General
Nexstellis (Drospirenone - estetrol)
Virtual visit

Nexstellis (Drospirenone - estetrol)

With our quick and easy online prescription process, you can manage your health effortlessly — whether you need a first-time prescription for Nexstellis (Drospirenone - estetrol) or a refill of an existing one.

Licensed providers in all 50 states

Expert-guided, evidence-based treatments

Skip the trip to the doctor's office

Visit options

Costs shown are for the visit only. You'll pay for medication at your preferred pharmacy.

Video Visit

$25

Est. or $100 w/o insurance

Chat Visit

$30

w/o insurance

Most insurance accepted

Board-certified

No hidden fees

Available nationwide

What is Nexstellis (Drospirenone - estetrol)?

Nexstellis is a combined oral contraceptive containing estetrol—a naturally occurring estrogen produced only during pregnancy—paired with drospirenone, a progestin with anti-mineralocorticoid properties. It's the first contraceptive to use estetrol (E4) as its estrogen component, which has a unique receptor profile that may offer a more favorable safety and tolerability profile compared to ethinyl estradiol-based pills. It's taken as a 24/4 regimen—24 active pills followed by 4 inactive pills—providing highly effective pregnancy prevention while potentially reducing estrogen-related side effects.

Estetrol estrogen component

Estetrol is a native human estrogen with selective tissue activity—it acts as an estrogen agonist in the brain and reproductive system while having limited stimulatory effects on breast and liver tissue, which may translate to a more favorable safety and tolerability profile.

Drospirenone progestin activity

Provides progestogenic contraceptive coverage alongside anti-mineralocorticoid effects that reduce water retention and bloating—a progestin profile associated with fewer weight-related side effects compared to older progestins.

Triple contraceptive mechanism

The combination suppresses ovulation through estrogenic and progestogenic activity, thickens cervical mucus to block sperm, and alters the endometrial lining—delivering comprehensive pregnancy prevention through three complementary mechanisms.

Virtual visit with clinician

Ongoing support, always available.

You’ll be supported by experienced clinicians who care for a wide range of health needs, from everyday concerns to more complex conditions.

Our clinicians track your progress over time and adjust your care as needed. If medication is prescribed, we’ll manage dosing and monitor for side effects. If lab testing is recommended, we review results and refine your plan accordingly. You’re never left to navigate care on your own.

All your care in one place. That’s the General Medicine difference.

We help you understand your options, connect you to the right clinicians, manage prescriptions, coordinate any needed evaluations, and keep an eye on your overall health along the way. It’s comprehensive care that looks at the full picture — your goals, your history, your lifestyle — and makes it simple to move forward with confidence.

Your care plan
Clinician

What our customers have to say

“I feel like I’m finally on the right path to improving my health with the right support now! It’s so refreshing and reassuring.”

Emerald

“My experience with General Medicine was amazing. The understanding and care that was taken to figure out what is exactly going on with me. I feel like a weight has been lifted off of me.”

Kaylee

“I couldn’t be happier with my experience with General Medicine! They are fast, responsive, kind and knowledgeable. It is much easier, more affordable and faster.”

Nika

Get the care you need, without the wait.

Frequently Asked Questions

What makes Nexstellis different from other combination birth control pills?

Nexstellis is the first contraceptive to use estetrol — a naturally occurring estrogen produced only during pregnancy — paired with drospirenone. Its unique estrogen offers a different receptor profile than the synthetic ethinyl estradiol in most pills.

How does estetrol differ from ethinyl estradiol?

Estetrol has selective tissue activity — acting as an estrogen in the brain and reproductive tract while having limited stimulatory effects on breast and liver tissue. This different profile may offer tolerability advantages for estrogen-sensitive patients.

What is the 24/4 dosing schedule?

Nexstellis uses a 24-day active pill / 4-day inactive pill schedule — a shorter hormone-free interval than the traditional 21/7 regimen. This maintains more consistent hormone levels and may reduce hormonal fluctuation symptoms.

What side effects might I experience?

Headache, nausea, breast pain, irregular bleeding, and mood changes are the most commonly reported effects. Like all combined hormonal contraceptives, there is an increased risk of blood clots — though absolute risk remains low in healthy women.

Can Nexstellis be used by women with estrogen sensitivity?

Some women who have experienced significant side effects on ethinyl estradiol-based pills may find Nexstellis better tolerated given estetrol's different receptor activity, but this should be discussed individually with your clinician.
Logo

© 2026 Path Healthcare Systems Corp.