Contraceptives

A. Contraceptive vaginal ring (NuvaRing) delivers 15 :g ethinyl estradiol and 120 :g of etonogestrel daily.

1. Advantages of the ring include rapid return to ovulation after discontinuation, lower doses of hormones, ease and convenience, and improved cycle control. Benefits, risks, and contraindications to use are similar to those with combined oral contraceptive pills, except for the convenience of monthly administration.

2. In women who have not used hormonal contraception in the past month, the ring is inserted on or before day 5 of the menstrual cycle, even if bleeding is not complete, and an additional form of contraception should be used for the following 7 days. New rings should be inserted at approximately the same time of day the ring was removed the previous week.

3. If the ring accidentally falls out, it may be rinsed with cool or warm water and replaced within 3 hours. If it is out of place for more than 3 hours contraceptive effectiveness decreases, so an additional form of contraception should be used until the ring has been inserted for 7 continuous days. If the ring remains in place more than 3 but <4 weeks, it is removed and a new one is inserted after a 1-week ring-free interval; if the ring is left in place for >4 weeks, backup contraception is recommended until a new ring has been in place for 7 days.

4. Despite the low ethinyl estradiol dose, in a study in 16 women the contraceptive vaginal ring resulted in equivalent suppression of serum gonadotropin concentrations and ovulation as a combined oral contraceptive containing ethinyl estradiol (30 mcg) and desogestrel (150 mcg).

5. In a multicenter study, including 2322 women, the Pearl Index of efficacy in compliant patients was 0.8. Irregular bleeding was uncommon (5.5% of cycles), and withdrawal bleeding occurred in 98.5% of cycles. Compliance was 86%, with 15% of women discontinuing treatment because of an adverse event, most commonly device-related discomfort, headache, or vaginal discharge/vaginitis. Only 2.5% of discontinuations were device related.

Bacterial Vaginosis Facts

Bacterial Vaginosis Facts

This fact sheet is designed to provide you with information on Bacterial Vaginosis. Bacterial vaginosis is an abnormal vaginal condition that is characterized by vaginal discharge and results from an overgrowth of atypical bacteria in the vagina.

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