{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T22:08:20Z","timestamp":1790978900633,"version":"4.1.0"},"reference-count":34,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med\ufffdInsights\ufffdReprod\ufffdHealth"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>The vaginal contraceptive ring is very effective and user dependent. In this article, we will discuss the different types of vaginal contraceptive rings, namely, the etonogestrel\/ethinyl estradiol (ENG\/EE) ring (NuvaRing, Merck, Rahway, NJ, USA) and the segesterone acetate (SA)\/EE (Annovera, Mayne Pharma, Raleigh, NC, USA) ring. The details of dosing and administration, indications, advantages, disadvantages, and cost-effectiveness are presented. This literature review was conducted using PubMed and Google Scholar. The search terms included \u2018vaginal contraceptive ring\u2019, \u2018etonogestrel\/ethinyl estradiol ring\u2019, and \u2018segesterone acetate\/ethinyl estradiol ring\u2019. The search was then sorted by year from 2000 until present, and the most recent articles were reviewed. The purpose of this article is to provide a comprehensive reference on the two vaginal contraceptive rings widely used in the United States for clinicians to guide management. Both vaginal contraceptive rings are combination of hormonal contraceptives that suppress ovulation and create physiologic conditions unfavorable for pregnancy. The ENG\/EE ring is designed to be replaced monthly, while the SA\/EE ring is a single device used over the course of 1\u2009year. Common side effects of both devices include headaches, nausea, vomiting, and vaginitis. Serious adverse reactions can occur with the vaginal contraceptive rings including venous thromboembolism, psychiatric events, and hypersensitivity. Both devices are contraindicated in patients at high risk for arterial or venous thrombotic events, patients with a history of breast cancer or other estrogen\/progesterone cancers, and patients with severe liver disease. Overall, the vaginal contraceptive ring is well tolerated and liked by patients. Patients should be well counseled on known severe adverse reactions. The vaginal contraceptive ring is more expensive than other forms of contraception and this should be an important point of discussion with patients.<\/jats:p>","DOI":"10.1177\/26334941231186733","type":"journal-article","created":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T04:53:52Z","timestamp":1689310432000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Advances in contraception: vaginal contraceptive rings"],"prefix":"10.1177","volume":"17","author":[{"given":"Sara","family":"Al-Haddad","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203-2098, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ki\u2019ara K. R.","family":"Branham","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Meharry Medical College, Nashville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille A.","family":"Clare","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Downstate Health Sciences University, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,7,14]]},"reference":[{"key":"bibr1-26334941231186733","volume-title":"Williams gynecology","author":"Hoffman BL","year":"2020","edition":"4"},{"key":"bibr2-26334941231186733","unstructured":"NuvaRing [Package Insert]. Whitehouse Station, NJ: Merck & Co., INC. 2013."},{"key":"bibr3-26334941231186733","doi-asserted-by":"publisher","DOI":"10.2147\/TCRM.S1964"},{"key":"bibr4-26334941231186733","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S6162"},{"key":"bibr5-26334941231186733","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2005.03.012"},{"key":"bibr6-26334941231186733","first-page":"207","volume":"58","author":"Rowland K","year":"2009","journal-title":"J Fam Pract"},{"key":"bibr7-26334941231186733","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/16.3.469"},{"key":"bibr8-26334941231186733","doi-asserted-by":"crossref","unstructured":"Schreiber C, Barnhart K. CHAPTER 34 \u2013 Contraception. In: Strauss JF, Barbieri RL. Yen and Jaffe\u2019s Reproductive Endocrinology. 