vaginal rings
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Author(s):  
Imogen Hawley ◽  
Mei Song ◽  
Rachel Scheckter ◽  
Tara McClure ◽  
Jeanna Piper ◽  
...  

Author(s):  
Thesla Palanee-Phillips ◽  
Marc M. Baum ◽  
John A. Moss ◽  
Meredith R. Clark ◽  
Jeremy Nuttall ◽  
...  

2021 ◽  
Vol 2 ◽  
Author(s):  
Thérèse Delvaux ◽  
Vicky Jespers ◽  
Lenka Benova ◽  
Janneke van de Wijgert

Introduction: Acceptability of and satisfaction with contraceptive methods are paramount for uptake and continuation. In the current context of multipurpose prevention of pregnancy and sexually transmitted diseases/HIV development, it is critical to have a better understanding of acceptability of and satisfaction with the contraceptive vaginal ring (CVR) including sexual satisfaction. The objective of this study was to review the evidence about acceptability of CVRs and general and sexual satisfaction of users.Methods: We searched PubMed, CINAHL, and Web of Science (until December 31, 2020) and selected original studies documenting actual use of hormonal CVR and explicitly addressing any of the 3 outcomes.Results: Of a total of 1,129 records screened, 46 studies were included. Most studies (n = 43, 93%) were prospective, conducted in high-income settings (n = 35), and reported on NuvaRing® use (n = 31). Overall, 27 (59%) studies included a comparison group, 38 (82%) studies used exclusively quantitative questionnaires, with qualitative only (n = 4, 9%), or mixed methods (n = 4, 9%) studies being less common. Ease of CVR insertion/removal/reinsertion was high in all the settings and improved with time of use, with qualitative studies supporting these findings. When mentioned, ring-related events were associated with discontinuation, and results on continuation of use were mixed. Among NuvaRing® studies, general satisfaction (being satisfied or very satisfied) was between 80 and 90% and tended to mirror continuation. Sexual satisfaction was less commonly reported and results were mixed. Overall, limited information was provided on actual CVR experiences of women (and men) and cultural norms that may affect sexuality and CVR use.Conclusion: Positive aspects of acceptability of and satisfaction with CVRs were reported, but ring-related events and factors, which may affect long-term CVR use, deserve further study. More information is needed on actual experiences of women using CVRs, relationship aspects, male partner opinions, and contextual norms to better understand the acceptability of and satisfaction with CVRs.


PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259779
Author(s):  
Mandeep Sekhon ◽  
Ariane van der Straten ◽  

HIV infection during pregnancy and breastfeeding has implications for maternal health. Between May- November 2018, we explored prospective acceptability of two novel HIV Pre-exposure Prophylaxis (PrEP) products, oral pills and vaginal rings, through focus group discussions with 65 pregnant and breastfeeding women in Malawi, South Africa, Uganda, Zimbabwe. Qualitative analysis was completed, guided by the Theoretical Framework of Acceptability (TFA). First, a deductive thematic analysis was applied to relevant coded data, into the seven TFA constructs (Affective Attitude; Burden; Ethicality, Intervention Coherence; Opportunity Costs; Perceived Effectiveness; Self-efficacy). Next, an iterative analysis was completed to generate themes within each of the TFA constructs. Women’s positive attitudes towards daily oral PrEP highlighted the familiarity of taking pills, understanding the purpose of taking pills, and the perception that it is an effective method to protect mothers and babies from HIV during pregnancy and breastfeeding. Women emphasized the ease of using the ring given its monthly duration that lowers burden on the user, its discreetness and invisibility once in place. The TFA analysis highlighted how acceptability of both methods could be enhanced by focusing on perceptions of the end users (i.e. the women) and not just the products themselves. This approach provided insights into how to refine the intervention materials and plans for implementation.


Author(s):  
Sarah T. Roberts ◽  
Imogen Hawley ◽  
Ellen Luecke ◽  
Barbara Mensch ◽  
Theresa Wagner ◽  
...  

Pharmaceutics ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 1714
Author(s):  
Petra Arany ◽  
Ildikó Papp ◽  
Marianna Zichar ◽  
Géza Regdon ◽  
Mónika Béres ◽  
...  

Vaginal drug delivery systems can provide a long-term and constant liberation of the active pharmaceutical ingredient even for months. For our experiment, FDM 3D printing was used to manufacture the vaginal ring samples from thermoplastic polyurethane filament, which enables fast manufacturing of complex, personalized medications. 3D printing can be an excellent alternative instead of industrial manufacturing, which is complicated and time-consuming. In our work, the 3D printed vaginal rings were filled manually with jellified metronidazole or chloramphenicol for the treatment of bacterial vaginosis. The need for manual filling was certified by the thermogravimetric and heatflow assay results. The manufactured samples were analyzed by an Erweka USP type II Dissolution Apparatus, and the dissolution profile can be distinguished based on the applied jellifying agents and the API’s. All samples were considered non-similar based on the pairwise comparison. The biocompatibility properties were determined by prolonged MTT assay on HeLa cells, and the polymer could be considered non-toxic. Based on the microbiological assay on E. coli metronidazole and chitosan containing samples had bactericidal effects while just metronidazole or just chitosan containing samples bacteriostatic effect. None of these samples showed a fungistatic or fungicide effect against C. albicans. Based on our results, we successfully manufactured 3D printed vaginal rings filled with jellified metronidazole.


