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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
Comprehensive overview of the recently FDA-approved contraceptive vaginal ring releasing segesterone acetate and ethinylestradiol: A new year-long, patient controlled, reversible birth control method
Published in Expert Review of Clinical Pharmacology, 2019
The most critical component that accounts for the success of this new CVR is the new progestin segesterone acetate. Segesterone acetate is a 19-nor-progesterone derivative, known as 19-norpregn-4-ene-3,20-dione, 17-hydroxy-16-methylene-19-nonpregn-4-ene-3,20-dione acetate ester and 16-methylene-17α-acetoxy-19-nor-pregn-4-ene-3,20-dione (see Figure 3). Its molecule formula is C23H3004 (see Figure 3). It is a white or yellowish-white powder with a molecular weight of 370.5 Dalton. This compound has significant potency; only low doses are needed for ovulation suppression. However, it is rapidly metabolized when administered orally, so a slow release, transdermal or transmucosal delivery system, such as the contraceptive vaginal ring, represents an excellent delivery system to utilize its strengths [11].
Advances in contraceptive vaginal rings: what does the future hold?
Published in Expert Opinion on Pharmacotherapy, 2018
Ilza Monteiro, Cristina Falbo Guazzelli, Luis Bahamondes
One inherent characteristic of segesterone acetate is non-absorption via the oral route; it is only effective if administered by a non-oral route such as the vaginal route, showed an excellent metabolic profile, and was also tested in combination with EE in several trials [26,27]. Multicenter study was conducted over a 1-year follow-up of 150 women who changed the same ring 13 times a year. Three formulations were used: 150/15, 150/20, or 200/15 µg/day segesterone/EE in a cyclic regimen (21 days with the CVR in situ and 7 days with no ring). Ovulatory activity was uncommon in all groups, except in women weighing 80 kg or more. The high prevalence of menstrual irregularity and consequent early removal of the ring resulted in increased rates of method failure [28–30].