6th ed. Elsevier, 2009, pp. 873\u2013892. https:\/\/www.sciencedirect.com\/science\/article\/pii\/B9781416049074000346 (accessed March 13, 2023).","DOI":"10.1016\/B978-1-4160-4907-4.00034-6"},{"key":"bibr9-26334941231186733","first-page":"585","volume":"100","author":"Dieben TO","year":"2002","journal-title":"Obstet Gynecol"},{"key":"bibr10-26334941231186733","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(03)00002-7"},{"key":"bibr11-26334941231186733","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2003.10.014"},{"key":"bibr12-26334941231186733","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/16.3.469"},{"key":"bibr13-26334941231186733","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2016.11.111"},{"key":"bibr14-26334941231186733","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2016.11.111"},{"key":"bibr15-26334941231186733","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14480"},{"key":"bibr16-26334941231186733","doi-asserted-by":"publisher","DOI":"10.5811\/cpcem.2020.1.44654"},{"key":"bibr17-26334941231186733","first-page":"e3103","volume":"10","author":"Selim M","year":"2018","journal-title":"Cureus"},{"key":"bibr18-26334941231186733","unstructured":"Merck Stands Behind the Safety Profile of NuvaRing\u00ae (etonogestrel\/ethinyl estradiol vaginal ring). Merck.com, https:\/\/www.merck.com\/news\/merck-stands-behind-the-safety-profile-of-nuvaring-etonogestrel-ethinyl-estradiol-vaginal-ring\/ (accessed 14 March 2023)."},{"key":"bibr19-26334941231186733","volume":"19","author":"Crespi S","year":"2013","journal-title":"Am J Manag Care"},{"key":"bibr20-26334941231186733","unstructured":"Population Counsil. Population council. The Nestorone\/ethinyl estradiol one year vaginal contraceptive system, https:\/\/popcouncil.org\/project\/the-nestorone-ethinyl-estradiol-one-year-vaginal-contraceptive-system\/ (accessed 14 March 2023)."},{"key":"bibr21-26334941231186733","unstructured":"Annovera [Package Insert]. New York, NY: Population Council 2018."},{"key":"bibr22-26334941231186733","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2021.03.024"},{"key":"bibr23-26334941231186733","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(19)30265-7"},{"key":"bibr24-26334941231186733","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2017.10.010"},{"key":"bibr25-26334941231186733","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2019.02.001"},{"key":"bibr26-26334941231186733","unstructured":"Population Counsil, 2018C. Population council. The Nestorone\/ethinyl estradiol one year vaginal contraceptive system, https:\/\/www.popcouncil.org\/research\/one-year-contraceptive-vaginal-ring (2018, accessed 14 March 2023)."},{"key":"bibr27-26334941231186733","unstructured":"The annovera birth control ring: is it right for you? The Pill Club, https:\/\/thepillclub.com\/blog\/the-annovera-birth-control-ring-pros-cons (accessed 20 March 2023)."},{"key":"bibr28-26334941231186733","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2008.08.003"},{"key":"bibr29-26334941231186733","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2017.12.011"},{"key":"bibr30-26334941231186733","unstructured":"Frequently Asked Questions About NuvaRing\u00ae (etonogestrel\/ethinyl estradiol vaginal ring). www.nuvaring.com, https:\/\/www.nuvaring.com\/frequently-asked-questions\/ (accessed February 2023)."},{"key":"bibr31-26334941231186733","doi-asserted-by":"publisher","DOI":"10.1080\/13625187.2002.11949333"},{"key":"bibr32-26334941231186733","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2007.12.007"},{"key":"bibr33-26334941231186733","unstructured":"Figure 2. Percent distribution of women aged 15\u201349, by current contraceptive status: United States, 2017\u20132019. https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db388.htm#fig1 (accessed 13 March 2013)."},{"key":"bibr34-26334941231186733","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181842071"}],"container-title":["Therapeutic Advances in Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/26334941231186733","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/26334941231186733","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/26334941231186733","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T01:11:25Z","timestamp":1777597885000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/26334941231186733"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":34,"alternative-id":["10.1177\/26334941231186733"],"URL":"https:\/\/doi.org\/10.1177\/26334941231186733","relation":{},"ISSN":["2633-4941","2633-4941"],"issn-type":[{"value":"2633-4941","type":"print"},{"value":"2633-4941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1]]},"article-number":"26334941231186733"}}