Patient's question:
After installing the siloxane ring, are there any side effects? What are the advantages and disadvantages respectively?Doctor's answer:
The vaginal ring is made of silicone rubber, with an outer diameter of 30～60 millimeters and a thickness of about 9 millimeters. It is placed inside the ring with progesterone or a combination of progesterone and estrogen. Commonly used progestins include 18-methyl, medroxyprogesterone, and others. Due to the good permeability and absorption of the vaginal epithelium for certain drugs, the use of silicone rubber allows for slow drug release. Therefore, after placing the vaginal ring in the vagina, the progesterone can slowly and continuously release through the ring wall, maintaining a constant level of female hormones in the plasma. This affects the endometrium and cervical mucus, making it unfavorable for conception or implantation of the fertilized egg, thereby providing long-term contraception.There are several methods for using the vaginal ring, with the most common method being to place the ring in the vagina on the 5th day of the menstrual cycle, reaching the posterior fornix or the cervix, and leaving it for 3 weeks before removal. Due to the withdrawal of progesterone, the endometrium undergoes withdrawal bleeding, leading to menstruation. This process can be repeated. Alternatively, the ring can be left in the vagina for 3 months or even 1 to 2 years for continuous use. Commonly used vaginal rings in China include Shanghai Silicone Ring (containing medroxyprogesterone) and Shanghai 18-methyl Ring (containing 18-methyl).
The advantages of the vaginal ring include a contraceptive effectiveness of over 95%; simple usage; the ability to be left in place for extended periods; and its suitability for most women needing contraception, requiring no size change as long as the ring surface adheres to the vaginal wall or cervix, allowing the drug to be absorbed by the epithelial cells for contraceptive effects. Although the vaginal ring contains sex hormones, it does not interfere with the body's normal endocrine function.
The disadvantages of the vaginal ring include certain side effects, such as irregular vaginal bleeding, which is caused by breakthrough bleeding due to progesterone. This can usually be managed by taking a small amount of estrogen or a short-acting oral contraceptive to stop the bleeding. A few women may experience ring slippage or pregnancy with the ring in place. In some cases, it may affect sexual activity or lead to secondary infections due to frequent vaginal bleeding.
Women who frequently exert force, adopt a squatting posture, or have conditions such as vaginitis, severe cervical erosion, vaginal relaxation, or uterine prolapse should not use the vaginal ring.