Hormonal patch What is the hormonal patch? A small, thin, square of flexible plastic worn on the body. (may be applied to the buttocks, upper outer arm, lower abdomen, or upper torso, excluding the breasts) What is the vaginal ring? A flexible ring that a woman places in her vagina. Also called Nuva ring These two can be a contraceptive option for a 23 year old nulliparous bisexual patients in which it Provides a similar reversible contraceptive with a more convenient dosing schedule that would enhance patient compliance and achieve high contraceptive efficacy. mechanism of action For Contraceptive patch: the contraceptive skin patch contains 75ug ethinyl estradiol and 6mg norelgestromin (xulane), a progestins that mimic the effect of natural progesterone. Once placed on the skin, contraceptive patches release the aforementioned hormones, which are absorbed through the skin and into the bloodstream. Vaginal ring: a ring device containing 2.7mg of ethinyl estradiol and 11.7 mg of etonogestrel. This ring is placed in the vagina and the steroids pass easily through the vaginal epithelium directly into the circulation. At high concentrations, the estradiol and the progestins exerts an inhibitory effect on gonadotropin secretion. So there would be a suppression of hypothalamic gonadotropin releasing factors with subsequent suppression of pituitary production such as FSH and LH. As a result, it prevents ovulation and as well thickening of the cervical mucus to stop the sperm from reaching the egg, thus avoids pregnancy. benefits SPECIFIC to the case help protects against: ovarian and endometrial cancer (most cases above 40s, new studies shows about 2-14% cases occurs in patients in their 20s prone to these cancers) reduce menstrual cramps, menstrual bleeding, ovulation pain reduce hair on face or body reduce of symptoms of PCOS (irregular bleeding, acne, irregular bleeding) add on: the hormones from the patch or ring aren't absorbed by the stomach, so it still works if you're sick (vomit) or have diarrhoea Contraceptive patch- convenient, easy to use and it does not interrupt your sexual activity - unlike the combined oral contraceptive pill, you don't have to think about it every day – you only have to remember to change it once a week effectiveness of the method perfect use: 1% failure rate typical use: 8% failure rate give the risks no protection from STDs, Couples having sex must always use condoms along with the patch or ring to protect against STDs changes in bleeding patterns (lighter, irregular, prolonged, no monthly bleeding/ amenorrhea) contraceptive patch: can cause skin irritation, itching and soreness vaginal ring: can cause vaginal irritation, she may not feel comfortable inserting and removing it as well. Woman’s concern as well her partner, having a foreign body in the vagina during sexual intercourse and the potential for expulsion. Vaginal ring: choose the position most comfortable, standing in one leg up, squatting or lying down. She should press the opposite sides of the ring together and gently push the folded ring entirely inside the vagina.
