Ethinyl Estradiol and Etonogestrel (Vaginal)

Ethinyl estradiol and etonogestrel play a role in hormonal contraceptives using a vaginal ring to prevent pregnancy by stopping the release of eggs during ovulation.

Overview

Ethinyl estradiol and etonogestrel belong to a class of medicines called combined hormonal contraceptives (CHC). They work by inhibiting ovulation, stopping the release of eggs from the ovaries. CHCs offer a secondary prevention function by changing the uterine lining and thickening the cervix mucus to block the sperm from entering.

The two hormones used in the ring are similar to what our own body produces and has proven to be an effective method of birth control. The ring does not stop or prevent the spread of sexually transmitted diseases.

  • Ethinyl estradiol is an estrogen
  • Etonogestrel is a progestin

The U.S. Food and Drug Administration (FDA) posted a warning on this medicine when combined with smoking, citing an increased risk of a heart attack, blood clot or stroke. The population groups with the highest risk are women over 35 years of age smoking over 15 cigarettes a day. If you fit this description, your doctor may not prescribe this contraceptive for you.

When you follow the instructions for using the ring correctly, the rate of effectiveness remains high for controlling unwanted pregnancy. Introducing these hormones to your body will cause certain aspects associated with menstrual cycles to change. Most women experience these changes when using the vaginal ring.

  • Lighter periods
  • Less cramping
  • Improved skin conditions linked with acne
  • Reduced iron deficiency
  • Decrease of ovarian and uterine cancers

Contraceptive effectiveness is only one element a woman needs to consider when selecting a birth control method. Women choosing to use ethinyl estradiol and etonogestrel need to learn about the risks associated with hormonal contraceptives. There are potential drug interactions when using a vaginal ring, related to health concerns on toxicity 'the conditions are monitored with routine lab tests, response observations and regular office visits.

Conditions Treated

  • Birth Control

Type Of Medicine

  • Combined hormonal contraceptives

Side Effects

Medicines influence the results of treatments, but they also cause some unwanted consequences. As individuals, we are unique in how we respond to some medications, causing the side effects to vary from person to person. Not all side effects occur because of the medications, in some situations, additional dynamics from lifestyle, genetics and unknown health factors contribute to side effects.

Before you use the vaginal ring, talk to your doctor. Share as much information about your family's medical history, current health ailments and daily routines. Each of these life phases has valuable information to help your doctor decide what works best for you.

Birth control for most individuals is a choice to prevent unwanted pregnancy, and in most cases, it works with other medicines treating a health condition. There are instances where a combination of medications can cause minor to serious side effects. When the condition worsens, the existing health condition or your own intolerance to the chemical substances could be linked to the effects.

Clinical trials and actual consumers report experiences with ethinyl estradiol and etonogestrel having common effects. If you experience any of these, or ones not listed 'tell your doctor. Your doctor will help to prevent or ease an uncomfortable effect.

Common

  • Cough
  • Fever
  • Headache
  • Itching of the vagina
  • Pain during sexual intercourse
  • Cramping
  • Sore throat
  • Stuffy or runny nose
  • White vaginal discharge
  • Tightness of the chest
  • Weight gain

Most side effects fade away as your body adjusts to the medication. It's a good idea to keep your doctor updated on how you are feeling. DO NOT self-diagnosis, allow your doctor to do what they do best, take care of you. Tell your doctor about the severity of the side effects. If they persist causing your health to decline, your doctor will check for causes and monitor your responses to find a workable solution for you.

The introduction of these hormones may change how your body responds and functions causing some of these effects. There may also be unknown health conditions, like an allergy to the medicine instigating the effect.

Least common

  • Bad breath
  • Brown spots on the skin
  • Change in appetite
  • Change in urine
  • Chills
  • Contact lenses intolerance
  • Dry mouth
  • Fatigue
  • Hunger
  • Irregular menstrual periods
  • Mood changes
  • Paranoia
  • Rash
  • Tenderness of the breasts
  • Thirst
  • Vaginal bleeding between regular monthly periods
  • Weight loss

This form of birth control is a good choice, you don't have to remember to take a pill every day, but the vaginal ring needs to be replaced to retain the hormone levels that prevent pregnancy.

Some effects are inconsistent, you need to keep track of your reactions and tell your doctor. One common effect for women using hormone contraceptives are mood swings and the hormones may escalate the reaction. Changes in your daily routine involving diets or emotional stress can prompt an annoying reaction. If you experience unusual changes, contact your doctor - ask for help.

