The FDA approval of ANNOVERA brings a new user-controlled, reversible, vaginal contraceptive ring that can be used for up to one year without refrigeration. ANNOVERA is a soft, flexible silicone ring, roughly 2 inches in diameter releasing an average of 13 mcg of estrogen (ethinyl estradiol) and a new progestin (segesterone acetate). This makes ANNOVERA one of the lowest estrogen dose methods available and the new non-androgenic progestin it contains, means fewer changes in lipid profile, acne, and weight gain. In clinical trials, ANNOVERA was 97.3% effective in preventing pregnancy when used correctly and 9 out of 10 of those who used ANNOVERA found that it was easy to use, comfortable, and did not affect their sex life.
The basics of using ANNOVERA
- ANNOVERA is placed in the vagina by the user and removed after 21 days. It is replaced after 7 ring-free days (it comes with a small case for storage while it’s out).
- Each ANNOVERA ring is reusable for 13 cycles, up to one year.
- Unlike NuvaRing, the current vaginal contraceptive ring, ANNOVERA never needs to be refrigerated.
- ANNOVERA does not need to be removed during sex or at any time during the 21 days, but can be removed from the vagina for 2 hours without the need for a backup method.
- Before reinserting ANNOVERA, the user must wash it with mild soap and water and pat it dry.
- If ANNOVERA remains in the vagina for more than 21 days, it should be removed for 7 days and then reinserted for 21 days to resume a 21/7 schedule.
You can encourage patients to start using ANNOVERA anytime you can be reasonably certain that they aren’t pregnant. If ANNOVERA is quick started after day 5 of the menstrual cycle, advise patients to use a backup method, like condoms, or abstain for the first 7 days of use.
Like other methods that contains estrogen, such as the patch, the combined birth control pill, or the NuvaRing, it may not be a good option for anyone with high risk of arterial or venous thrombotic diseases, current or history of breast cancer or other estrogen- or progestin-sensitive cancer, liver tumors, acute hepatitis, or severe (decompensated) cirrhosis, undiagnosed abnormal uterine bleeding, or use of Hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir.
How to get ANNOVERA
ANNOVERA is now available from all commercial pharmacies, so you should be able to send a prescription to a local pharmacy or mail-order pharmacy, like PillPack. Patients can also get their ANNOVERA delivered after a telehealth visit from SimpleHealth, The Pill Club, or PlushCare, skipping the in-person visit altogether.
Many commercial insurance plans nationwide now cover ANNOVERA with no out-of-pocket cost. But for those who do not have coverage, the ANNOVERA savings program is available to ensure that people with a copayment pay as little as $60 for their ANNOVERA.
Since each ANNOVERA is good for a year, it could be a good option for anyone who wants an easy-to-use, long-lasting birth control option that can be started and stopped without a procedure.