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[Dancinggirl]

My daughter has just been given a different type of contraceptive called 'The Ring'. I assume it must be fairly new (a long time since I've needed contraception!!!!).
It seems to be like the Estring device you can use to help Vaginal Atrophy but contains oestrogen and progesterone. I looked it up on Google and it even states it can be helpful in relieving menopause symptoms!!!!!!  I would assume this might be particularly helpful through peri meno when you still need some form of contraception.
How come there aren't specific HRT treatments that can be delivered in this way? How great to just pop a rubbery ring inside the vagina and forget about it for a week or month (depending on how long it would last)?  A bit like an internal patch! It would surely be a good transdermal route for HRT?  Many ladies are already using Utrogestan vaginally so to just add some oestrogen would be fabulous - for those who still get VA with full HRT treatment this would probably help VA as well. 
Have any peri meno ladies out there been offered this as an early type of HRT?  Any thoughts or info ladies?  DG x

[CLKD]

I used the Dutch Cap for a while - messy …….. and didn't like the feel of it inside of me 

[Dancinggirl]

The ring isn't like the Cap - which is such a palaver. She just puts it in (it doesn't have to go over the neck of the uterus it just sits high up in the vagina) and then leave it for three weeks - then have a week without it for the withdrawal bleed and pop a new one in after that!
The Estring ( used for local oestrogen treatment for VA) is left in place for 3 months and you don't know it's there.  I just thought it sounded rather easy to use?!  Dg x

[CLKD]

Easy to fall out too?  Interesting, perhaps she could keep a Journal ……….

[lubylou]

Dancing Girl,
I have never heard of it (I thought it was a scary film)  It never ceases to amaze me how quickly medical developments came around in some area and not in other.  I sounds a lot better than the old cap.

[honeybun]

The cap was such a passion killer and so difficult to get it in. More than once mine snapped across the bathroom and ended up pinging off the door and landing in a messy heap on the floor. By the time I had cleared up the mess and cleaned the cap the moment had passed 

I must speak to my daughter about the ring thing. Is that it's official name or just a description. She can't tolerate birth control pills with oestrogen as they make her sick. She is stuck using the mini pill and that gives her breakthrough bleeds which is not great either.


Honeyb
x

[Dancinggirl]

Hi honeybun
I thought this 'Ring' thing (yes, that's what it's called!!) sounds jolly good.  No messing around just pop it in and forget about it until you have your week off for a withdrawal bleed -  apparently it is unlikely to fall out but if it does you just wash it in warm water a pop it back in! 

It might help your daughter as it's basically transdermal so not going through the stomach and liver so may be better tolerated?!
My daughter has been given 'The Ring' because she is getting prolonged bleeding on the other contraceptive pill she was taking - she's loving it - it's stopped her bleeding and finds it perfectly comfortable.  She was even told she could just use it continuously for a few months (changing it every 3 weeks) - just have a break when convenient.

What surprised me was that it states that it might help to reduce meno symptoms - I assume in peri stage.!!!!!  There is plenty of info if you google.
http://www.fpa.org.uk/contraception-help/contraceptive-vaginal-ring
DG x

[honeybun]

Thanks DG, I will pass on the information.

Things have really improved haven't they.


Honeyb
x

[Hurdity]

An interesting idea for menopause and not much different from the Mirena - just with added oestrogen.

if the ring is the one I found here http://www.medicines.org.uk/emc/medicine/21419/SPC/nuvaring/ then it is just like the pill in that both the estrogen and progestogen are synthetic so not ideal for menopause - but no reason why one could not be developed with estradiol though.

The downside is that, like the Mirena it would deliver continuous progestogen.

Also the Mirena and the Estring deliver progestogen, or local oestrogen to the vagina and uterus with less systemic absorption, but with HRT, it is the beneficial systemic effects we are interested in, rather than the effect on the uterus. Perhaps not the ideal transdermal route for HRT!

As you say Dancinggirl - good for peri-meno though maybe, if you don't mind the synthetic hormones?

Hurdity x

[CLKD]

One assumes then that it can be felt all the while  otherwise how would one know if it dropped into the loo 

Not something I would have trusted ………..

[Dancinggirl]

Hurdity - the reason i did this post was really to pose the question why not an HRT form of this 'Ring'? If only they could produce a 'Ring' with natural oestrogen and a kinder progesterone it would seem logical that there may be many benefits?  I take your point that it would need to be quite high dose to offer the benefits of patches. I just liked the idea that it wasn't permanently stuck inside you like the Mirena - so more controllable.
In hindsight, when I had the Mirena I was getting quite a bit of chronic fatigue.  I wonder why they can't put a kinder progesterone in it?
Dydrogesterone(which is in Femiston) seems to be better tolerated by many women and yet it is not more widely used?  It's a shame is it not available as a pill to be had with oestrogen patch or Oestrogel.
I'm wanting more choice - crying for the moon!
CLKD - my daughter can't feel it while it's in place and I think you would know if it was going to come out as you would feel it - it's like the Estring. 
DG x

[honeybun]

I think it's a great post DG.

CLKD.....Did you feel the cap when it was in place. I didn't but then I had had three pregnancies and it sort of stretches things 

My daughter is one of the strange ones who tolerates progesterone really well but not oestrogen. She has tried  variety of BCP and the only one that does not make her vomit is the mini pill. Even then she still has bleeds which are inconvenient as she never knows when.
This sounds ideal for her to try so I will suggest it to her.


Can't think it would be used if you could feel it at all or young women would not use it.


Honeyb
x

[CLKD]

 

[Hurdity]

honeybun - it is likely that your daughter is unfortunately affected by the synthetic oestrogens in the combined pill and that bio-identical estradiol would not necessarily affect her in the same way, so there is still hope for her many years in the future when she will be thinking about HRT. I'm not sure whether any BCP contain estradiol?

Dancinggirl - progesterone is unstable as a molecule so could not be put in a ring as I understand, and dydrogesterone is closely related to progesterone so it may be true for this progestogen too? Dydrogesterone used to be available separately as Duphaston but was withdrawn commercially a few years ago - I think it is still available in some countries. I think there was even one HRT which had separate estradiol and dydrogesterone tablets - but of course that is now available as Femoston in a combined tablet. Not much help for those who want to try a different progesterone from Utrogestan, but one of the least androgenic ones!

I also looked up one of the papers which talks about different routes of administration for HRT and there has been research done on vaginal rings containing higher doses of estradiol than the Estring - which gave favourable systemic concentrations, so it could be made available. Unfortunately we are at the mercy of the big Pharmas in all of this and it is extremely frustrating that perfectly good products are withdrawn from the market, or not developed for commercial use, because of markets and profits. I presume also there have to be trials as well to look into long term effects etc which are costly. Not good news for menopausal women though   

Hurdity  x

[Dancinggirl]

Thanks Hurdity - all very interesting.  We can always rely on you to find some interesting background or explain reasons for things that we question, which is great. DG xxx