Nextstellis is a combination oral contraceptive pill used to prevent pregnancy. It contains two active ingredients: drospirenone (a progestin) and estetrol (an estrogen). Like most hormonal contraceptives, Nextstellis can cause side effects as your body adjusts to the hormones. The duration of these effects can vary from person to person.
The Initial Adjustment Period
When you first start taking Nextstellis, your body goes through an adjustment period. During this time, you may experience a range of mild side effects that are often temporary, resolving within a few days to a few weeks. For hormonal contraceptives in general, reassurance that symptoms will likely improve within three to five months is often helpful.
Irregular bleeding or spotting is a common side effect during this initial phase, particularly in the first four months of use. This is expected to decrease over time; clinical studies showed a reduction in unscheduled bleeding from 30.3% in the first cycle to 17.4% by the twelfth cycle.
Common Side Effects and Their Typical Duration
Many common side effects of Nextstellis are temporary. However, if they last for more than a few weeks, become troublesome, or are severe, it's advisable to consult a doctor.
Common side effects include:
- Bleeding Irregularities: Spotting and breakthrough bleeding are frequent in the first 4 months and typically diminish. Contact your doctor if bleeding is heavy or doesn't improve.
- Mood Disturbances: Mood changes, anxiety, irritability, and depression are possible. Seek immediate medical advice for symptoms of depression or severe mood changes.
- Headache: Headaches are common during adjustment. Discontinue use and seek medical advice for new, recurrent, persistent, or severe migraines, especially with aura.
- Breast Symptoms: Tenderness, pain, and discomfort are common and often lessen after the initial period.
- Acne: Acne may occur, but some may see improvement after three months.
- Weight Gain: Reported by some users.
- Decreased Libido: A reduced interest in sex is possible.
Consult your doctor if these common side effects persist or cause concern.
Serious Side Effects: When to Seek Immediate Medical Attention
Nextstellis can have serious side effects requiring immediate medical attention, which are not expected to resolve on their own.
Boxed Warning: A boxed warning highlights the increased risk of serious cardiovascular events, such as blood clots, heart attack, and stroke, particularly for women over 35 who smoke. Nextstellis is not recommended for smokers over 35 due to this risk.
Seek immediate medical help if you experience signs of:
- Blood Clots: Symptoms include pain, swelling, or redness in a leg; sudden shortness of breath; sharp chest pain; or coughing up blood. The risk of venous thromboembolism (VTE) is highest in the first year of use.
- Heart Attack or Stroke: Symptoms may include chest pain spreading to the jaw or shoulder, sudden severe headache, weakness/numbness on one side, slurred speech, or sudden vision changes.
- High Potassium Levels (Hyperkalemia): Symptoms include nausea, weakness, tingly feeling, chest pain, or irregular heartbeats. Potassium levels may be monitored, especially in the first cycle.
- Liver Problems: Look for stomach pain, dark urine, yellowing skin/eyes (jaundice), loss of appetite, or vomiting.
- Severe Depression or Mood Changes: Seek immediate help if experiencing thoughts of self-harm.
This is not a comprehensive list. Always refer to the patient information and consult your healthcare provider.
Comparison of Side Effect Durations
| Side Effect Type | Typical Duration | When to Contact a Doctor |
|---|---|---|
| Mild & Common (e.g., headache, nausea, breast tenderness) | A few days to a few weeks | If they last longer, are severe, or bothersome |
| Bleeding Irregularities | Common in the first 4 months, decreasing over time | If bleeding is heavy or does not improve |
| Acne | May improve after 3 months | If it worsens significantly or is distressing |
| Serious (e.g., signs of blood clots, stroke, severe depression) | Do not resolve on their own; persistent | Immediately |
Conclusion
For most individuals starting Nextstellis, many of the initial side effects are part of a temporary adjustment period that lasts from a few days to several weeks. Key side effects like irregular bleeding may take up to four months to regulate. However, it is crucial to distinguish these common, transient effects from the signs of serious medical issues. Any side effect that is severe, persistent, or causes significant concern should be discussed with a healthcare provider. Always seek immediate medical attention for symptoms of serious conditions like blood clots, stroke, or severe depression.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your medical care.
