From the Guidelines
It is not recommended to skip periods while on Nextstellis (estetrol and drospirenone) without consulting a healthcare provider first. Nextstellis is a combined hormonal contraceptive pill designed to be taken for 24 active days followed by 4 placebo days, during which you would typically experience withdrawal bleeding (a period) 1. Skipping the placebo pills to avoid periods is not specifically approved for Nextstellis and could potentially lead to breakthrough bleeding or spotting.
Key Considerations
- The U.S. Selected Practice Recommendations for Contraceptive Use, 2024, do not provide specific guidance on skipping periods for Nextstellis users 1.
- For combined hormonal contraceptive (CHC) users, including those on extended or continuous regimens, the guidelines suggest that a hormone-free interval for 3–4 consecutive days may be considered, but this is not recommended during the first 21 days of extended or continuous CHC use and not more than once per month because contraceptive effectiveness might be reduced 1.
- If you're interested in menstrual suppression, it's essential to discuss this with your healthcare provider, as they may recommend a different contraceptive option that is specifically designed for extended or continuous use 1.
Recommendations for Nextstellis Users
- If you experience difficult periods or other menstrual concerns that make you want to skip periods, your healthcare provider can help determine the best approach for your specific situation 1.
- Having regular withdrawal bleeding while on hormonal contraceptives can help reassure you that you're not pregnant, though the bleeding itself isn't medically necessary 1.
- Your healthcare provider may consider alternative treatment options, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or hormonal treatments, to manage bleeding irregularities 1.
From the Research
Skipping Periods on Nextstellis
- Nextstellis is a combined oral contraceptive containing estetrol and drospirenone, and its effects on menstrual bleeding have been studied in several clinical trials 2, 3, 4.
- The studies have shown that the estetrol-drospirenone combination provides a predictable and regular bleeding profile for most users, with a high stable rate of scheduled bleeding and a low rate of unscheduled bleeding 2, 3, 4.
- However, the question of whether it is okay to skip periods while on Nextstellis is not directly addressed in these studies.
- A review of health and lifestyle issues related to avoiding menstruation suggests that estrogen-progestogen combinations, such as Nextstellis, can be used to suppress menstrual bleeding for several months 5.
- The review also notes that oral contraceptive users can skip the pill-free period and continue with the active pills in the next package to postpone normal menses 5.
- However, it is essential to consult with a healthcare provider before making any changes to the dosing regimen, as individual results may vary and potential risks and benefits need to be considered 2, 3, 4, 5.
Potential Risks and Benefits
- The estetrol-drospirenone combination has been shown to have a favorable safety profile, with low rates of adverse events and no clinically significant effects on metabolic parameters 2, 3, 4.
- However, as with any hormonal contraceptive, there may be potential risks associated with skipping periods, such as changes in bleeding patterns, breakthrough bleeding, or spotting 5.
- On the other hand, skipping periods may also have benefits, such as reducing menstrual discomfort, improving quality of life, and increasing convenience 5.
Consultation with a Healthcare Provider
- Given the potential risks and benefits associated with skipping periods on Nextstellis, it is crucial to consult with a healthcare provider before making any changes to the dosing regimen 2, 3, 4, 5.
- A healthcare provider can help determine the best course of action based on individual needs and medical history, and provide guidance on how to minimize potential risks and maximize benefits 2, 3, 4, 5.