In August the US Food and Drug Administration approved a new birth control ring called Annovera, a vaginal ring which can be used for a full year. It's a welcome alternative to the pill that could be an option for women who would rather not use other similar long-term contraceptive methods like the coil or implant.
The Annovera ring contains a combination of hormones that prevent ovulation (and hence pregnancy), and can be reused each month for 13 cycles before it has to be replaced.
Annovera is not currently available in the UK and, following licensing, the decision as to whether or not it's introduced on the NHS would be made by NICE (the National Institute for Health and Care Excellence), the Medicines and Healthcare Products Regulatory Agency told Refinery29. The NuvaRing is already an option for people on the NHS, but this only lasts a month.
The ring is likely to be made available in the US in late 2019 or early 2020, according to The Population Council, the nonprofit research organisation that developed it.
The fact that Annovera can last for a year before it has to be replaced might intrigue people shopping around for new birth control methods. Compared to an IUD, birth control rings tend to be more flexible — literally and figuratively — because they can be inserted and removed by the user, and they sit in the vagina not the uterus. But just as an IUD isn't the right birth control choice for every person with a uterus, there are a few things you should know about Annovera before you decide to get it.
It's soft and made from silicone, measures 5.7 cm/2.25 inches in diameter and is inserted inside your vagina. Once up there, it releases a combination of progestin and oestrogen hormones into the body. Although it's being marketed as a ring that "lasts for a year", you still have to take it out every 21 days (using your fingers) for a seven-day period, according to the prescriber information. During this time, you'd bleed and get your period like usual, and keep your ring in a case (after you wash it with mild soap and warm water) that comes with it.
The NuvaRing can stay in for three weeks, but you have to dispose of it and get a new one each cycle, which can be a pain. Another annoying thing about the NuvaRing is that you have to keep it stored away from sunlight or inside a fridge. But if you follow this three weeks in, one week out cycle, then one Annovera ring is good for 13 cycles or 273 days, and it can withstand temperatures up to 30 degrees Celsius.
So, Annovera sounds great, but how well does it work? In three clinical trials of 2,308 women aged 18 to 40, they found that about two to four women out of 100 women may get pregnant during the first year using Annovera. (It's important to note that women with a body mass index higher than 29 were excluded from these trials, so we don't know how well it would work for people in this category yet.) In comparison, the birth control ring has a typical use failure rate of about 9%, which is the same as a hormonal birth control pill, according to the US Centers for Disease Control and Prevention.
Of course, Annovera isn't perfect, and it can be accidentally expelled while removing a tampon, during sex, or while passing a bowel movement. There are also some common side-effects that people experienced in the clinical trials, like headaches (including migraines), nausea and vomiting, vaginal yeast infections, abdominal pain, and menstrual cramps. Also, people at increased risk of venous thromboembolism (a blood-clotting condition), or who have a history of breast cancer, liver tumours, or abnormal uterine bleeding, shouldn't use Annovera.
If you're curious whether Annovera is a good option for you right now, it's important to talk to your obstetrician/gynaecologist or healthcare provider who can take your whole medical history into account and help you make a decision.
This new ring is being marketed as a contraceptive method that's "fully under a woman's control," which is a nice sentiment for the time being. Ultimately, it's great that there are more birth control options available — because birth control is vital to people's health.
Dr Michael Brady, medical director at sexual health charity the Terrence Higgins Trust, said the vaginal ring currently available to women in the UK is "highly effective at preventing pregnancy."
"We would welcome any innovations that make contraception easier and more convenient for women. It's important for women to have as many choices as possible when it comes to contraception and this would be a welcome addition. But it's also important to remember that the ring only prevents unwanted pregnancy and not sexually transmitted infections."