Drug & supplement interaction

Flaxseed + Drospirenone, Estetrol

Drospirenone, Estetrol brand name: Nextstellis.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Flaxseed has a moderate interaction with Drospirenone, Estetrol. Theoretically, taking flaxseed might decrease the effects of estrogens.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Flaxseed and Drospirenone, Estetrol

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ESTROGENS

Why this applies to Drospirenone, Estetrol

Drospirenone, Estetrol falls under ESTROGENS — the group Flaxseed interacts with.

Theoretically, taking flaxseed might decrease the effects of estrogens.
Flaxseed contains lignans with mild estrogenic and possible antiestrogenic effects. The lignans seem to compete with circulating endogenous estrogen and might reduce estrogen binding to estrogen receptors, resulting in an anti-estrogen effect. It is unclear if this effect transfers to exogenously administered estrogens.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Nextstellis is a birth control pill that combines drospirenone with estetrol, a plant-like estrogen. The concern with flaxseed is mostly on paper. Flaxseed contains lignans that act a little like estrogen and may also compete with estrogen at the receptor level. In theory, that could blunt the estrogen part of your pill, but honestly, this is a weak, theoretical worry that hasn't been shown to matter in real life, especially with the estrogen given in a pill.

Here's the practical side: eating flaxseed as a food (a spoonful on yogurt or in a smoothie) is very unlikely to affect how well Nextstellis prevents pregnancy or to cause breakthrough bleeding. Concentrated lignan supplements are less studied, so if you're considering those, run it by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Mousavi Y, Adlercreutz H. Enterolactone and estradiol inhibit each other's proliferative effect on MCF-7 breast cancer cells in culture. J Steroid Biochem Mol Biol 1992;41:615-9.. PubMed
  2. Rose DP. Dietary fiber and breast cancer. Nutr Cancer 1990;13:1-8.. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Flaxseed Also Interacts With Other Medications

Flaxseed has 596 moderate known drug interactions in our database — the Drospirenone, Estetrol one above is one of them. If you take anything else, check it against the full list below.

Moderate 596 No known interaction 2,234 (incl. Drospirenone, Estetrol)
Taking anything else?

Check Another of Your Medications Against Flaxseed

Covers the 2,830 medications we’ve checked against Flaxseed. Pick one to open its full report.

From our Q&A

Questions About Flaxseed or Drospirenone, Estetrol

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Flaxseed or Drospirenone, Estetrol, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Drospirenone, Estetrol

This page covers Flaxseed only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Drospirenone, Estetrol page lists 245 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 200 moderate · 39 minor.

From our pharmacist’s overview on the Drospirenone, Estetrol page

“The stakes with Nextstellis (drospirenone and estetrol) are the ones that come with any birth control pill, because an interaction that lowers its hormone levels can mean an unplanned pregnancy, and I would treat this list with genuine seriousness. Most of what is here changes how the body handles the hormones.”

Reviewed by 2 · Jul 18, 2026

Open the Drospirenone, Estetrol interaction page

One more smart check

Taking Flaxseed as Part of a Dietary Supplement Product? Check It for Interactions

We hold 236 real supplement products containing Flaxseed, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Flaxseed. Your product may carry other ingredients that interact with Drospirenone, Estetrol too, on top of Flaxseed — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Flaxseed and Drospirenone, Estetrol Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Flaxseed
Top half

#470 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Drospirenone, Estetrol
Top half

#1,228 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Flaxseed

What is Flaxseed?

Flaxseed
  • Constipation and digestive health
  • High cholesterol
  • Heart health
  • Menopausal symptoms
  • Blood sugar support

Flaxseed is a nutritious food rich in fiber, omega-3 fats (ALA), and plant compounds called lignans. It is most reliably helpful for constipation and may modestly lower cholesterol, but evidence for many other uses is mixed or limited. It is generally safe as a food, but talk to your pharmacist or doctor before using it as a supplement, especially if you are pregnant or breastfeeding.

Read the full Flaxseed monograph & all interactions
Keep checking

Other Drugs & Flaxseed

Browse every other medication we’ve checked against Flaxseed — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
596Moderate
0Minor
2,233No known interaction
596 Moderate 2,233 No interaction
Moderate

596 interactions

Showing 60 of 596 moderate interactions — see all 596 on the Flaxseed page.

No interaction 2,233 drugs checked — show the list

We also checked Flaxseed against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,233 medications checked with no known interaction — see the full Flaxseed list.

See the full Flaxseed interactions page
See every supplement checked against Drospirenone, Estetrol, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Flaxseed monograph › Uses, safety, and every drug interaction in one place Drospirenone, Estetrol supplement interactions › Every supplement checked against Drospirenone, Estetrol, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Flaxseed and Drospirenone, Estetrol Together: Common Questions

Can you take Flaxseed with Drospirenone, Estetrol?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Flaxseed and Drospirenone, Estetrol interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Drospirenone, Estetrol and Flaxseed?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.