Estrogen Content Comparison in Contraceptives

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
• Approximately 20 micrograms of ethinyl estradiol is equivalent to 2 mg of estradiol valerate in terms of hormonal effect 1

Metabolic Impact Differences

• Nextellis with estradiol demonstrates less impact on coagulation and fibrinolysis markers 1
• Nextellis with estradiol has a lower risk of thromboembolic events 1, 2

Clinical Implications

• The American Heart Association implies that natural estradiol in Nextellis has less impact on blood pressure compared to ethinyl estradiol in Marvelon, as reported by the Hypertension journal 3, 4
• The American Stroke Association suggests a direct relationship exists between higher doses of ethinyl estradiol and increased stroke/thrombosis risk 2

Common Pitfalls in Comparing Contraceptives

• The European Society of Contraception notes that the type of estrogen (natural vs. synthetic) matters significantly in determining side effects, as lower estrogen does not automatically mean fewer side effects 1
• The American College of Cardiology recommends considering the progestin component alongside estrogen content when evaluating side effect profiles 3, 4