The Hormonal Makeup of Nextstellis
Nextstellis is a combined hormonal oral contraceptive containing two active ingredients: drospirenone, a synthetic progestin, and estetrol (E4), a naturally occurring estrogen. The combination of these hormones works primarily by preventing ovulation to effectively prevent pregnancy. The specific composition of Nextstellis is notable because it uses estetrol, a plant-based estrogen that interacts with the body differently than the ethinyl estradiol (EE) found in many older birth control pills.
Drospirenone: The Diuretic Effect
- Antimineralocorticoid Activity: Drospirenone is structurally similar to spironolactone, a diuretic often used to treat high blood pressure. This similarity gives drospirenone its antimineralocorticoid properties, which help counteract salt and water retention in the body.
- Potential to Reduce Bloating: Because of its diuretic effect, drospirenone can help reduce the fluid retention and bloating that are sometimes associated with other types of oral contraceptives. This property is a key reason Nextstellis may be associated with a more neutral weight profile for many users compared to older birth control formulations.
Estetrol (E4): The 'Natural' Estrogen
- Unique Profile: As a newer estrogen, estetrol works differently than the more common ethinyl estradiol. This unique pharmacological profile may contribute to fewer side effects overall, including potentially fewer weight-related issues.
Clinical Trial Findings on Nextstellis and Weight
During clinical studies for Nextstellis, weight gain was reported as a possible side effect, but the data showed it was less common than with some other hormonal contraceptives.
- Reported Incidence: In clinical trials, roughly 3% of participants reported weight gain. It is important to note that a definitive causal link between the pill and weight gain was not firmly established, as various factors can influence body weight during any study.
- Nextstellis vs. Yaz: Comparative data suggests that certain side effects, including weight gain, were reported less often with Nextstellis than with Yaz, another pill containing drospirenone but combined with ethinyl estradiol.
Separating Water Weight from Fat Gain
One of the most crucial distinctions when discussing weight changes on birth control is the difference between water retention and actual fat gain. Many initial weight changes are due to temporary fluid shifts rather than an increase in body fat.
- Temporary Water Retention: Hormonal fluctuations, both natural and induced by birth control, can cause the body to hold onto more water, leading to bloating and temporary weight increases.
- Drospirenone's Role: The diuretic properties of drospirenone in Nextstellis are specifically designed to counteract this effect. However, some initial water retention can still occur as the body adjusts to the new hormonal balance. This initial fluctuation often subsides within a few months.
Factors That Influence Weight While on Birth Control
While hormonal effects are a key consideration, several other factors can influence weight changes while taking Nextstellis or any other birth control:
- Appetite and Food Cravings: Changes in hormone levels can impact appetite. Some people may experience an increase in appetite, which could lead to greater caloric intake and subsequent weight gain.
- Mood Disturbances: Mood changes, such as anxiety or irritability, are a potential side effect of Nextstellis. For some, emotional changes can trigger a change in eating habits, such as stress eating.
- Lifestyle Changes: Changes in diet, exercise, and stress levels that occur over time are often completely unrelated to birth control but can significantly affect body weight.
Comparing Nextstellis to Other Oral Contraceptives
This table provides a general comparison of common combination oral contraceptives and their typical associations with weight gain. Individual responses will always vary.
| Feature | Nextstellis | Yaz (Drospirenone/EE) | Levonorgestrel Combo Pills | Progestin-Only Pills (POP) |
|---|---|---|---|---|
| Hormonal Composition | Drospirenone (Progestin) & Estetrol (Estrogen) | Drospirenone (Progestin) & Ethinyl Estradiol (Estrogen) | Levonorgestrel (Progestin) & Ethinyl Estradiol (Estrogen) | Progestin Only (e.g., Drospirenone, Norgestrel) |
| Typical Weight Effect | Often more weight-neutral; some experience temporary water retention. | Potential for weight gain due to water retention; similar to Nextstellis but Nextstellis may report less often. | Historically associated with more weight gain, though data is mixed; less common with newer formulations. | Weight gain possible, depends on progestin and individual. |
| Water Retention | Less likely due to drospirenone's diuretic properties. | Possible, but similar to Nextstellis due to drospirenone. | Can be more common with older progestins, but varies. | Can cause bloating and fluid retention in some users. |
| Key Takeaway | Designed with unique hormonal profile to minimize some side effects, including water weight. | Another option with drospirenone, may have slightly higher incidence of some side effects. | Very common type of pill; some people may experience more weight side effects. | Weight effects are highly individual and vary by progestin type. |
What to Do If You're Concerned About Weight Gain
If you believe you are gaining weight because of Nextstellis, or are concerned about this side effect, consider the following steps:
- Track Your Weight and Symptoms: Maintain a journal to track your weight, diet, and exercise habits. This can help you identify if weight changes correlate with other factors besides the pill.
- Be Patient: Give your body a few months to adjust. Hormonal contraceptives can cause temporary water retention that resolves over time.
- Lifestyle Assessment: Reflect on your dietary habits and physical activity. Sometimes, subtle lifestyle shifts are the true cause of weight changes.
- Discuss Options with a Healthcare Provider: If weight gain is a persistent concern, talk to your doctor. They can help determine if Nextstellis is the cause and discuss alternative birth control methods that may be a better fit for you. You can find more information about different options on resources like Bedsider, a trusted website for contraceptive information.
Conclusion
Nextstellis, like other hormonal birth control methods, can cause side effects including weight gain, though clinical data suggests this is a less frequent occurrence compared to some older formulations. Its unique combination of drospirenone and estetrol may minimize issues like water retention. Ultimately, the experience is highly individual, and while weight fluctuations can occur, they are often minor and temporary. Open communication with a healthcare professional is the most effective way to address concerns and determine the best contraceptive choice for your body.