Once the body adjusts to ethinyl estradiol and etonogestrel the effects will subside. The best method of controlling side effects and maintaining hormonal balance is consistency. Following the instructions on how to use the ring and keeping to your schedule for replacing the ring during the 4-week cycle will help prevent unwelcomed side effects and pregnancy.

These effects are rare, but they may happen.

Rare

  • Confusion
  • Constipation
  • Diarrhea
  • Dizziness
  • Irregular heartbeat
  • Jaundice
  • Nausea
  • Nervousness
  • Pain or discomfort
  • Seizures
  • Severe headaches of sudden onset
  • Skin color changes
  • Sweating
  • Vision changes
  • Vomiting

Existing Health Conditions

Before starting this contraceptive therapy, talk with your doctor. Our body functions, both mentally and physically play a role in these side effects with the introduction of external hormones. There are known cases with increased risks and adverse reactions. If you suffer from any of these existing health conditions, talk to the doctor to prevent provoking consequences that are more serious.

  • High blood pressure
  • Pre-existing heart disease
  • Diabetes
  • Gallstones
  • Hereditary angioedema

One inherited health condition is angioedema caused by the fluctuation in estrogen. Imbalances of hormones and sensitivities to changes in body hormones can trigger swelling attacks with different levels of severity.

Ethinyl estradiol and etonogestrel may increase the chance of non-cancerous liver tumors causing serious internal bleeding. The ring may also increase your risk for developing breast cancer. You need to recognize the symptoms of these reactions and keep your scheduled health visits with your doctor.

Precautions

If you have other medical or health treatments scheduled, be sure to tell the doctor or the attending physicians that you are taking this drug before proceeding with the treatment. Under certain circumstances, you may need to stop using this medicine before having medical tests or surgery.

  • Before you stop taking this medicine, talk to the doctors' stopping any medication suddenly can prompt severe side effects.

Dosage

The vaginal ring is a flexible plastic containing synthetic hormones absorbed by the body when it's placed into the vagina. The hormones regulate your menstrual cycle to prevent pregnancy with no affect to your reproductive health. It has an effective rate, when used correctly of less than 2 out of 100 women getting pregnant.

If you are considering a vaginal ring with ethinyl estradiol and etonogestrel as a method of birth control, you need to understand how to use the vaginal ring for the best results. Keep in mind, the hormones in the ring take 7 days to become effective. During this time, it's necessary to use another form of birth control. Talk to the doctor or the pharmacist for more information about your own health and the expected results with ethinyl estradiol and etonogestrel therapy.

To prevent pregnancy, you need to follow your doctor's instructions and read the product label to make sure you insert the ring correctly. If you have questions'ask your doctor.

This is an average daily release of ethinyl estradiol and etonogestrel for birth control.

  • 0.12 milligrams (mg) of ethinyl estradiol
  • 0.12 mg of etonogestrel

Adult Dose

The vaginal ring works on a 4-week cycle. You need to set up a schedule for removing the old ring and re-inserting a new ring to maintain its effectiveness. During the 1-week break, you should have a normal menstrual cycle.

  • Insert the ring into the vagina and leave it in place for 3 weeks
  • At the end of the 3rd week remove the ring
  • Wait 1 week before inserting a new ring
  • Discard the old ring DO NOT reuse it
  • If the ring breaks during the 3 week cycle, discard it and replace it with a new one.

It's important to read the instructions on inserting the ring and sticking to the prescribed schedule. On occasion, the ring may slip out. If it does, wash it with warm water and reinsert at once. If the ring is outside of your body for less than 3 hours, its contraceptive efficacy remains intact. Any longer than 3 hours may diminish the efficacy and you will need to use other birth control methods to prevent pregnancy.

  • If you forget and leave the ring in during the 4th week' remove it and replace the new ring according to your schedule.

If you are switching from another form of CHC, talk to your doctor. You may need to continue with the same schedule. You want to prevent any lapse in hormone protection. Your doctor can explain how the transition works best for you. If you are replacing an implant device or pills, you will need to follow the ring's initial starting instructions.

Adolescent and Pediatric

  • Your doctor will determine the use and dose' this medicine is prescribed for use only after menstrual cycles begin.

After Childbirth, Miscarriage or Abortion

Your doctor will guide you through this process. If you breastfeed, your doctor may not recommend continuing with this birth control.

You can use a vaginal ring after a miscarriage or abortion at the end of the first trimester. In the meantime, use other forms of birth control to prevent pregnancy. If either of these two events occurs in the second trimester, wait 4 weeks before inserting the vaginal ring. Always talk to the doctor first.

  • These events have a precautionary warning of increased risk of blood clots.

