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Nesterone (segesterone acetate) plus estradiol is an investigational combination hormonal contraceptive consisting of a potent progestin (nesterone/segesterone acetate) and the natural estrogen, estradiol. This combination has been studied in both transdermal gel and vaginal ring formulations for female contraception. Nesterone acts as a highly selective agonist of the progesterone receptor, effectively suppressing ovulation, while the addition of low-dose estradiol serves as an “add-back” therapy to mitigate hypoestrogenic symptoms such as irregular bleeding and bone loss that can occur with progestin-only regimens. Unlike most marketed combined hormonal contraceptives that use ethinyl estradiol, this formulation uses native 17β-estradiol to potentially reduce thrombotic risk and improve safety. The primary indication under investigation is contraception for women of reproductive age[1][2][5].
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