormones: estetrol (an estrogen) and drospirenone (a progestin).
  • Combination pills work by preventing ovulation, thickening cervical mucus, and changing the uterine lining to prevent pregnancy.
  • Nextstellis is unique because it uses estetrol instead of the more common estrogen ethinyl estradiol found in many combined oral contraceptives.
  • Like other hormonal contraception methods, Nextstellis may cause side effects such as breast tenderness, mood changes, or vaginal bleeding.
  • Because it contains estrogen, it may increase the risk of blood clots in some individuals.

What Is Nextstellis?

Nextstellis is a prescription birth control pill approved by the FDA for pregnancy prevention. It is part of a category of hormonal contraception known as combined oral contraceptives.

Combination birth control pills contain two hormones that mimic naturally occurring reproductive hormones in the body. These hormones work together to prevent pregnancy and regulate the menstrual cycle.

Nextstellis is packaged in a blister pack with active hormone tablets and inactive tablets taken at the end of the cycle. Taking the medication daily as directed helps maintain consistent hormone levels that support effective birth control.

Why Nextstellis Is Considered a Combination Pill

Nextstellis is classified as a combined oral contraceptive because it contains both an estrogen and a progestin.

The active ingredients include:

  • Estetrol – a type of estrogen derived from a plant source that acts on estrogen receptors in the body.
  • Drospirenone – a progestin that helps prevent ovulation and thickens cervical mucus.

These hormones work together to stop ovulation, change cervical mucus in the cervix, and alter the lining of the uterus. These effects make it difficult for sperm to reach and fertilize an egg.

Because it contains both hormone types, Nextstellis falls into the same category as other combined hormonal contraception methods.

How Nextstellis Differs From Other Combination Pills

Many birth control pills contain ethinyl estradiol as the estrogen component. Nextstellis is different because it contains estetrol instead.

Estetrol is a naturally occurring estrogen produced during pregnancy. Researchers developed a plant-derived version for use in this hormonal contraceptive.

How Nextstellis Prevents Pregnancy

Like other combined oral contraceptives, Nextstellis prevents pregnancy through several mechanisms.

These include:

  • Preventing ovulation so the ovary does not release an egg
  • Thickening cervical mucus so sperm have difficulty entering the cervix
  • Altering the uterine lining to make implantation less likely

When taken consistently at the same time every day, this method of birth control is highly effective at preventing pregnancy.

However, missing pills may reduce effectiveness, so a back-up birth control method, such as condoms, may be recommended if doses are missed.

Common Side Effects of Nextstellis

Many people tolerate Nextstellis well, but some side effects may occur while taking the medication.

Common side effects include:

  • Breast tenderness
  • Headaches
  • Mood changes
  • Nausea
  • Vaginal bleeding or spotting between periods
  • Changes in sex drive
  • Weight gain in some individuals

Skin changes such as chloasma may also develop in people sensitive to estrogen-containing contraceptives.

These symptoms often improve after the body adjusts to hormonal contraception.

Serious Side Effects and Risks

Because Nextstellis contains estrogen, it carries certain risks similar to other combined oral contraceptives.

Possible serious side effects include:

  • Blood clots or thromboembolic events
  • Heart attack or stroke
  • High blood pressure
  • Liver problems, such as increased liver enzymes
  • New or worsening headaches, including migraine headaches
  • Gallbladder disease or cholestasis (slowed flow of bile from the liver)
  • High potassium level (hyperkalemia), which can be serious and may lead to death
  • Increased risk of hormone-sensitive cancers
  • New or worsening depression
  • Increased blood sugar

The risk of blood clots may be higher in people with certain medical conditions or lifestyle factors such as smoking.

Anyone experiencing symptoms like chest pain, severe headache, or sudden shortness of breath should seek immediate medical attention.

Who Should Not Take Nextstellis?

Nextstellis may not be appropriate for people with certain medical conditions.

A healthcare provider may recommend avoiding this medication if someone has:

  • A history of blood clots or thromboembolic disorders
  • Breast cancer or hormone-sensitive cancers
  • Severe liver disease or liver problems
  • Uncontrolled hypertension
  • High cholesterol
  • Gallbladder disease
  • Kidney disease or adrenal gland disorders that affect potassium levels
  • Angioedema (swelling of the face, tongue, or throat)

People over 35 years of age who smoke may also have an increased risk of cardiovascular complications with estrogen-containing birth control.

Drug Interactions to Consider

Some medications and supplements can interact with hormonal birth control and affect its effectiveness.

Examples include:

  • Hepatitis C drugs containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir
  • Medications that increase potassium levels, like potassium supplements, spironolactone, and amiloride
  • Thyroid medicines, such as levothyroxine
  • St. John’s wort or certain other over-the-counter supplements
  • Other CYP inhibitors, such as itraconazole, fluconazole, voriconazole, ketoconazole, and others

These drug interactions may reduce contraceptive effectiveness or increase side effects.

A healthcare provider should review all medications, supplements, and medical conditions before starting Nextstellis.

When to Talk to a Healthcare Provider

Anyone considering hormonal birth control should discuss options with their healthcare provider. They can help determine whether Nextstellis is an appropriate birth control method based on:

  • Personal medical history
  • Risk factors for complications
  • Current medications and supplements
  • Age and body mass index (BMI)

This evaluation helps reduce the risk of complications and ensures the chosen method of birth control is safe and effective.

The Bottom Line

Yes, Nextstellis is a combination birth control pill. It contains two hormones: estetrol, an estrogen, and drospirenone, a progestin, that work together to prevent pregnancy.

While it includes an estrogen, Nextstellis is unique because it uses estetrol instead of the more common estrogen ethinyl estradiol found in other combined oral contraceptives.

Anyone interested in this form of hormonal contraception should discuss benefits, risks, and potential side effects with a healthcare provider.

Frequently Asked Questions

What hormones are in Nextstellis?
Nextstellis contains two active ingredients: estetrol and drospirenone. Estetrol functions as the estrogen component, while drospirenone acts as the progestin in this combined oral contraceptive.

Is Nextstellis different from other birth control pills?
Yes, Nextstellis is unique because it uses estetrol as its estrogen component instead of ethinyl estradiol, which is commonly found in other combination pills. This newer hormone was developed for hormonal contraception and evaluated in clinical trials before FDA approval.

Does Nextstellis contain estrogen?
Yes, Nextstellis contains estrogen in the form of estetrol. Because it includes both estrogen and progestin, it is classified as a combined oral contraceptive.

Can Nextstellis increase the risk of blood clots?
Like other combined hormonal contraception methods, Nextstellis may increase the risk of blood clots in some individuals. People with certain medical conditions or lifestyle risk factors may have a higher risk and should discuss this with a healthcare provider.

Do you need back-up contraception when starting Nextstellis?
Depending on when the first pill is taken in the menstrual cycle, a healthcare provider may recommend using back-up contraception such as condoms for a short period of time. This helps ensure pregnancy prevention while hormone levels stabilize.

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