2021 ◽  
pp. 395-446
Author(s):  
Shelley Raine

This chapter begins with the principles of contraception (choice, access, measures of effectiveness) and a risk/benefit analysis and eligibility of different types. It explains emergency contraception. The chapter goes on to discuss different formulations, preparations, methods of use (or administration and insertion). This includes the combined oral contraceptive pill (COCOP), the transdermal patch, intra vaginal rings, progestogen-only pills, the subdermal implant, injectables, intra-uterine devices and systems, barrier methods for both male and female use, and spermicides. Finally it covers fertility awareness, and the sterilization of women and men.


2021 ◽  
Author(s):  
Therese Delvaux ◽  
Vicky Jespers ◽  
Lenka Benova ◽  
Janneke van de Wijgert

Introduction Acceptability of and satisfaction with contraceptive methods are paramount for uptake and continuation. In the current context of multipurpose prevention of pregnancy and sexually transmitted diseases /HIV development, it is critical to have a better understanding of acceptability of and satisfaction with the contraceptive vaginal ring (CVR), including sexual satisfaction. The objective of this study was to review the evidence about CVRs acceptability, and users general and sexual satisfaction. Methods We searched PubMed, CINAHL and Web of Science (until December 31th, 2020) and selected original studies documenting actual use of hormonal CVR and explicitly addressing any of the three outcomes. Main Results Of a total of 1129 records screened, 46 studies were included. Most studies (n=43, 93%) were prospective, conducted in high-income settings (n=35) and reported on NuvaRing use (n=31). Overall, 27 (59%) studies included a comparison group, 38 (82%) used exclusively quantitative questionnaires, with qualitative only (n=4, 9%) or mixed methods (n=4, 9%) studies being less common. Ease of CVR insertion/removal/reinsertion was high in all setting and improved with time of use, with qualitative studies supporting these findings. When reported, results on continuation of use were mixed and ring-related events were associated with discontinuation. Among NuvaRing studies, general satisfaction (being satisfied or very satisfied) was between 80 and 90% and tended to mirror continuation. Sexual satisfaction was less commonly reported and results were mixed. Overall, limited information was provided on actual CVR experiences of women (and men) and cultural norms that may affect sexuality and CVR use. Conclusion Positive aspects of acceptability of and satisfaction with CVRs were reported but continuation rates and ring-related events deserve further study. More information is needed on actual experiences of women using CVRs, relationship aspects, male partner opinions, and contextual norms to better understand the acceptability of and satisfaction with CVRs.


2021 ◽  
Author(s):  
Moataz Dowaidar

Contraception has previously provided alternative medication delivery techniques for the treatment of endometriosis. Only LNG-IUSs and depot formulation (DMPA), however, have been studied in numerous RCTs to treat patients. These approaches tend to enhance patient compliance and satisfaction when compared to other conventional treatment alternatives. Nanotechnologies are potential new drug delivery techniques that have been shown to deliver compounds with a particular therapeutic impact. However, the information is limited and preliminary. Endometriosis research has identified the patients who could benefit most from this kind of medication administration. No one has ever been used in a clinical study to treat endometria. Alternative medication delivery techniques may help to enhance compliance, effectiveness, and the development of novel treatment approaches. The use of vaginal rings as a unique and alternative medication delivery route for AIs, as well as the experience with danazol, are examples. The vaginal ring has been studied as a new medication delivery mechanism for danazol and aromatase inhibitors. Nanotechnologies are made up of bioconjugates that deliver anti-inflammatory, antioxidant, anti-angiogenic, and immunomodulating chemicals directly to the illness site. At this early stage of proof-of-concept, the evidence is limited and tentative. Clinical effectiveness can not be predicted using mouse models.


Author(s):  
Thomas Römer ◽  
Johannes Bitzer ◽  
Christian Egarter ◽  
Peyman Hadji ◽  
Marion Kiechle ◽  
...  

AbstractHormonal contraceptives are an effective and safe method for preventing pregnancy. Progestins used in contraception are either components of combined hormonal contraceptives (tablets, patches or vaginal rings) or are used as a single active ingredient in progestin mono-preparations (the progestin-only pill (POP), implants, intrauterine systems or depot preparations). Progestins are highly effective in long-term contraception when used properly, and have a very good safety profile with very few contraindications. A new oestrogen-free ovulation inhibitor (POP) has recently been authorised in the USA and the EU. This progestin mono-preparation contains 4 mg of drospirenone (DRSP), which has anti-gonadotropic, anti-mineralocorticoidic and anti-androgenic properties. The hormone administration regimen of 24 days followed by a 4-day hormone-free period was chosen to improve bleeding control and to maintain oestradiol concentrations at early follicular-phase levels, preventing oestrogen deficiency. Clinical trials have demonstrated a high contraceptive effectiveness, a very low risk of cardiovascular side effects and a favourable menstrual bleeding pattern. Due to the long half-life of DRSP (30 – 34 hours), the effectiveness of the preparation is maintained even if a woman forgets to take a pill on a single occasion. Studies involving deliberate 24-hour delays in taking a pill have demonstrated that ovulation inhibition is maintained if a single pill is missed. Following a summary of the current status of oestrogen-free contraception, this review article will describe the clinical development programme of the 4 mg DRSP mono-preparation and the resulting data on the effectiveness and safety of this new oestrogen-free oral hormonal contraceptive.


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