Vaginal health in contraceptive vaginal ring users – A review

Abstract

Background To provide an overview of the available data from clinical studies of vaginal conditions in women who use a vaginal ring as a contraceptive.

Methods A systematic review of the literature.

Results Millions of women have already used the ethylene vinyl acetate vaginal ring that releases ethinylestradiol and etonogestrel for contraception. Because of its small size, more than four out of five women using the ring report that they do not feel it, even during sexual intercourse. No colposcopic or cytological changes have been observed in users, although approximately 10% have increased vaginal discharge. While in vitro studies have shown adhesion of Candida yeasts to the vaginal ring surface, clinical studies have not demonstrated a greater incidence of Candida infections compared to users of equivalent oral contraceptives. Some clinical studies suggest a lower incidence of bacterial vaginosis. No interaction exists between concomitant use of the vaginal ring and other drugs or products for vaginal use.

Conclusion The use of a contraceptive vaginal ring does not alter the vaginal ecosystem and therefore does not substantially affect vaginal health.

KEYWORDS:

• Contraceptive vaginal ring
• Vaginal health
• Vaginal infections
• Cytology
• Colposcopy

ACKNOWLEDGEMENTS

The original manuscript was initially written in Spanish. The funding to cover the cost of English translation and copy editing was provided by Merck, Sharp & Dohme de España, S.A.

Declaration of interest: I. Lete has been a consultant for Bayer Healthcare, Merck (formerly Schering Plough, Organon), and Teva Laboratories, and has received direct lecture fees from Bayer Healthcare, Merck (formerly Schering Plough, Organon), Teva, HRA Pharma, Janssen, and Wyeth Laboratories (now Pfizer). The other authors report no conflicts of interest related to this publication. The authors alone are responsible for the content and the writing of the paper.