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Wisest Elder Ever
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Join Date: Aug 2006
Location: Great Lakes
Posts: 33,508
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Wisest Elder Ever
Join Date: Aug 2006
Location: Great Lakes
Posts: 33,508
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here is a quote from the article:
Quote:
The vagina has a rich system of defenses and dynamic microbiology, as well as a rich vascular plexus that makes it ideal for absorbing drugs, according to moderator Dr. Anita L. Nelson, who presented a brief overview of the anatomy, histology, and immunology of the vagina. According to Dr. Nelson, the classic teaching has been that the opening and lower one third of the vagina are narrow and open into a larger space after passing through the urogenital and pelvic diaphragms, which act like sphincters. Although this understanding has been updated by findings from magnetic resonance imaging studies performed by Dr. Kurt Barnhart and colleagues at the University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, both anatomical explanations and clinical experience explain why the vagina can securely retain drug delivery systems. The lower portion of the vagina has a peripheral nerve supply that is sensitive to pain, while the upper vaginal nerves are supplied by the autonomic nervous system, making it possible for a device to be inserted into the upper vagina and not be felt.
History of Vaginal Drug Administration
Vaginal drug administration has a long history dating back to the Middle Ages, reported Dr. Nelson. This route of administration has long been employed for postmenopausal delivery of hormones, and vaginal administration of recreational drugs such as cocaine has been reported in the medical literature. "Clinicians are already using drugs routinely in the vagina; we use bromocriptine vaginally in the treatment of hyperprolactinoma in women who suffer from nausea and vomiting with oral administration. In many cases, vaginal administration has proven to be superior to oral administration," she said. Of note, a recent study of vaginal delivery of misoprostol compared with oral administration for the induction of labor showed the vaginal route to be superior, while another study demonstrated that vaginally administered indomethacin was more effective than oral indomethacin for halting preterm labor.[2,3]
Advantages of Vaginal Hormonal Administration
The vaginal contraceptive ring confers steady serum hormone levels (Figure 5) and produces lower serum concentrations compared with oral or transdermal delivery (ethinyl estradiol, 15 µg/d) (Table 1). It also avoids hepatic first-pass metabolism, as well as GI interference with absorption. Finally, Dr. Nelson noted that there is no need for daily administration and the ring is a discreet method, which appeals to many women.
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