Contraceptive vaginal ring

NuvaRing
	NuvaRing is a flexible plastic ring with both oestrogen and progesterone.
Background
Type	Hormonal
First use	2001
Failure rates (first year)
Perfect use	0.3 for Nuvaring%[1]
Typical use	1.5 to 9 for Nuvaring%[2][1]
Usage
Duration effect	4 weeks for Nuvaring, 3 months for progesterone only vaginal ring
User reminders	Inserted for 3 weeks and then removed for 7 days for Nuvaring
Clinic review	Annual
Advantages and disadvantages
STI protection	No
Weight	No proven effect
Benefits	Easy insertion and removal.

A Contraceptive vaginal ring is a type of hormonal insert that is placed in the vagina for the purpose of birth control. It consists of either both oestrogen and progesterone, the ethinylestradiol/etonogestrel vaginal ring (Nuva-ring), or just progesterone, the progesterone vaginal ring.[3][4]

Combined hormonal contraceptive vaginal ring

The combined hormonal contraceptive, vaginal ring, is also known as NuvaRing. It is a flexible plastic (ethylene-vinyl acetate copolymer) ring that releases a low dose of a progestin and estrogen over three weeks.[5]

About 8% of women using a vaginal ring will still get pregnant every year, although this drops to 1% with correct use. There is a small chance of blood clots, heart attacks and stroke with vaginal rings, and they are not recommended for women over 35 who smoke.[6]

A one-year combined hormonal contraceptive ring, marketed as Annovera, was approved in the United States in 2018. It is a silicone elastomer vaginal ring containing the progestin segesterone acetate and the estrogen ethinylestradiol.[7]

Progesterone only vaginal ring

A progesterone vaginal ring has also been developed.[2][8] It is specifically made for use during breast feeding as it does not affect milk production.[2]

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References

Trussell, James (2011). "Contraceptive efficacy". In Hatcher, Robert A.; Trussell, James; Nelson, Anita L.; Cates, Willard Jr.; Kowal, Deborah; Policar, Michael S. (eds.). Contraceptive technology (20th revised ed.). New York: Ardent Media. pp. 779–863. ISBN 978-1-59708-004-0. ISSN 0091-9721. OCLC 781956734. Table 26–1 = Table 3–2 Percentage of women experiencing an unintended pregnancy during the first year of typical use and the first year of perfect use of contraception, and the percentage continuing use at the end of the first year. United States.
Birtley, Ellie J.; Lohr, Patricia A. (2014). "7. Emerging methods and methods not available in the United States". In Whitaker, Amy; Gilliam, Melissa (eds.). Contraception for Adolescent and Young Adult Women. Springer. p. 98–99. ISBN 9781461465799.
Temmerman, Marleen (2019-08-01). "A new woman-controlled contraceptive vaginal ring: a global step forward". The Lancet Global Health. 7 (8): e986–e987. doi:10.1016/S2214-109X(19)30289-X. ISSN 2214-109X. PMID 31231064.
"Vaginal ring". nhs.uk. December 2017. Retrieved 25 August 2019.
"FSRH Clinical Guideline: Combined Hormonal Contraception (January 2019, Amended February 2019) - Faculty of Sexual and Reproductive Healthcare". www.fsrh.org. Retrieved 14 August 2019.
"Vaginal Rings - Family Planning". www.familyplanning.org.nz. Retrieved 25 August 2019.
"Prescribing Information: Annovera" (PDF). Drugs@FDA: FDA-Approved Drugs. August 2018. Retrieved 13 July 2020.
Wieder, Devorah R; Pattimakiel, Lynn (12 November 2010). "Examining the efficacy, safety, and patient acceptability of the combined contraceptive vaginal ring (NuvaRing®)". International Journal of Women's Health. 2: 401–409. doi:10.2147/IJWH.S6162. ISSN 1179-1411. PMC 2990910. PMID 21151688.

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[Trussell_2011-1] Trussell, James (2011). "Contraceptive efficacy". In Hatcher, Robert A.; Trussell, James; Nelson, Anita L.; Cates, Willard Jr.; Kowal, Deborah; Policar, Michael S. (eds.). Contraceptive technology (20th revised ed.). New York: Ardent Media. pp. 779–863. ISBN 978-1-59708-004-0. ISSN 0091-9721. OCLC 781956734. Table 26–1 = Table 3–2 Percentage of women experiencing an unintended pregnancy during the first year of typical use and the first year of perfect use of contraception, and the percentage continuing use at the end of the first year. United States.

[Whit2014-2] Birtley, Ellie J.; Lohr, Patricia A. (2014). "7. Emerging methods and methods not available in the United States". In Whitaker, Amy; Gilliam, Melissa (eds.). Contraception for Adolescent and Young Adult Women. Springer. p. 98–99. ISBN 9781461465799.

[Temmerman2019-3] Temmerman, Marleen (2019-08-01). "A new woman-controlled contraceptive vaginal ring: a global step forward". The Lancet Global Health. 7 (8): e986–e987. doi:10.1016/S2214-109X(19)30289-X. ISSN 2214-109X. PMID 31231064.

[NHS2017-4] "Vaginal ring". nhs.uk. December 2017. Retrieved 25 August 2019.

[FSRH-5] "FSRH Clinical Guideline: Combined Hormonal Contraception (January 2019, Amended February 2019) - Faculty of Sexual and Reproductive Healthcare". www.fsrh.org. Retrieved 14 August 2019.

[FPNZ-6] "Vaginal Rings - Family Planning". www.familyplanning.org.nz. Retrieved 25 August 2019.

[7] "Prescribing Information: Annovera" (PDF). Drugs@FDA: FDA-Approved Drugs. August 2018. Retrieved 13 July 2020.

[Weider2010-8] Wieder, Devorah R; Pattimakiel, Lynn (12 November 2010). "Examining the efficacy, safety, and patient acceptability of the combined contraceptive vaginal ring (NuvaRing®)". International Journal of Women's Health. 2: 401–409. doi:10.2147/IJWH.S6162. ISSN 1179-1411. PMC 2990910. PMID 21151688.