User:A Lee Express/Contraceptive vaginal ring

Dosing
The ethinylestradiol/etonogestrel 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. The low dose is a constant rate that averages to about 0.015 mg of ethinyl estradiol and 0.12 mg etonogestrel per day.

Administration
About 9% of women using a vaginal ring will still get pregnant every year, although this drops to 1% with perfect use. The most common mistakes when using the ring are adherence issues and incorrect administration, including forgetting to replace the ring on time and failure to insert the ring far enough into the vagina. A study in Kenya demonstrated that there was concern circling on vaginal insertion and ring placement that called for practice from users, initially. Comparably, in Rwanda participants, there were challenges with ring insertion and removal originally but those worries dissipated with practice, and later described the process as "easy". Multiple other common reasons for nonadherence include removing the ring for washing or before sexual intercourse. If the ring has been removed for more than three hours, then backup contraception should be used until the ring has been inserted and back in place for at least seven days. Due to lack of patient education, some users struggle to insert the device comfortably and completely, which may hinder the contraceptive effects of the ring.

Side Effects
For any patients interested in using a contraceptive vaginal ring, it is important for their healthcare provider to provide counseling and support their understanding on these topics to ensure proper usage techniques and time. 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.

A common concern with contraceptive vaginal rings are that they will impact vaginal health. Multiple studies have demonstrated that vaginal health is not impacted as contraceptive vaginal rings do not affect the vaginal microbiome. However, adverse effects that can lead to discontinuation of vaginal ring use include foreign body sensation, coital problems, and expulsion of the device.

The one-year combined hormonal contraceptive ring is also known as Annovera. It is a silicone elastomer vaginal ring containing the progestin segesterone acetate and the estrogen ethinylestradiol.