Nextstellis is a combined oral contraceptive (COC) that has gained attention for its unique hormonal composition, specifically the inclusion of estetrol, a plant-based estrogen that mimics a naturally occurring hormone. This differs from most other COCs that rely on synthetic estrogens like ethinyl estradiol. The progestin component in Nextstellis is drospirenone, also found in other birth control formulations. Because of this unique profile, there is no exact replica of Nextstellis on the market. However, many alternatives offer comparable contraceptive efficacy and may be suitable depending on a patient's side effect profile and medical history. These alternatives range from other types of combination pills to entirely different methods of contraception.
Oral Contraceptive Alternatives with Drospirenone
For those who tolerate the progestin drospirenone well, alternatives that use this same hormone but with a different estrogen are a common starting point. This category includes well-known brands like Yaz and Yasmin.
- Yaz (drospirenone/ethinyl estradiol): This is a low-dose COC that uses the same progestin as Nextstellis but with the synthetic estrogen ethinyl estradiol. It is also approved for treating moderate acne and premenstrual dysphoric disorder (PMDD). Side effect profiles may differ due to the estrogen type, with some users reporting more mood changes, acne, or weight fluctuations on Yaz compared to Nextstellis.
- Yasmin (drospirenone/ethinyl estradiol): Similar to Yaz, Yasmin uses drospirenone and ethinyl estradiol in slightly different doses. It is also a popular alternative for those looking for a drospirenone-containing pill but may have a different side effect profile than Nextstellis.
Other Combined Oral Contraceptives
Beyond drospirenone-containing pills, a wide range of COCs exist with different progestins and estrogen dosages. These may be suitable for individuals seeking an alternative to Nextstellis.
- Lo Loestrin Fe (norethindrone acetate/ethinyl estradiol/ferrous fumarate): This is a very low-dose combination pill that uses a different progestin, norethindrone. Its lower estrogen content may appeal to some, though its side effect profile, particularly regarding spotting, can be different.
- Sprintec (norgestimate/ethinyl estradiol): This is a monophasic combination pill containing norgestimate, a progestin with minimal androgenic effects. It is a good option for those seeking contraception with less potential for androgen-related side effects like acne.
- Seasonique (levonorgestrel/ethinyl estradiol): This is an extended-cycle pill, meaning periods occur only once every three months. It is a good option for those who want fewer periods, but the hormonal profile and side effects will differ from Nextstellis.
Non-Oral Hormonal Alternatives
For individuals who prefer not to take a daily pill, several other hormonal contraceptive methods offer similar efficacy but are administered differently. These can be considered viable alternatives to Nextstellis.
- NuvaRing/Annovera (vaginal rings): These are flexible rings inserted into the vagina that release hormones over a period of time. Annovera uses a combination of etonogestrel and ethinyl estradiol for a full year of contraception, while NuvaRing is used monthly.
- Twirla (transdermal patch): This weekly patch delivers a combination of levonorgestrel and ethinyl estradiol through the skin. It offers convenience for those who struggle with remembering a daily pill.
- Slynd (progestin-only pill): Slynd is a progestin-only pill that, like Nextstellis, contains drospirenone but without any estrogen. This is an option for individuals who need to avoid estrogen, and it offers a more flexible dosing schedule than traditional norethindrone-based mini-pills.
- Hormonal IUDs (Intrauterine devices): Brands like Mirena release levonorgestrel (a progestin) directly into the uterus, offering long-term, highly effective contraception.
Comparison of Nextstellis and Similar Contraceptives
| Feature | Nextstellis | Yaz (Drospirenone/EE) | Lo Loestrin Fe (Norethindrone/EE) | Slynd (Drospirenone only) |
|---|---|---|---|---|
| Estrogen | Estetrol (natural) | Ethinyl Estradiol (synthetic) | Ethinyl Estradiol (synthetic) | None |
| Progestin | Drospirenone | Drospirenone | Norethindrone | Drospirenone |
| Type | Low-dose COC | Low-dose COC | Very low-dose COC | Progestin-only pill |
| Key Differentiator | First and only pill with estetrol, potentially fewer estrogen-related side effects. | Contains drospirenone with standard synthetic estrogen, approved for PMDD and acne. | Very low estrogen dose, may reduce estrogenic side effects but risk of spotting may increase. | Estrogen-free, suitable for patients with contraindications to estrogen. |
| Administration | Daily oral tablet | Daily oral tablet | Daily oral tablet | Daily oral tablet |
Choosing the Right Contraceptive
Selecting a birth control method is a highly personal decision that should be made in consultation with a healthcare provider. While Nextstellis offers a unique option with its natural estrogen, other factors may make a different alternative more suitable for a particular individual. When discussing options with a doctor, consider the following:
- Hormonal Sensitivity: If you have previously experienced negative side effects from ethinyl estradiol, Nextstellis might be a better choice, or a progestin-only option may be necessary. Conversely, if you tolerate synthetic estrogens well, other COCs offer a broader range of options.
- Side Effect Management: Side effects such as acne, mood changes, breast tenderness, or weight gain can be influenced by the specific hormones and their dosages. Your doctor can help you find a pill with a hormonal profile best suited to your needs.
- Convenience: Daily pills may not be the best fit for everyone. Patches, rings, or implants offer extended protection and remove the stress of daily dosage management.
- Medical History and Risk Factors: Certain medical conditions, such as a history of blood clots, or lifestyle factors, like smoking, can impact which contraceptives are safe. Your doctor will evaluate these risks when recommending an alternative. Nextstellis, like other CHCs, carries a boxed warning for smokers over 35 due to an increased risk of cardiovascular events.
- Fertility Plans: Some methods, like IUDs, offer long-acting, reversible contraception, while the pill requires daily compliance and has a quick return to fertility.
Ultimately, the choice comes down to a balance between effectiveness, side effect profile, and personal preference, guided by professional medical advice.
Conclusion
No birth control is an exact match for Nextstellis due to its use of the unique, plant-based estrogen estetrol. However, a wide range of contraceptive options provide similar effectiveness and can be better suited for different individuals based on their medical history and needs. Potential alternatives include other combined oral contraceptives (such as Yaz or Sprintec), progestin-only pills (like Slynd), and non-oral hormonal methods (such as the NuvaRing or Annovera). In addition, there are non-hormonal methods available for those who cannot or prefer not to use hormones. Discussing the pros and cons of each option with a healthcare provider is the most effective way to find a suitable alternative to Nextstellis. An authoritative resource for further information on medications is the National Library of Medicine's MedlinePlus.
