The name 'Estelle' can be confusing as it is used for different hormonal medications in different countries. The original version, also sold as a generic for Diane-35, is a treatment for androgen-dependent conditions in women. In contrast, a newer, distinct medication with the brand name Estelle (Nextstellis in the US) is primarily used as a combined oral contraceptive. Understanding the differences in ingredients, purpose, and side effects is key for anyone considering or currently using one of these treatments.
Estelle-35 (Cyproterone acetate and Ethinylestradiol)
This formulation is commonly indicated for treating androgen-dependent diseases in women, including severe acne and hirsutism. Its primary mechanism involves targeting the effects of androgens, or male sex hormones, which are present in women and can cause symptoms like oily skin, acne, and excessive hair growth. Estelle-35 works in two key ways:
- Cyproterone acetate: A progestogen with strong anti-androgenic properties. It acts as a competitive antagonist, blocking androgen receptors in target tissues and reducing the synthesis of androgens.
- Ethinylestradiol: An estrogen that amplifies the anti-androgenic effect by increasing levels of Sex Hormone-Binding Globulin (SHBG). SHBG binds to excess free androgen in the bloodstream, reducing its biological availability and impact on skin and hair.
Because of its hormonal composition, Estelle-35 also provides an effective oral contraceptive effect. However, it is not recommended for contraception alone and is reserved for women who also require treatment for the androgen-dependent conditions mentioned.
Indications for Estelle-35
- Severe Acne: Especially pronounced forms like acne papulopustulosa or nodulocystica, when other treatments like oral antibiotics or topical applications have failed.
- Hirsutism: Treatment for mild to moderate excessive facial or body hair growth.
- Seborrhoea: Reduction of excessive greasiness of the hair and skin.
- Polycystic Ovary Syndrome (PCOS): Management of androgen-related symptoms associated with PCOS.
Estelle (Estetrol and Drospirenone) / Nextstellis
This is a newer, distinct combined oral contraceptive developed by the company Mithra. It is primarily a birth control pill and is not the same as Estelle-35.
- Estetrol (E4): A naturally produced estrogen during pregnancy that can now be synthesized from plant sources. This is the first birth control pill to use a naturally occurring estrogen. In clinical trials, it was found to have a different and potentially more favorable safety profile compared to older pills containing synthetic estrogens like ethinylestradiol.
- Drospirenone (DRSP): A progestin also found in other well-known oral contraceptives. It helps provide the contraceptive effect and has anti-androgenic properties.
Clinical trials have shown this formulation to be highly effective at preventing pregnancy, with potentially fewer side effects like breast tenderness and spotting compared to older combined oral contraceptives.
Comparison: Estelle-35 vs. Estelle (Nextstellis)
| Feature | Estelle-35 | Estelle (Nextstellis) |
|---|---|---|
| Primary Purpose | Treatment of androgen-dependent conditions (severe acne, hirsutism). | Combined oral contraception (pregnancy prevention). |
| Key Hormones | Cyproterone acetate (anti-androgen) + Ethinylestradiol (synthetic estrogen). | Estetrol (natural estrogen) + Drospirenone (progestin). |
| Contraceptive Use | Effective as contraception, but not recommended for contraception alone. | Primarily and specifically for contraception. |
| Safety Profile | Higher risk of venous thromboembolism (VTE) compared to other pills. Requires careful consideration by a doctor. | Potential for lower side effects like breast tenderness and potentially lower blood clotting risk compared to some older COCs. |
| Market Availability | Available in countries such as Australia, New Zealand, and parts of Asia. | Marketed in the US as Nextstellis and in other countries under different brand names (e.g., Drovelis). |
Side Effects and Risks
Both versions of the Estelle pill are hormonal medications and carry potential side effects, which vary depending on the specific formulation. Common, milder side effects can include:
- Nausea and gastrointestinal upset
- Headaches
- Breast tenderness
- Mood changes, including depression
- Changes in body weight
- Breakthrough bleeding (spotting) or irregular periods
More serious risks are primarily associated with the use of estrogen-containing hormonal medications. All combined oral contraceptives, including Estelle-35 and Nextstellis, carry an increased risk of venous thromboembolism (VTE), or blood clots. However, the level of risk varies with the specific hormones and their dosages. For example, Estelle-35 (and its generic Diane-35) has been linked to a higher risk of blood clots compared to some other pills. Nextstellis, containing the natural estrogen estetrol, has been studied to show minimal impact on certain blood clotting parameters, though risks still exist. It is crucial to discuss your personal and family medical history with your doctor to assess your individual risk factors before starting treatment.
Conclusion
In conclusion, the answer to "what is the Estelle pill for?" is dependent on the specific product and geographical location. Estelle-35, containing cyproterone acetate and ethinylestradiol, is primarily an anti-androgenic treatment for severe acne and hirsutism that also provides contraception, but with known risks related to blood clots. The newer Estelle formulation, known as Nextstellis in the U.S., uses a natural estrogen (estetrol) and is marketed as a combined oral contraceptive with potentially a more favorable side effect profile. Both medications work by modulating hormones to achieve their therapeutic goals. Anyone considering or prescribed an Estelle product should consult their healthcare provider to confirm the specific formulation and understand its indications, risks, and benefits fully. More details can often be found in the medication's Consumer Medicine Information (CMI) leaflet for specific regions.
