Is Nextellis (estradiol) a lower estrogen option compared to Marvelon (ethinyl estradiol)?

Nextellis vs Marvelon: Estrogen Content Comparison

Yes, Nextellis (containing estradiol) is a lower estrogen option compared to Marvelon (containing ethinyl estradiol) in terms of potency and metabolic impact. 1, 2

Estrogen Types and Potency Comparison

• Nextellis contains natural estrogen (17β-estradiol or estradiol valerate), which has a milder impact on the body compared to the synthetic ethinyl estradiol found in Marvelon 1
• Ethinyl estradiol (EE) in Marvelon is a potent synthetic estrogen with longer half-life and slower metabolism, making it significantly more potent than natural estradiol 1, 2
• Approximately 20 micrograms of ethinyl estradiol is equivalent to 2 mg of estradiol valerate in terms of hormonal effect 1

Metabolic Impact Differences

• Marvelon contains 30 micrograms of ethinyl estradiol, which causes more pronounced effects on:

  • Hemostasis (blood clotting factors) 3
  • Lipid metabolism 4
  • Sex hormone binding globulin (SHBG) levels 4

• Nextellis with estradiol demonstrates:

  • Less impact on coagulation and fibrinolysis markers 1
  • Milder effects on lipid profiles 1, 4
  • Lower risk of thromboembolic events 1

Clinical Implications

• Blood pressure effects: Natural estradiol in Nextellis has less impact on blood pressure compared to ethinyl estradiol in Marvelon 1
• Venous thromboembolism risk: Direct relationship exists between higher doses of ethinyl estradiol and increased stroke/thrombosis risk 1
• Metabolic markers: Marvelon shows more significant increases in factors that may contribute to hypercoagulability 3, 4

Comparative Studies

• Research comparing similar formulations shows that pills containing 30 micrograms of ethinyl estradiol (like Marvelon) cause more pronounced increases in:

  • Total cholesterol and triglycerides 4
  • HDL cholesterol 4
  • Apolipoprotein B 4
  • SHBG levels 4

• A direct comparison study between Mercilon (20 μg ethinyl estradiol) and Marvelon (30 μg ethinyl estradiol) showed that even this small difference in ethinyl estradiol dosage results in significant metabolic differences, with the higher dose causing more pronounced effects 5, 4

Common Pitfalls in Comparing Contraceptives

• Don't assume that lower estrogen automatically means fewer side effects - the type of estrogen (natural vs. synthetic) matters significantly 1, 2
• Remember that the progestin component also influences side effect profiles and must be considered alongside estrogen content 1
• Be aware that individual responses to hormonal contraceptives vary considerably, and what works well for one person may not for another 1