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Contraception
Published in S Paige Hertweck, Maggie L Dwiggins, Clinical Protocols in Pediatric and Adolescent Gynecology, 2022
Segesterone acetate 103 mg–ethinyl estradiol 17.4 mg (Annovera®)Inserted for 3 weeks and removed for a 1-week interval during which time a withdrawal bleed occurs. The ring is cleaned and stored in a provided case during this week. The same ring is reinserted and can be used for a total of 13 cyclesCan be used for extended cycling by keeping the ring in the vagina with no ring-free interval. However, should be removed once a month for brief cleansing with warm water and a gentle cleanserDesigned to stay in place during sex; however, it can be removed for up to 2 hoursIf the ring is removed for more than 2 hours, abstinence or a backup method is necessary until it has been replaced for 7 consecutive days
The effect of different contraceptive methods on the vaginal microbiome
Published in Expert Review of Clinical Pharmacology, 2021
Carlo Bastianelli, Manuela Farris, Paola Bianchi, Giuseppe Benagiano
A third CVR has been developed under the auspices of the Population Council [53]; it is known as Annovera and received approval from FDA during 2018. It consists of a soft, flexible silicone ring, releasing the orally inactive progestin, segesterone acetate (SGSA), also called nestorone, as well as EE, at estimated rates of 150 μg/day and 13 μg/day, respectively. It is inserted and kept in place for 21 days, then removed for 7 days; the same ring can be reused up to 1 year [53]. A new, 90-day version of this VR is under development; three variants are being tested, releasing 75, 100, or 200 μg of E2 and 200 μg SGSA [54]. No data on VM are available as yet.
The ins and outs of drug-releasing vaginal rings: a literature review of expulsions and removals
Published in Expert Opinion on Drug Delivery, 2020
Peter Boyd, Ruth Merkatz, Bruce Variano, R. Karl Malcolm
Data from the Phase 3 Annovera™ acceptability study revealed that 120 of the 905 participants (13%) reported removals >2 h [199]. Women cited several reasons for these removals including washing the ring, sexual intercourse, and finding CVR insertion difficult. Women residing in Europe or Australia were less likely to remove the ring for >2 h compared with women in the US. There was a greater overall likelihood of ring removal >2 h among women with lower educational attainment. Women who reported removals >2 h were more likely to discontinue using Annovera™ report dissatisfaction and become pregnant during the study.
A technology evaluation of Annovera: a segesterone acetate and ethinyl estradiol vaginal ring used to prevent pregnancy for up to one year
Published in Expert Opinion on Drug Delivery, 2020
Elizabeth A. Micks, Jeffrey T. Jensen
The CVR is used in a 21/7 regimen, similar to other combined hormonal contraceptives including many oral contraceptive pills, the transdermal patch, and the etonogestrel/EE CVR [7]. However, unlike these other products, only one Annovera ring is required for an entire year of contraception. Women are instructed to insert the CVR by compressing the sides of the ring to reduce the diameter, and then placing it vaginally while in a comfortable position such as lying down or squatting.