New Contraception Update — Annovera, Phexxi, Slynd, and Twirla

Purpose of Review In this review, we discuss the efficacy, safety, and benefits of four new contraceptive products available in the USA, specifically Annovera, Phexxi, Slynd, and Twirla. Recent Findings Annovera is a vaginal ring releasing ethinyl estradiol and segesterone acetate that can be used for up to one year (13 cycles), offering patients an effective, user-controlled option that may improve contraceptive access for those in low-resource settings or those with barriers to retrieving monthly prescriptions; however, given limited efficacy and safety data in people with body mass index (BMI) > 29 kg/m2, clinicians may consider whether Annovera is an appropriate contraceptive method for obese patients if there are other acceptable alternatives. Phexxi prescription-only vaginal gel is a user-controlled, non-hormonal, on-demand contraceptive method that represents a novel addition to the market with its additional uses as a personal lubricant and as a potential microbicide for urogenital infection prevention. Slynd, a drospirenone-only pill, provides more flexibility for delayed or missed pills while maintaining efficacy and a more favorable bleeding profile compared with previously available progestin-only pills. Lastly, Twirla is a transdermal patch releasing ethinyl estradiol and levonorgestrel that offers users an additional option for a user-controlled, combined hormonal contraceptive method without daily dosing; however, prescription is limited to patients with BMI < 30 kg/m2 due to decreased efficacy and VTE events in people with obesity. Summary The addition of these products expands the available options for pregnancy prevention to address unmet contraceptive needs.

A prospective multicenter study of the use of a combined hormonal contraceptive with drospirenone

Objective – to determine the satisfaction of patients with the drug DELSIA® used as a contraceptive for 6 months. Design. A prospective multicenter observational programme: the actual clinical practice of using a combined contraceptive Delsia® in female patients of reproductive age for the purposes of contraception. Results. Of 207 women who took part in the programme 204 (98.56%) completed the study. Women who adhered to the drug intake regimen had no pregnancies, which in demonstrative of a high contraceptive reliability of Delsia. Among the women included in the programme, 30% had profuse menstruation,37.3% had painful and 31.9% irregular menstruation, whereas by the end of the 6th month of drug intake these parameters decreased to 0.5, 2.0 and 1.5% respectively (р < 0.001). The average duration of menstrual bleeding decreased from 5.62 ± 1.09 to 3.13 ± 1.37 days (р < 0.001). The frequency of side effects was 23.7% during the first 3 months and 12.7% at the end of the study, and 98.0% of women assessed them as mild or moderate, not necessitating the use of medications. The absolute majority (95.5%) of women expressed a high satisfaction with the drug, assessing it as 4–5 scores on a Likert, the average score being 4.48. Conclusion. The results of studying the administration of the low-dose combined oral contraceptive Delsia in actual clinical practice in Russia have shown a beneficial effect on the characteristics of the menstrual cycle, high scores of drug intake satisfaction, high reliability, safety and compliance. Key words: Delsia, drospirenone, combined oral contraceptives, contraception, ethinylestradiol