Description
In October 2001, the US Food and Drug Administration approved Nuva Ring, a vaginal contraceptive ring developed by Organon, Inc. Nuva Ring is a non-biodegradable, flexible, colorless ring made up of a polymer of ethylene vinyl acetate and magnesium
stearate.
How It Works
The outer diameter of the ring is 54 millimeter and the cross-sectional diameter is 4 mm. The ring contains 11.7 milligrams of etonogestrel and 2.7 milligrams of Ethinyle Estradiol. It releases 120 micrograms of etonogestrel and 15 micrograms of Ethinyle Estradiol every day.
The ring is left in place for three weeks followed by one ring-free week.
The ring can be inserted any time during the first five days of the menstrual cycle. The ring should be placed in the vagina even if the woman has not finished bleeding, and
she should use a backup contraceptive method for 7 days. A new ring should be inserted each month. If the ring comes out during the first three weeks of use, it should be washed with lukewarm water and placed again. If the ring-free interval is more than three hours, a backup contraceptive method should be used for 7 days. The ring should never be left in the vagina for more than four weeks. If left in for more than four weeks, pregnancy should be ruled out before inserting a new ring and a backup contraceptive method should be used for seven days after inserting a new ring.
Advantages and Precautions
Nuva Ring has many advantages. Some are common to combined oral contraceptive pills and some are unique to the ring.
Vaginal rings are highly effective as they result in complete suppression of ovulation. The steady release of hormone provides exceptional cycle control. As there is no need for daily intake, it is easily inserted and removed by the woman herself, and rapid return of fertility on discontinuation makes it a highly acceptable method for women and their partners. An acceptability rate of 85% was reported by women and their partners during the clinical trials. Because the hormones are absorbed directly into the blood through the vaginal mucosa, the hepatic first pass metabolism of progestin is prevented. The ring delivers the lowest dose of Ethinyle Estradiol as compared to other combined hormonal contraceptives. Unlike combined oral contraceptives there is no effect of diarrhea and vomiting on the ring use.
