title: Contraceptive vaginal rings.
abstract: Contraceptive vaginal rings (CVRs) contain sex steroids that diffuse through a plastic polymer ring at a constant rate and are absorbed directly through the vaginal epithelium into the systemic circulation. This delivery system provides many advantages over oral contraceptives (OCs), including avoidance of the first-pass effect through the liver, constant serum steroid levels, longer duration of use, and greater bioavailability of the hormones. CVRs containing progestin only are designed for continuous use for 3 to 6 months. Those containing progesterone alone are indicated for use in women who are breastfeeding. Large clinical trials of progestin-containing CVRs demonstrated good efficacy and safety of the CVR, with continuation rates similar to that of OCs. CVRs containing a combination of estrogen and progestin are designed to be used for 1 to 12 months in a cyclic manner similar to OCs, with withdrawal bleeding in the fourth week of each cycle. In clinical trials these CVRs have typical use efficacies similar to OCs, with an acceptable pattern of bleeding.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213-3180, USA.
authors.forename: B
authors.initials: B
authors.lastname: Harwood
authors.forename: D R
authors.initials: DR
authors.lastname: Mishell
mesh_terms: D000282:Administration, Intravaginal; D003271:Contraceptive Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D003274:Contraceptive Devices, Female; D017135:Desogestrel; D004338:Drug Combinations; D004958:Estradiol / Q000008:administration & dosage; D004967:Estrogens / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016912:Levonorgestrel / Q000008:administration & dosage; D009640:Norethindrone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000077563:Norethindrone Acetate; D009653:Norprogesterones / Q000008:administration & dosage; D010342:Patient Acceptance of Health Care; D011374:Progesterone / Q000008:administration & dosage; D011372:Progestins / Q000008:administration & dosage; D014753:Vinyl Compounds / Q000008:administration & dosage
chemical_list: D003271:Contraceptive Agents, Female; D004338:Drug Combinations; D004967:Estrogens; D009653:Norprogesterones; D011372:Progestins; D014753:Vinyl Compounds; C044815:etonogestrel; D011374:Progesterone; D004958:Estradiol; D016912:Levonorgestrel; C029167:ST 1435; D017135:Desogestrel; D000077563:Norethindrone Acetate; D009640:Norethindrone