History of Contraceptives
Contraception has a long history that dates back to the recent past. Combination oral contraceptives, or COCs, have been the technique of choice for many women globally since the advent of hormonal contraceptive methods in the early 1960s. Current research includes producing more effective hormone preparations, lowering dosages, and creating novel delivery systems with enhanced acceptability and efficacy that are tailored to the requirements of each user. Despite being widely utilized and having greatly improved over the last few decades, COCs as a class have certain drawbacks. Treatments used orally may lose a considerable portion of their active ingredient due to first-pass metabolism, vomiting, and medication interactions, which can alter the drug's bioavailability. They significantly alter serum hormone levels, and they do have an issue with compliance.1 Other non-oral hormonal contraceptive techniques, some of which include controlled release formulation, have been developed as a result of these concerns. Among the developments in this area is the combination contraceptive vaginal ring (CCVR).
Non oral non Injectable Vaginal Contraception
Vaginal delivery provides a number of benefits. Because of its anatomy, histology, and physiology, it is possible to administer progesterone and estrogen at lower dosages than with COCs, avoid gastrointestinal disturbances and hepatic first pass metabolism, and use controlled release formulation to achieve constant serum hormone levels. 2 Potential advantages of using vaginal rings include easy insertion and removal by the user, self-control on the part of the user, no daily intervention needed, and a quick return to regular cycling following removal.
The flexible, transparent, evatane-made combined contraceptive vaginal ring has an outer diameter of 54 mm and a cross sectional diameter of 4 mm. It contains 2.7 mg of ethinylestradiol and 11.7 mg of etonorgestrel, which release 15 mcg of ethinylestradiol and 120 mcg of etonorgestrel daily. 3 Every ring is meant to be used for a single cycle, which consists of three weeks of ring use followed by a week without wearing any rings. 4 Studies' findings demonstrate that CCVR is a highly effective form of birth control with superior cycle management, great user satisfaction, and an ideal safety profile. 5
Benefits of CCVR
The combined contraceptive vaginal ring is an effective contraceptive with good cycle control that is well tolerated.
It has neutral effect on blood pressure and body weight,
Has no clinical relevant effect on blood sugar,
Has minimal effects on lipid metabolism,
Has no clinical significant effect on liver function,
Has no unfavourable effect on vagina and cervix.
It is associated with high level of user and partner acceptability
And has a low incidence of adverse effect such as nausea, headache and leucorrhoea
And has a very low incidence of spontaneous expulsion.
Conclusion
Due to the less severe systemic adverse effects of exogenous hormone therapy, CCVR is an useful and effective substitute for oral medications. Because the hormone levels in the serum remain consistent, its administration successfully regularizes bleeding patterns. Additionally, it is less laborious to use because it only needs to be inserted once a month as opposed to oral tablets, which must be taken every day. So, gynaecologists and policy makers should give emphasis and spread more awareness regarding its routine use.
