The vaginal ring - a convenient and effective hormonal contraception

The vaginal ring - a convenient and effective hormonal contraception

Author: Dr. Almeria Ionescu - Specialist in Obstetrics and Gynaecology
General
Contraception in one form or another has probably existed since ancient times. At first there were rituals that then, with the emergence doctors have developed methods becoming more efficient.
The ancient Greeks are those who have realized for the first time that the union of woman and man that leads to fetus conception (not as previously thought that only need the semen of men) and since then several methods were used with different degrees of effectiveness. A wide range of products have been used as barrier methods, lemon juice, extract the essence of mahogany, honey, cedar oil, peppermint oil, etc.
Eggs, suppositories and spermicides are still used today, but unfortunately not one of the easiest forms of contraception, because it requires the insertion closer to the beginning sex.
Prolonged breastfeeding was also a method used for many years. Women have realized that when lactating likely to fall pregnant. Because it represented the easiest way to feed a baby, the method was very popular. Research has suggested that amenorrhea may take up to 2 months when baby is not breastfed until 9 months when breastfeeding occurs (provided it be done according to a fixed schedule). Although women can conceive a child even during the last period, it is unlikely that this will happen. In third world countries where very few are available contraceptive methods this method is still commonly used.
Coitus interruptus is mentioned in the Bible and is still widely used. Studies show that in Romania at least 45% of women have used this method and it ranks in the top three contraceptive methods. Obviously, it is not very effective.
Calculating the effectiveness of contraceptive methods is based on the probability of pregnancy in a woman using that method over a period of one year. For example, if a method is considered to be 85% effective means that 15 of every 100 women who use these methods are likely to become pregnant for a period of one year. Effectiveness of various methods is dependent on correct use, so lack of experience or inconsistency can lead to failures of a method.
The vaginal ring - a convenient and effective hormonal contraception
Hormonal contraception
Contraceptive methods can be classified according to several criteria:
 - Type of method: hormonal and non-hormonal
 - Frequency of administration: multi (implant, device hormone), quarterly (contraceptive injection), monthly (vaginal ring), weekly (patch) daily (pill) in each sex (non hormonal methods)

 When used as directed contraceptive methods provide significant protection against unwanted pregnancies.
• barrier methods.
Condoms, spermicides and diaphragm plays an important role in preventing sexually transmitted diseases (STDs). BTS is an important issue. Although no contraceptive is 100% effective in preventing sexually transmitted diseases, condoms can significantly reduce the transmission of viruses such as HIV, HPV.
• Hormonal methods.
Combined oral contraceptives offer substantial protection against:
(I) diseases such as ovarian cancer, endometrial cancer, ectopic pregnancy and pelvic inflammatory disease;
(Ii) other diseases such as anemia caused by iron deficiency, benign tumors localized to the breast, menstrual problems and cysts progesterone based ovariene.Contraceptivele reduce monthly menstrual flow and therefore protects important incidences of anemia and also some BTS raportatprotecţia imoptriva and pelvic inflammatory disease.


Contraceptive pill discovery and its introduction as a preventive measure against unwanted pregnancies in 1960, was a major revolution.
Subsequently, as in any medical field researchers have tried to "refine" the method by reducing the amount of hormones and by finding other routes of administration, ways to make it easier to use, be more comfortable for women and, why not, to reduce side effects.
Contraception injection was first introduced in the 50's. This method was discovered by Dr. K Junkman progesterone has realized that mixing certain amounts of alcohol, the drug would have a long term effect.
Contraceptive vaginal ring was placed on the market in the 90s. The mode of action is the release of estrogen and progesterone through the vaginal wall.
Other methods of contraception including injections, patches, gels and nasal sprays, vaccines and contraceptive pill for men.
The vaginal ring - a convenient and effective hormonal contraception
Why vaginal administration
Vaginal drug administration is believed to have originated with pharmacotherapy, the first documents dating from the 19th century. Although traditionally known for treating local symptoms (eg.: Vaginitis) the early twentieth century, the first experiments showed a significant systemic absorption of vaginally administered drugs, leading to the development of drugs that were administered but were indicated for the treatment of vaginal Non-vaginal diseases.
Technological developments in drug administration led to the conclusion that there are options beyond oral administration. Vagina was the historic route of drug administration that has long been unexplored, but recent research has shown that the vagina is an extremely effective contraceptive hormones management. Doctors already using vaginal administration of drugs such as bromocriptine (treatment hyperprolactinemia), indomethacin, misoprostol and in many cases proved that vaginal administration is superior to oral.

Complexity vaginal epithelium allows absorption contraceptive hormones. Vaginal folds known as "praying" provide increased surface area for absorption.

Vaginally administered hormones are absorbed by the vaginal epithelium through several mechanisms: concentration-dependent diffusion (which occurs in the cell) cell-mediated transport.

Absorption of hormones vagina provides both local and systemic. Contraceptive hormones have been absorbed in the vaginal epithelium are then distributed to the systemic circulation through a dense network of blood vessels, allowing the contraception to control the system even if the administration is not classic.
The vaginal ring - a convenient and effective hormonal contraception
Vaginal administration advantages:
Ease of administration (vaginal ring is given once a month by simply inserting into the vagina, not interfere with sexual intercourse);
Possibility of self-administration (although it is a vaginal administration method does not require medical intervention, she could to introduce and to remove one ring);
low doses (vaginal contraceptive ring contains the lowest dose of estrogen available in a systemic-acting hormonal contraceptive)
continuous release of medication (administration once a month allows continuous release of small doses of hormones);
avoid gastrointestinal absorption (vaginal administration avoids the gastrointestinal absorption, thus not affecting contraceptive efficacy in cases of stomach problems);
avoids first-pass metabolism;
reduce systemic hormonal exposure (through vaginal administration was possible to reduce the dose of estrogen, thereby reducing systemic exposure to hormones);
reducing side effects (by reducing systemic exposure and reduced side effects typical hormonal contraceptives, such as, nausea, breast tension, headaches, etc.).
So contraceptive vaginal ring provides stable serum estrogen, lower versus oral (pill) or transdermal (patch) representing an effective method of contraception and discreet.

Informed choice is key to the effectiveness of contraceptive
Contraceptive choice should take into account the needs of the couple to be truly effective. When choosing contraceptive method is based on complete information, based on torque needs, lifestyle and associated risk factors, there is the chance that satisfaction with the method to be great and then the couple to choose a continuation method long time. Providing various contraceptive methods is important because each choice depends on health, personal perceptions, costs, cultural influences. Contraceptive needs also change during a woman's fertile life: from adolescence of menopause. A method that is appropriate and acceptable to a young woman may not represent the best way for her after a few years.
When choosing a method of contraception is important to consult with your gynecologist or family planning at.