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Contraception
Published in S Paige Hertweck, Maggie L Dwiggins, Clinical Protocols in Pediatric and Adolescent Gynecology, 2022
Etonogestrel 11.7 mg–ethinyl estradiol 2.7 mg (Nuvaring®)Inserted for 3 weeks and removed for 1 week to have withdrawal bleed; however, a single ring is effective for up to 6 weeksCan be used for extended cycling by replacing the ring once a month with no ring-free intervalRings that will not be used within 4 months need to be stored in the refrigerator (may cause privacy concern for adolescents)Designed to stay in place during sex; however, it can be removed for up to 3 hours.If the ring is removed for more than 3 hours, abstinence or a backup method is necessary until it has been replaced for 7 days. If the ring is out for more than 3 hours during the third week of use, it should be removed on day 21 and a new ring immediately inserted, skipping the ring-free week
Termination and Contraceptive Options for the Cardiac Patient
Published in Afshan B. Hameed, Diana S. Wolfe, Cardio-Obstetrics, 2020
The etonogestrel contraceptive implant is a radio-opaque single-rod progestin implant that is placed subdermally in the inner arm. It contains 68 mg of etonogestrel and provides highly effective contraception for at least 3 years with a pregnancy rate of only 0.05% in the first year [8]. Its primary mechanism of action is suppression of ovulation. Secondary progestin mechanisms are similar to the hormonal IUD [14].
Novel treatment modalities
Published in Seema Chopra, Endometriosis, 2020
Subcutaneous implants are commonly marketed as Implanon and Nexplanon and are inserted intradermally. The therapeutic efficacy of depot medroxyprogesterone acetate and incidence of pain relief was compared with the implant by Walch et al. [66], and it was found that both groups had similar side effect profiles and degrees of satisfaction with either modality. Commonly reported side effects include irregular menstrual bleeding, weight gain, nausea, headache, breast tenderness, and acne and are similar to depot medroxyprogesterone acetate. In carefully selected women who do not desire fertility, an etonogestrel implant could be another option for treatment of endometriosis.
Etonogestrel-releasing contraceptive implant in a patient using thalidomide for the treatment of erythema nodosum leprosum: a case report
Published in Gynecological Endocrinology, 2022
Edson Santos Ferreira-Filho, Luis Bahamondes, Daniele Coelho Duarte, Ana Lúcia Monteiro Guimarães, Patrícia Gonçalves de Almeida, José Maria Soares-Júnior, Edmund Chada Baracat, Isabel Cristina Esposito Sorpreso
ENG-implant acts primarily through ovulation inhibition and effectiveness was well documented including a suppression of LH and FSH peaks [22]; all these findings were reproduced in this case report. The ENG-implant also produces a profound effect in the cervical mucus [22], which was also observed in this report. Such findings sufficiently demonstrate the full effectiveness of the etonogestrel implant in at least two of its chief action mechanisms [23]. Fluctuating levels of estradiol (E2) are compatible with the literature. Although ENG-implant effectively inhibits ovulation, ovarian follicular activity as assessed by measuring serum E2 levels are not completely suppressed [24]. Besides, a favorable bleeding pattern was observed; this happens with at least four out of five women using ENG-implant [25].
Metformin metabolic and vascular effects in overweight/moderately obese hyperinsulinemic PCOS patients treated with contraceptive vaginal ring: a pilot study
Published in Gynecological Endocrinology, 2019
Elena Morotti, Paolo Giovanni Artini, Nicola Persico, Cesare Battaglia
For many decades, oral contraceptives (OCs) have been the standard therapy for women with PCOS not seeking pregnancy. The hormonal components of OCs are known to have various adverse metabolic effects on lipid and carbohydrate metabolism and hemostasis [1]. A recent meta-analysis showed an increased risk of cardiovascular and cerebrovascular (CCV) accidents (odds ratio, 2.01) in third-generation OCs current users [2] and a WHO study reported a 4.7-fold increased risk of myocardial infarction associated with low-dose OCs use [3]. The specific contribution of estrogens and progestogens is not fully understood. Recently, a flexible, combined contraceptive vaginal ring releasing 15 µg EE and 120 µg etonogestrel per day over three consecutive weeks was developed [4]. The progestogen etonogestrel seems to have no androgenic activity. Therefore, the positive estrogenic effects on the lipid profile are not diminished by the opposite effects of androgenic progestins [5]. Furthermore, although Piltonen et al. showed in normal-weight women that oral, transdermal, and vaginal hormonal contraceptives worsen insulin sensitivity [6], it was demonstrated that vaginal hormonal contraception might restrain the pill-induced increase of insulinogenic index and homeostatic model assessment estimate for insulin resistance (IR) values [1].
Reviewing the role of progesterone therapy in endometriosis
Published in Gynecological Endocrinology, 2019
Abdul Kadir Abdul Karim, Mohamad Nasir Shafiee, Nor Haslinda Abd Aziz, Mohd Hashim Omar, Nur Azurah Abdul Ghani, Pei Shan Lim, Reena Rahayu Md Zin, Norfilza Mokhtar
Subdermal implants is marketed as Implanon, uses a single rod containing Etonogestrel 68 mg with a life span of three years. Etonogestrel is a 19-nortestosterone derivative. It is a safe and well-tolerated alternative for treatment of endometriosis besides being non-patient dependent contraception. It has been found equally effective compared to DMPA in pain relief in 12 months use with the significant reduction in the first three months [56]. This long-term progestogen delivery method has also been proven to reduce dysmenorrhea [57]. As such Etonogestrel should be considered as an alternative in treating endometriosis associated pain. Etonogestrel should be preferred to DMPA because it has not shown to have any effect on BMD [58] and also in patients with a high body mass index (BMI) and in women with a desire for pregnancy. There has been no recent clinical study assessing Etonogestrel for endometriosis.