Myloop (Ethinylestradiol, Etonogestrel)

Myloop, a combined estrogen‑progestogen vaginal ring, is indicated for hormonal contraception and related menstrual management.

• Contraception: Prevents pregnancy in women of childbearing potential.
• Menstrual cycle regulation: Promotes more predictable bleeding patterns and reduces irregular spotting.
• Management of dysmenorrhea: Decreases menstrual pain associated with ovulation.

• Ethinylestradiol and etonogestrel bind to estrogen and progesterone receptors, respectively, suppressing the hypothalamic‑pituitary‑ovarian axis. This inhibition prevents the mid‑cycle luteinizing hormone surge, thereby blocking ovulation. In addition, the progestogen component thickens cervical mucus and the estrogen component alters the endometrial lining, creating an environment unfavorable for implantation.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Headache: tension‑type or migraine‑like pain.
• Breast tenderness: swelling or discomfort.
• Vaginal irritation: itching or discharge at the insertion site.
• Spotting or breakthrough bleeding: irregular light bleeding.
• Mood changes: irritability or mild depression.

Serious or Rare Side Effects

• Thromboembolic events: deep‑vein thrombosis or pulmonary embolism.
• Hepatic adenoma or tumor: abnormal liver growth.
• Severe allergic reaction: rash, swelling, or anaphylaxis.
• Hypertension: sudden increase in blood pressure.
• Vision changes: blurred vision or visual disturbances.
• Gallbladder disease: inflammation or stones.

Before prescribing Myloop, clinicians should assess individual risk factors and contraindications.

• Contraindicated in pregnancy: Category X, do not use during any stage of pregnancy.
• Avoid in smokers over 35 years: increased risk of cardiovascular events.
• Screen for history of thromboembolism: contraindicated in patients with prior clotting disorders.
• Monitor blood pressure regularly: hormonal therapy may elevate blood pressure.
• Assess liver function: caution in patients with active hepatic disease.
• Store at ambient temperature: keep in original packaging, protect from moisture and direct sunlight.

Myloop may interact with other medicines that affect hormone metabolism or increase clotting risk.

Major Interactions (Avoid)

• Enzyme‑inducing anticonvulsants (e.g., carbamazepine, phenytoin): may reduce contraceptive efficacy.
• Antiretroviral protease inhibitors (e.g., ritonavir): may decrease hormone levels.
• St. John's Wort: can lower plasma concentrations of the active hormones.

Moderate Interactions (Monitor Closely)

• Antifungal agents (e.g., fluconazole): may increase hormone exposure.
• Macrolide antibiotics (e.g., erythromycin): may affect hepatic metabolism.
• Selective serotonin reuptake inhibitors (SSRIs): may heighten risk of mood‑related side effects.