WARNING

Estrogen and progestin vaginal ring contraceptives, like any medication, carry certain risks. Here’s a brief overview:

• Thromboembolic Disorders: Estrogen can increase the risk of blood clots forming in veins, leading to conditions like deep vein thrombosis (DVT) or pulmonary embolism (PE). This risk is higher in women who smoke, are overweight, or have a history of blood clots.
• Cardiovascular Risks: Estrogen can also increase the risk of cardiovascular events such as heart attack or stroke, particularly in women with existing cardiovascular conditions or risk factors such as hypertension, diabetes, or high cholesterol.
• Breast Cancer: Some studies suggest a slightly increased risk of breast cancer with long-term use of estrogen-progestin contraceptives, particularly in women over 35.
• Liver Problems: Estrogen metabolism occurs in the liver, and long-term use of estrogen-containing contraceptives may increase the risk of liver problems such as benign liver tumors or liver cancer, though this risk is considered rare.
• Other Risks: Other potential risks include headaches, nausea, breast tenderness, mood changes, and vaginal irritation or discharge. There may also be a small risk of ectopic pregnancy if the ring is not placed correctly.

It’s essential for individuals considering these contraceptives to discuss their medical history and any potential risk factors with their healthcare provider to determine the most suitable contraceptive option. Regular check-ups are also recommended to monitor for any adverse effects.

Why is this medication prescribed?

Estrogen and progestin vaginal ring contraceptives are prescribed primarily for birth control. They work by releasing a combination of estrogen and progestin hormones into the bloodstream, which prevents ovulation (the release of an egg from the ovaries) and thickens cervical mucus to prevent sperm from reaching the egg.

Additionally, they may be prescribed to:

• Regulate Menstrual Cycles: Vaginal ring contraceptives can help regulate menstrual cycles, making them more predictable and reducing symptoms like irregular bleeding or menstrual pain.
• Reduce Menstrual Symptoms: They may also help reduce menstrual symptoms such as heavy bleeding, cramps, and premenstrual syndrome (PMS).
• Treatment of Endometriosis: In some cases, vaginal ring contraceptives may be used to treat conditions like endometriosis, a painful disorder in which tissue similar to the lining of the uterus grows outside the uterus.

How should this medicine be used?

Here are some general guidelines for using the vaginal ring :

• Insertion: The vaginal ring is a small, flexible ring that is inserted into the vagina and left in place for three weeks. It’s typically inserted on the first day of the menstrual cycle for immediate contraceptive protection.
• Removal: After three weeks, the ring is removed, and a new one is inserted one week later, on the same day of the week, to maintain contraceptive effectiveness.
• Continuous Use: Some individuals may choose to skip the withdrawal bleed by immediately inserting a new ring after removing the old one. This continuous use can be done for several cycles in a row, as advised by a healthcare provider.
• Proper Placement: It’s essential to ensure the ring is placed correctly in the vagina to ensure optimal effectiveness. Healthcare providers typically instruct patients on how to insert and remove the ring properly.

As with any medication, it’s crucial to follow the instructions provided by your healthcare provider and read the patient information leaflet that comes with the medication. If you have any questions or concerns about using estrogen and progestin vaginal ring contraceptives, consult your healthcare provider for guidance.

Other uses for this medicine

In addition to birth control, estrogen and progestin vaginal ring contraceptives may be used for other medical purposes, including:

• Menstrual Regulation: They can help regulate menstrual cycles, making them more predictable and reducing symptoms like irregular bleeding or menstrual pain.
• Treatment of Menstrual Symptoms: Vaginal ring contraceptives may also be used to alleviate symptoms of heavy menstrual bleeding, severe menstrual cramps, and premenstrual syndrome (PMS).
• Endometriosis Treatment: In some cases, healthcare providers may prescribe estrogen and progestin vaginal ring contraceptives to manage symptoms of endometriosis, a painful condition in which tissue similar to the lining of the uterus grows outside the uterus.

What special precautions should I follow?

Special precautions to follow when using estrogen and progestin vaginal ring contraceptives include:

• Regular Check-ups: It’s important to have regular check-ups with your healthcare provider while using these contraceptives to monitor for any potential side effects or complications.
• Medical History: Inform your healthcare provider about your complete medical history, including any current medications, allergies, or medical conditions, particularly if you have a history of blood clots, cardiovascular disease, liver problems, or breast cancer.
• Smoking: Avoid smoking while using estrogen and progestin vaginal ring contraceptives, as smoking increases the risk of blood clots and cardiovascular complications.
• Weight and Lifestyle: Maintain a healthy weight and lifestyle, as obesity and sedentary habits can increase the risk of certain complications associated with estrogen and progestin contraceptives.
• Medication Interactions: Some medications, including certain antibiotics, anticonvulsants, and herbal supplements, may interact with estrogen and progestin contraceptives, affecting their effectiveness. Inform your healthcare provider about all medications you are taking.
• Emergency Contraception: Estrogen and progestin vaginal ring contraceptives should not be used as emergency contraception. If you have had unprotected intercourse and are concerned about pregnancy, discuss emergency contraception options with your healthcare provider.

