Contraception vaginal rings

Starting the contraceptive vaginal ring - Consider the possibility of ovulation and conception prior to the first use of the contraceptive vaginal ring. 

Switching from a combination oral contraceptive Insert the contraceptive vaginal ring anytime within 7 days after the last combined (estrogen plus progestin) oral contraceptive tablet and no later than the day that a new cycle of pills would have started. No backup method is needed. 

Switching from a progestin-only method Insert the first contraceptive vaginal ring as follows ... 

Any day of the month when switching from a progestin-only pill do not skip any days between the last pill and the first day of contraceptive vaginal ring use ... 

Following complete first-trimester abortion The patient may start using the contraceptive vaginal ring within the first 5 days following a complete first trimester abortion and does not need to use an additional method of contraception. If use is not started within 5 days following a first trimester abortion, the patient should follow the instructions for No preceding hormonal contraceptive use in the past month. Advise the patient to use a nonhormonal contraceptive method. 

Consider the possibility of pregnancy if the ring-free interval has been extended beyond 1 week. Use an additional method of contraception until the contraceptive vaginal ring has been used continuously for 7... 

In the event of a missed menstrual period If the patient has not adhered to the prescribed regimen, consider the possibility of pregnancy at the time of the first missed period and discontinue the use of the contraceptive vaginal ring if pregnancy is confirmed. 

Vaginal ring - Advise women who are breast-feeding not to use the contraceptive vaginal ring but to use other forms of contraception until the child is weaned. 

Vaginal use The contraceptive vaginal ring may not be suitable in conditions that make the vagina more susceptible to vaginal irritation or ulceration. 

The contraceptive vaginal ring may interfere with the correct placement and position of a diaphragm. A diaphragm is not recommended as a backup method with contraceptive vaginal ring use. 

Oddson, K., et al. 2005. Superior cycle control with a contraceptive vaginal ring compared with an oral contraceptive containing 30 mu g ethinylestradiol and 150 mug levonorgestrel A randomized trial. Hum Reprod 20 557. 

Dieben, T.O.M., F.J.M.E., Roumen, and D. Apter. 2002. Efficacy, cycle control, and user acceptability of a novel combined contraceptive vaginal ring. Obstet Gynecol 100 585. 

Novak, A., et al. 2003. The combined contraceptive vaginal ring, NuvaRing An international study of user acceptability. Contraception 67 187. 

Timmer, C.J., and T.M.T. Mulders. 2000. Pharmacokinetics of etonogestrel and ethinylestradiol released from a combined contraceptive vaginal ring. Clin Pharmacokin 39 233. 

Verhorven, C.H.J., et al. 2004. The contraceptive vaginal ring NuvaRing and antimycotic comedication. Contraception 69 129. 

Weisberg, E., et al. 1997. Effect of different insertion regimens on side effects with a combination contraceptive vaginal ring. Contraception 56 233. 

Johansson, E.D.B., and R. Sitruk-Ware. 2004. New delivery systems in contraception Vaginal rings. Am J Obstet Gynecol 190 S54. 

Roumen, F. J., Apter, D., Mulders, T. M., and Dieben,T. O. (2001), Efficacy, tolerability and acceptability of a novel contraceptive vaginal ring releasing etonogestrel and ethinyl oestradiol, Hum. Reprod., 16,469-475. 

Oddsson, K., Leifels-Fischer, B., de Melo, N. R., Wiel-Masson, D., Benedetto, C., Verhoeven, C. H., and Dieben,T. O. (2005), Efficacy and safety of a contraceptive vaginal ring (NuvaRing) compared with a combined oral contraceptive A 1-year randomized trial, Contraception, 71,176-182. 

Fig. 12 Structural components of a contraceptive vaginal ring containing the combination of 3-keto-desogestrel and ethinylestradiol. (From Ref...

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