gynecology and obstetrics
Transdermal and Vaginal Ring Hormonal Contraceptives
Introduction
Combined estrogen-progestin contraceptives can be administered through a transdermal or vaginal route and are available as skin patches and vaginal rings. The efficacy of the estrogen-progestin patches and rings are the same as Oral Contraceptives ; the pregnancy rate after 1 year is 0.3% with perfect use and about 9% with typical (ie, inconsistent) use. Adherence is typically better with a patch or ring than with OCs, because dosing is every 1 to 3 weeks rather than daily. A quick-start protocol, similar to that used for OCs, can be used for patches and rings. If either contraceptive method is started at any time other than the first 5 days of menses, a backup contraceptive method should be used concurrently for 7 days. Breakthrough bleeding is uncommon when transdermal or ring contraception is used. If breakthrough bleeding occurs, it typically decreases within 2 to 6 months of use. Adverse Effects are the sames as for OCs. 