Cycle Changes

When you use a CHC, your periods will change, and most women experience shorter menstrual cycles. In the beginning, you may experience light spotting for the first 6 months. If you are worried about these changes, talk to your doctor.

  • If you get pregnant while using a vaginal ring, let your doctor know.
  • If you stop using the ring, it may take two months for your normal cycle to return.
  • You may experience irregular periods as your body adjusts to the change.

Once you stop using the vaginal ring, whether or not you get your period, getting pregnant is possible. If you stop using the ring and you still want to prevent pregnancy, be sure to use another form of birth control.

Missed Dose

If you've removed the ring after the 3 week interval and forgotten to re-insert a new ring beyond the 1 week break, you need to insert a new ring at once.

  • If you have been sexually active, take a pregnancy test before starting your 4-week cycle again.

Be sure to use another method of birth control for at least 7 days to allow your body to absorb the ethinyl estradiol and etonogestrel from the ring.

Interactions

In most circumstances, medicines work well together to manage several health conditions at the same time. Your doctor may adjust the doses of two different drugs as needed to treat multiple conditions. In other instances, the interactions of two different medicines will cause serious effects. Your doctor may change the frequency or time of administering to reduce or prevent the reactions.

There are health situations where using multiple medications is necessary. The concerns with the interactions involve changing the results of treatment or increasing the individual's risks. Look at the names on this list, some share similarities - this is a sign they also share similar compounds that interact with other drugs or change the treatment or outcome due to the chemical quantities.

Your doctor will decide how to treat you if you are taking any of these medications. It may be necessary to change some medicines. If you are taking any of these medicines listed or others that may affect your response to this treatment ' tell your doctor. There may be other medications not listed that interact with this therapy.

Your doctor will check the medications you are taking now to be sure this contraceptive is safe for you.

  • Alprazolam
  • Amprenavir
  • Anagrelide
  • Aprepitant
  • Atazanavir
  • Bacampicillin
  • Betamethasone
  • Bexarotene
  • Boceprevir
  • Bosentan
  • Bupropion
  • Carbamazepine
  • Ceritinib
  • Clarithromycin
  • Clozapine
  • Colesevelam
  • Cyclosporine
  • Dabrafenib
  • Darunavir
  • Delavirdine
  • Donepezil
  • Efavirenz
  • Eliglustat
  • Etoricoxib
  • Etravirine
  • Fosamprenavir
  • Fosaprepitant
  • Fosphenytoin
  • Ginseng
  • Griseofulvin
  • Idelalisib
  • Isotretinoin
  • Lamotrigine
  • Lesinurad
  • Licorice
  • Lixisenatide
  • Lumacaftor
  • Modafinil
  • Nelfinavir
  • Ombitasvir
  • Oxcarbazepine
  • Paclitaxel
  • Parecoxib
  • Paritaprevir
  • Phenobarbital
  • Phenytoin
  • Piperaquine
  • Pirfenidone
  • Pitolisant
  • Prednisolone
  • Primidone
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Ritonavir
  • Roflumilast
  • Rosuvastatin
  • Rufinamide
  • Selegiline
  • St John's Wort
  • Sugammadex
  • Telaprevir
  • Theophylline
  • Tipranavir
  • Tizanidine
  • Topiramate
  • Troglitazone
  • Troleandomycin
  • Ulipristal
  • Valdecoxib
  • Voriconazole
  • Warfarin

There are over 2700 brand and generic names known to interact with this medicine. Some drugs cause major, moderate or minor interactions affecting your health or interfering with the treatment. Minor interactions will not affect the results of your medications. Moderate interactions can be managed with adjustments to doses and prescribed frequency. The last alternative is a complete change of medicines to prevent adverse reactions. The major interactions can cause serious to life-threatening events.

  • 159 drugs have minor interactions
  • 366 drugs have moderate interactions
  • 48 drugs have major interactions

Other Interactions

Besides different medicines, foods can trigger interactions. Be sure to read the package instructions or ask your doctor about the possible interactions. Alcohol or tobacco will cause minor to major interactions with this medication. If you take over-the-counter (OTC) medicines, they can affect your response to treatment. It's best not to take other medicines without talking with your doctor first.

  • Alcohol effects intensify when taking hormones'one drink could equate to three depending on the individual.

Your doctor will watch for responses to the hormone levels, and you need to learn to recognize the symptoms and when it's necessary to contact your doctor. Toxicity remains a concern for women because hormonal balance plays a significant role in maintaining good health. The introduction of the external hormone can cause imbalances triggering adverse effects.

Major concerns exist when prescribing this therapy for women who smoke. Reports show smoking may weaken the effects of estrogen, in this case, it may reduce the effectiveness of the vaginal ring for birth control. Many women continue to use contraceptives until reaching menopause. The reduction of estrogen caused by smoking may also increase the risk of early osteoporosis.