Always follow the instructions provided by your healthcare provider and read the patient information leaflet that comes with the medication. If you have any questions or concerns about using estrogen and progestin vaginal ring contraceptives, consult your healthcare provider for guidance.

What special dietary instructions should I follow?

Special dietary instructions for estrogen and progestin vaginal ring contraceptives are generally not necessary. However, maintaining a healthy diet rich in fruits, vegetables, whole grains, and lean proteins is always advisable for overall health.

What should I do if I forget a dose?

If you forget to insert a new vaginal ring on the scheduled day:

• Less than 48 hours: If you remember within 48 hours (2 days) of the scheduled time to insert a new ring, insert the ring as soon as you remember. Contraceptive effectiveness should not be significantly affected.
• More than 48 hours: If it has been more than 48 hours since the scheduled time to insert a new ring, remove the old ring and insert a new one immediately. Additional backup contraception (e.g., condoms) may be necessary for the next seven days. If you had unprotected intercourse during this time, consider emergency contraception.

What side effects can this medication cause?

Estrogen and progestin vaginal ring contraceptives, like any medication, can cause side effects in some individuals. These side effects can vary in severity and may include:

• Nausea: Some individuals may experience nausea, especially during the first few weeks of using the vaginal ring. Taking the ring out during intercourse or removing it at night may help alleviate this symptom.
• Headache: Headaches are a common side effect of estrogen-containing contraceptives. If headaches persist or become severe, consult your healthcare provider.
• Breast Tenderness: Estrogen and progestin contraceptives can cause breast tenderness or enlargement in some individuals.
• Vaginal Discharge or Irritation: Some individuals may experience vaginal discharge, irritation, or itching while using the vaginal ring. These symptoms typically resolve on their own but if they persist or worsen, consult your healthcare provider.
• Spotting or Irregular Bleeding: It is common to experience spotting or irregular bleeding, especially during the first few months of using the vaginal ring. However, if bleeding is heavy or persists for an extended period, consult your healthcare provider.
• Mood Changes: Some individuals may experience changes in mood, such as mood swings or feelings of depression, while using estrogen and progestin contraceptives.
• Decreased Libido: Some individuals may experience a decrease in libido (sex drive) while using hormonal contraceptives.
• Fluid Retention: Estrogen-containing contraceptives can cause fluid retention, leading to bloating or weight gain in some individuals.
• Skin Changes: Hormonal contraceptives can affect the skin, causing acne or changes in skin pigmentation.
• Potential Serious Side Effects: In rare cases, estrogen and progestin contraceptives may increase the risk of serious side effects such as blood clots, cardiovascular events, liver problems, or breast cancer.

If you experience any concerning or persistent side effects while using estrogen and progestin vaginal ring contraceptives, consult your healthcare provider for further evaluation and guidance.

What should I know about storage and disposal of this medication?

Storage and Disposal:

• Storage: Store the vaginal ring at room temperature away from moisture and heat. Keep it out of reach of children and pets. Do not store the ring in the refrigerator or freezer.
• Disposal: After removing the vaginal ring, it should be disposed of properly. Do not flush it down the toilet. You can wrap it in tissue and throw it in the trash. Some pharmacies also offer disposal programs for medications and medical devices.

In case of emergency/overdose

In case of an emergency or overdose, such as accidental ingestion of multiple rings, contact emergency medical services or a poison control center immediately. Symptoms of overdose may include nausea, vomiting, and vaginal bleeding.

What other information should I know?

• Always follow the instructions provided by your healthcare provider and read the patient information leaflet that comes with the medication.
• Keep track of when you insert and remove the vaginal ring to ensure continuous contraceptive effectiveness.
• Inform your healthcare provider if you experience any unusual or concerning symptoms while using the vaginal ring.
• The vaginal ring does not protect against sexually transmitted infections (STIs). Additional protection, such as condoms, may be necessary.
• If you experience persistent or severe side effects, or if you have concerns about the effectiveness of the vaginal ring, consult your healthcare provider.
• It’s essential to have regular check-ups with your healthcare provider while using estrogen and progestin vaginal ring contraceptives to monitor for any potential side effects or complications.

Following these guidelines will help ensure the safe and effective use of estrogen and progestin vaginal ring contraceptives. If you have any questions or concerns, consult your healthcare provider for guidance.