gynecology and obstetrics
Transdermal and Vaginal Ring Hormonal Contraceptives
Vaginal ring contraceptives
Vaginal rings are flexible, soft, and transparent. Two types of rings are available: Etonogestrel/ethinyl estradiol: A 3-week ring that releases 120 mcg ofetonogestrel(progestin) and 15 mcg ofethinyl estradiol(estrogen) a day; a new ring must be used each month Segesterone acetate/ethinyl estradiol: A year-long ring that releases 150 mcg segesterone acetate (progestin) and 13 mcgethinyl estradiol(estrogen) a day; a new ring is used only once a year Both types of rings are typically left in place for 3 weeks, then removed for 1 week to allow for withdrawal bleeding. The year-long ring is removed, left out for 1 week, and then the same ring is reinserted. Adverse effects with vaginal rings are similar to Adverse Effects , but patient adherence may be better with a vaginal ring because it is inserted monthly rather than taken daily. Women may wish to remove the vaginal ring at times other than after 3 weeks. However, if the ring is removed for > 3 hours, women should be advised to use a backup contraceptive method concurrently for 7 days. Women insert and remove the ring themselves; no fitting by a clinician is required. The hormones released by vaginal rings are absorbed through the vaginal epithelium. When a vaginal ring is used, hormone blood levels are relatively constant. 