The Contraceptive Ring

The contraceptive ring releases a continuous low dose of estrogen and progestin to prevent pregnancy

From the National Family Planning and Reproductive Health Association

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New to the market in 2002 is Organon's NuvaRing�, a flexible, transparent, colorless vaginal ring measuring two inches in diameter that releases a continuous low dose of estrogen and progestin. The ring is inserted by the user into the vagina and remains for three weeks. The ring is then removed for one week to allow a woman to get her period. A new ring is used with each cycle. It is inserted and removed by pressing the sides of the ring together between the thumb and index finger and gently pushing in or pulling out of the vagina. Use begins on or before the fifth day of a woman's period.

Effectiveness

The ring is 98-99 percent effective in preventing pregnancy, but efficacy decreases with improper use.

Advantages

The dosage schedule is easy to follow, as the ring only needs to be changed once a month, compared to birth-control pills, which must be taken every day. Most of the reported 7 percent failure rate of oral contraceptives is due to missed pills. The ring is easily inserted and removed by the woman, and since it is not a barrier contraceptive, its placement within the vagina is not critical for effectiveness. As the doses of hormones are low and steady, there is little loss of cycle control (less spotting and irregular bleeding), and ovulation returns quickly after discontinuation.

Disadvantages

The ring does not provide protection against STDs. Reported side effects include vaginal infections and irritation, discharge, headache, weight gain, and nausea; some of these are similar to side effects of birth control pills. Women who use the ring are strongly advised not to smoke, as doing so can increase the risk of severe cardiovascular effects. The ring is not suggested for women who are or may be pregnant or who have blood clots, severe high blood pressure, certain cancers, or a history of heart attacks and strokes.

Availability

NuvaRing� was first introduced to select doctors through the NuvaRing� Premier Program earlier in 2002, but it is now widely available by prescription.

Cost

NuvaRing� is available to public-health providers (through the 340B drug discount program) for $24.50. The product should range from $35 to $40 at retail pharmacies.