NuvaRing (ethinylestradiol + etonogestrel) is inserted at the start of a menstrual cycle and left in place continuously for three weeks followed by a ring-free week. The ring may be inserted and removed by the woman herself at home.
In a 13-cycle open-label study comparing NuvaRing with a combined oral contraceptive (COC) containing ethinylestradiol 30 microgram and drospirenone 3mg, NuvaRing was as effective and well tolerated as the COC. Compliance and satisfaction were high in both the COC and NuvaRing groups; 84 per cent of women were satisfied with NuvaRing as a method of contraception, and 87 per cent would recommend the ring to others.1
In a 12-cycle study, involving 1145 women, most of those who completed the study were very satisfied with NuvaRing (96 per cent) and happy to recommend it to others (98 per cent). Compliance with NuvaRing was high, with criteria for compliance to the prescribed regimen being met in 90.8 per cent of cycles. The most frequently reported events leading to discontinuation from the study (2.6 per cent) were device-related events comprising foreign body sensation, coital problems and device expulsion.2
In a 13-cycle open-label study in 1030 women, NuvaRing showed superior cycle control to a COC (ethinylestradiol 30 microgram and levonorgestrel 150 microgram). The incidence of breakthrough bleeding and spotting over cycles 2-13 was lower for NuvaRing (significantly lower in cycles 2 and 9). The incidence of intended bleeding was significantly higher in the NuvaRing treatment group for cycles 1-12.3
A small study compared the oestrogen exposure of NuvaRing with a contraceptive patch and a COC over one cycle in 24 women. In the NuvaRing group, the exposure of women to ethinylestradiol was on average 3.4 times lower than in women receiving the patch (releasing ethinylestradiol 20 microgram and norelgestromin 150 microgram daily) and 2.1 times lower than the women receiving the COC (ethinylestradiol 30 microgram and levonorgestrel 150 microgram).4
1. Ahrendt H, Nisand I, Bastianelli C et al. Efficacy, acceptability and tolerability of the combined contraceptive ring, NuvaRing, compared with an oral contraceptive containing 30 micrograms of ethinylestradiol and 3mg of drospirenone. Contraception 2006; 74: 451-7.
2. Roumen F, Apter D, Mulders T et al. Efficacy, tolerability and acceptability of a novel contraceptive vaginal ring releasing etonogestrel and ethinyl oestradiol. Human Reproduction 2001; 16: 469-75.
3. Oddsson K, Leifels-Fischer B, Wiel-Masson et al. Superior cycle control with a contraceptive vaginal ring compared with an oral contraceptive containing 30 micrograms ethinylestradiol and 150 micrograms levonorgesterel: a randomised trial. Human Reproduction 2005; 20: 557-62.
4. van der Heuvel M, Van Bragt A, Alnabawy A, Comparison of ethinylestradiol pharmacokinetics in three hormonal contraceptive formulations: the vaginal ring, the transdermal patch and an oral contraceptive. Contraception 2005; 72: 168-74.
Further information: Schering-Plough