Efficacy, User Acceptability, Tolerability, and Cycle Control of a Combined Contraceptive Vaginal Ring: The Indian Perspective

Abstract

Objective To assess the contraceptive efficacy, user acceptability, cycle control, and tolerability of a combined contraceptive vaginal ring for up to 13 cycles. Materials and Methods Healthy women coming to the OPD for contraceptive advice were enrolled in this oneyear study. Each ring was used for three weeks followed by a one-week ring-free period. Results A total of 184 women started treatment forming the intent to treat population. Subjects were followed for 13 cycles. Compliance was good with 99 % of cycles in full compliance with specified criteria. In the intent to treat population, no pregnancies occurred giving a Pearl Index of 0. The mean incidence of withdrawal bleeding was 99 % in all cycles. There was 0.16 % incidence of intermenstrual bleeding and 2 % incidence of early withdrawal bleeding. The ring was well tolerated with a low incidence of adverse events. Conclusion The ring is an effective contraceptive that is convenient, well tolerated with excellent cycle control, and highly acceptable to users.

A Qualitative Systematic Review of Women's Experiences Using Contraceptive Vaginal Rings: Implications for New Technologies

“…Because a given factor (e.g., access to contraceptive services) could be perceived as either a barrier (if access is lacking) or a facilitator (if access is good), depending on the context, our classifi cations methods, 37 long-acting reversible contraceptives 42,46,49,52 or contraceptives in general (i.e., both hormonal and nonhormonal methods). 29,[31][32][33][34][35][36]38,39,43,44,48,50,51 In many of the studies, information about the ring was limited to brief summaries, along with a few illustrative examples and quotes (sometimes only one) pertaining to the method.…”

“…Some articles were based on posthoc analyses related to patient-provider interactions. 49,51 Studies varied in their analytic rigor and in the clarity with which the analytic strategy was described.…”

“…39 In a study exploring the implicit bias that many patients perceive from their providers, one young adult reported feeling pressured to have an IUD inserted; she explained that her provider had given her more information about the IUD than about other methods, and had demonstrated a fl at aff ect when speaking about such options as the ring. 51 A young adult in a diff erent U.S. study felt pressured to use the ring because her provider said it was a great method; she anticipated that she would not like it, was proven correct after trying it and discontinued use after one week. 49…”

“…As ring development continues, complementary behavioral science research can provide valuable insight into strategies for optimizing ring uptake and long‐term use among women who would benefit from single‐ or multipurpose prevention technologies. Overall, studies show that contraceptive vaginal rings are well‐tolerated by and highly acceptable to women . In studies that have compared them to oral contraceptive pills, rings have yielded similar rates of acceptability and higher rates of continuation and adherence .…”

Multicenter Study of Contraceptive Vaginal Ring (NuvaRing®) in Normal Daily Practice in Indian Women

“…To overcome these limitations, various nonoral hormonal contraceptive methods were investigated. Most of these are progestogen-only methods requiring a medical procedure and trained personnel's intervention for use, and may lead to inherent unpredictable bleeding pattern, which make them less acceptable to women [4]. On the contrary, NuvaRing Ò is a combined contraceptive vaginal ring meant for single-month use and contains etonogestrel (11.7 mg) and ethinylestradiol (2.7 mg) in an Evatane Ò core.…”