Nextstellis (drospirenone and estetrol) introduced a genuinely new estrogen into a category that had relied on the same one for decades.
It is the first birth control pill to use estetrol, an estrogen naturally produced during pregnancy and manufactured here from a plant source, paired with the progestin drospirenone. The combined tablet is taken once daily to prevent pregnancy.
Nextstellis faces no generic competition in a category otherwise dominated by low-cost generics, which is its central commercial challenge. Estetrol’s novelty is its principal asset, and its cardiovascular and hepatic profile relative to ethinyl estradiol is the key question shaping uptake in contraception.