Adverse Health Reactions

Ethinyl estradiol is also known to affect hypertension, putting this interaction into a major category. The condition is associated with serious health risks when using estrogen contraceptives, elevating the blood pressure of an existing condition causing serious complications. Continued durations can worsen the effects. If you have high blood pressure, you need to check it regularly and if you experience an increase in blood pressure while using this medicine, tell your doctor.

Moderate interactions are listed as precautions when using estrogens. Conditions include hyperlipidemia and fluid retention. Magnification of hyperlipidemia is linked to estrogen hormones. If you are treated for this disorder, your doctor will watch your blood levels and the hormone interactions throughout therapy.

Ethinyl estradiol (estrogen) and etonogestrel (progestogens) in the body influence fluid retention. Prolonged periods of treatment can trigger detrimental health responses. Conditions most affected from fluid accumulation include asthma, migraines and cardiovascular or renal malfunctions.

Medical Problems

Current health conditions affect your response to this medicine or instigate other harmful illnesses. If you are treated for these disorders, talk to your doctor. The doctor may decide not to prescribe this form of therapy for you. You need to understand the risks before taking any form of birth control.

  • Abnormal Vaginal Bleeding
  • Angioedema
  • Blood clots
  • Breast Malignancy
  • Cervical cancer
  • Chloasma gravidarum
  • Cholestasis (bile problem)
  • Depression
  • Diabetes
  • Estrogenic carcinomas
  • Fluid Retention
  • Gallbladder Disease
  • Glucose Intolerance
  • Heart attack
  • Hepatic Neoplasms
  • Hypercalcemia
  • Hyperlipidemia
  • Hypertension
  • Kidney disease
  • Liver Disease
  • Melasma
  • Migraine headache
  • Obesity
  • Stroke
  • Toxic shock syndrome
  • Tumors (estrogen-dependent)
  • Vaginal or cervical ulcers

Warnings

The FDA has warnings posted for ethinyl estradiol and etonogestrel with public health precautions when selecting this medicine as a method of birth control. Ask your doctor or pharmacist for information if you have questions. The postings provide valuable information for the consumer and the medical professionals when making health decisions for different individuals.

Read the information and responses collected about medical conditions and the effects of this therapy. These notices are founded on illnesses and therapy results of women in their reproductive years. These health warnings help to recognize the early signs of potential weakening to prevent health disorders or harmful events during short or long-term treatment.

Pregnancy

If you become pregnant while using the ring, tell your doctor at once. You should know that using a vaginal ring while you are pregnant could harm the developing fetus.

If you have given birth and want to restart this therapy, make sure the doctor knows the date of birth. You need a 4-week interval from birth before using a vaginal ring again.

Nursing Mothers

The combination of ethinyl estradiol and etonogestrel in a vaginal ring may reduce the amount and the quality of breast milk during the first 6 weeks after giving birth. If you breastfeed, talk with your doctor. Waiting the 6 weeks after giving birth is recommended to make sure your breast milk is nutritional and not harmful to the infant.

  • Studies have shown traces of the ring's hormones in breast milk. The chances of serious side effects are low, but precautions are still necessary for the baby.

When refilling or continuing to use the vaginal ring after birth, your doctor will request a full physical examination. Your body may have undergone changes and your doctor may need to change the contraceptive prescription.

Pediatric

Clinical studies and research continue to review the effectiveness of estrogen and progestogen in this population group, pertaining to adolescents (teenagers). Precautions are taken when considering prescriptions in this group, based on biological changes in younger individuals compared to reproductive aged adult women.

Geriatric

There are few reports on the relationship between the geriatric population and the effects of ethinyl estradiol and etonogestrel. This medicine should not be prescribed to elderly women.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. You can store this medicine for up to 4 months after you receive it.

  • Keep it from freezing.
  • Keep it out of the reach of children.
  • Do not keep outdated medicine or medicine no longer needed.
  • Place the removed ring after the 3-week interval in the re-sealable pouch.
  • DO NOT flush it

Ask your healthcare professional how you should dispose of any medicine you do not use.

Summary

Ethinyl estradiol and etonogestrel have a reliable effectiveness in preventing pregnancy. Improvements to medical contraceptives have helped to decrease the side effects. Less than two out of 100 women become pregnant when using the vaginal ring as instructed. Smoking tobacco is a major health risk when taking this medicine. With all the success, caution is necessary when using hormones in any form of health treatment. Studies show an increasing number of incidents in female health conditions associated with estrogen hormone problems.