Effect on carbohydrate metabolism and analysis of acceptability (menstrual cycle control) of extended regimens of the vaginally inserted hormone-releasing system ‘NuvaRing’ as compared with the standard 21/7 regime in reproductive-age women with type 1 diabetes mellitus

Grodnitskaya, E E; Grigoryan, O. R.; Klinyshkova, E.; Андреева, Елена; Мельниченко, Г. А.; Dedov, Ivan I.

doi:10.3109/09513591003686296

Cited by 14 publications

(6 citation statements)

References 11 publications

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“…Dozens of studies that have in total included thousands of participants have confirmed the safety of extended and continuous combined contraceptive regimens 14–53,55–59 . This body of work has documented that there are no harmful effects on the uterus or endometrium in women who use extended or continuous contraceptive regimens.…”

Section: Evidence‐based Counseling For Extended and Continuous Contramentioning

confidence: 99%

“…Extended use of the vaginal ring does not change blood pressure significantly 55 . The vaginal ring generally has no effect on carbohydrate metabolism in both cyclic and extended regimens and is therefore safe and effective for use in women with diabetes 56,57 . Lipid metabolism and lipoprotein levels were similar in women using 84/7 extended regimens of the vaginal ring or combined oral contraceptives 58 …”

Section: Vaginal and Transdermal Options For Extended And Continuous mentioning

confidence: 99%

“…Dozens of studies that have in total included thousands of participants have confirmed the safety of extended and continuous combined contraceptive regimens. [55][56][57][58][59] This body of work has documented that there are no harmful effects on the uterus or endometrium in women who use extended or continuous contraceptive regimens. Blood pressure measurements and laboratory test findings were not different between groups of women using cyclic regimens and extended or continuous regimens.…”

Section: Safetymentioning

confidence: 99%

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Extended and Continuous Combined Contraceptive Regimens for Menstrual Suppression

Jacobson¹,

Likis²,

Murphy³

2012

J Midwife Womens Health

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Many women have medical indications for menstrual suppression or a personal preference to reduce or eliminate monthly bleeding, which can be achieved with extended and continuous regimens of combined estrogen and progestin contraceptives. Combined contraceptives are traditionally administered in a 28-day cycle, with 21 days of a contraceptive pill, vaginal ring, or transdermal patch followed by a hormone-free interval that is usually 7 days. During the hormone-free interval, women either take a placebo pill or do not use their combined contraceptive method. Hormone-related symptoms are significantly worse during the hormone-free interval than the days when the contraceptive is used. Alterations of the standard 28-day cyclic regimen for menstrual suppression include decreasing the frequency of the hormone-free interval, thus extending the time between withdrawal bleeding episodes (extended use), and eliminating the hormone-free interval altogether (continuous use). This article reviews menstrual suppression indications and physiology. Research demonstrating that the effectiveness, safety, and side effects of oral, vaginal, and transdermal extended and continuous regimens are comparable to cyclic regimens is summarized. Findings from studies of women's and health care providers' attitudes toward menstrual suppression also are reviewed. Important topics to include in evidence-based counseling for extended and continuous combined contraceptive use are presented.

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Section: Evidence‐based Counseling For Extended and Continuous Contramentioning

confidence: 99%

Section: Vaginal and Transdermal Options For Extended And Continuous mentioning

confidence: 99%

Section: Safetymentioning

confidence: 99%

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Extended and Continuous Combined Contraceptive Regimens for Menstrual Suppression

Jacobson¹,

Likis²,

Murphy³

2012

J Midwife Womens Health

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“…Furthermore, cycle control with the vaginal ring has been shown to be superior to that with a combined oral contraceptive pill containing 30 mcg of EE and 150 mcg of levonorgestrel or 3 mg drosperinone [12,13]. The vaginal ring proved to be a reliable and safe means of contraception for late reproductive age women with type-1 Diabetes Mellitus (DM) [14].…”

Section: Introductionmentioning

confidence: 99%

Efficacy, User Acceptability, Tolerability, and Cycle Control of a Combined Contraceptive Vaginal Ring: The Indian Perspective

Shet¹,

Seeru²,

Bangar³

2013

J Obstet Gynecol India

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Objective To assess the contraceptive efficacy, user acceptability, cycle control, and tolerability of a combined contraceptive vaginal ring for up to 13 cycles. Materials and Methods Healthy women coming to the OPD for contraceptive advice were enrolled in this oneyear study. Each ring was used for three weeks followed by a one-week ring-free period. Results A total of 184 women started treatment forming the intent to treat population. Subjects were followed for 13 cycles. Compliance was good with 99 % of cycles in full compliance with specified criteria. In the intent to treat population, no pregnancies occurred giving a Pearl Index of 0. The mean incidence of withdrawal bleeding was 99 % in all cycles. There was 0.16 % incidence of intermenstrual bleeding and 2 % incidence of early withdrawal bleeding. The ring was well tolerated with a low incidence of adverse events. Conclusion The ring is an effective contraceptive that is convenient, well tolerated with excellent cycle control, and highly acceptable to users.

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“…Reasons for exclusion were that five publications were case-control studies (Diab 2000;Grigoryan 2008;Petersen 1994;Petersen 1995;Petersen 1996); one article was a review (Skouby 1986b); one article was a case report (Reder 1967); one study was a nonrandomised prospective follow-up study (Klein 1999b); one study (Aznar 1976) was performed randomly but included patient with a single impaired glucose intolerance test and no diabetes mellitus was diagnosed during the trial; one study was only randomised for di erent regimens of using a vaginal ring and did not randomise for di erent types of contraceptives (Grodnitskaya 2010).…”

Section: Excluded Studiesmentioning

confidence: 99%

Hormonal versus non-hormonal contraceptives in women with diabetes mellitus type 1 and 2

Visser

Snel

Vliet

2013

Cochrane Database of Systematic Reviews

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The four included randomised controlled trials in this systematic review provided insufficient evidence to assess whether progestogen-only and combined contraceptives differ from non-hormonal contraceptives in diabetes control, lipid metabolism and complications. Three of the four studies were of limited methodological quality, sponsored by pharmaceutical companies and described surrogate outcomes. Ideally, an adequately reported, high-quality randomised controlled trial analysing both intermediate outcomes (that is glucose and lipid metabolism) and true clinical endpoints (micro- and macrovascular disease) in users of combined, progestogen-only and non-hormonal contraceptives should be conducted. However, due to the low incidence of micro- and macrovascular disease and accordingly the large sample size and long follow-up period needed to observe differences in risk, a randomised controlled trial might not be the ideal design.

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Effect on carbohydrate metabolism and analysis of acceptability (menstrual cycle control) of extended regimens of the vaginally inserted hormone-releasing system ‘NuvaRing’ as compared with the standard 21/7 regime in reproductive-age women with type 1 diabetes mellitus

Abstract: The releasing system 'NuvaRing' proved to be a reliable and safe means of contraception for late reproductive age women with type 1 DM.

Cited by 14 publications

References 11 publications

Extended and Continuous Combined Contraceptive Regimens for Menstrual Suppression

Extended and Continuous Combined Contraceptive Regimens for Menstrual Suppression

Efficacy, User Acceptability, Tolerability, and Cycle Control of a Combined Contraceptive Vaginal Ring: The Indian Perspective

Hormonal versus non-hormonal contraceptives in women with diabetes mellitus type 1 and 2

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