title: Vaginal health in contraceptive vaginal ring users - A review.
abstract: BACKGROUND
  To provide an overview of the available data from clinical studies of vaginal conditions in women who use a vaginal ring as a contraceptive.
  
  
  METHODS
  A systematic review of the literature.
  
  
  RESULTS
  Millions of women have already used the ethylene vinyl acetate vaginal ring that releases ethinylestradiol and etonogestrel for contraception. Because of its small size, more than four out of five women using the ring report that they do not feel it, even during sexual intercourse. No colposcopic or cytological changes have been observed in users, although approximately 10% have increased vaginal discharge. While in vitro studies have shown adhesion of Candida yeasts to the vaginal ring surface, clinical studies have not demonstrated a greater incidence of Candida infections compared to users of equivalent oral contraceptives. Some clinical studies suggest a lower incidence of bacterial vaginosis. No interaction exists between concomitant use of the vaginal ring and other drugs or products for vaginal use.
  
  
  CONCLUSIONS
  The use of a contraceptive vaginal ring does not alter the vaginal ecosystem and therefore does not substantially affect vaginal health.
authors.affiliation: Department of Gynaecology, Hospital Universitario Araba-Santiago, Basque Health Service-Osakidetza, Vitoria, Spain. luisignacio.letelasa@osakidetza.net
authors.forename: Iñaki
authors.initials: I
authors.lastname: Lete
authors.forename: María C
authors.initials: MC
authors.lastname: Cuesta
authors.forename: Juan M
authors.initials: JM
authors.lastname: Marín
authors.forename: Sandra
authors.initials: S
authors.lastname: Guerra
mesh_terms: D002181:Candidiasis, Vulvovaginal / Q000453:epidemiology*; D003127:Colposcopy; D003274:Contraceptive Devices, Female / Q000382:microbiology / Q000706:statistics & numerical data*; D017135:Desogestrel / Q000627:therapeutic use*; D004997:Ethinyl Estradiol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D014621:Vagina / Q000166:cytology*; D019522:Vaginal Discharge / Q000453:epidemiology*; D014623:Vaginal Diseases / Q000453:epidemiology
chemical_list: C044815:etonogestrel; D004997:Ethinyl Estradiol; D017135:Desogestrel