The benefits of vaginal administration with NuvaRing contraception
For years scientists have been researching and developing new forms of female contraception that are better tolerated, more effective and user-friendly than existing methods, while offering the user maximum convenience, comfort and ease of use.
During their research, they have discovered that the vagina is an ideal route for drug administration, because it means:
· Less frequent administration
· Lower hormonal dosing and low exposure1,2
· Achievement of steady hormonal levels1
· Excellent cycle control3
· Hormone absorption is unaffected by gastrointestinal disturbance
· Discretion of use4.
Less frequent administration - once a month
Incorrect use of a contraceptive can lead to an unacceptable failure rate. One of the best ways to encourage correct use of contraception is to reduce the scope for human error by reducing the frequency of dose. Because NuvaRing is a once-a-month contraceptive, this increases its ease of use and reduces the scope for human error or imperfect use and therefore possible contraceptive failure.
At the same time, NuvaRing has the advantage over other long-acting contraceptive methods because it is self-administered. This allows a woman to remain in overall control of her contraception. Other long-term contraceptives - such as the implant or medicated intrauterine system - must be administered and removed by a trained medical professional.
Lower hormonal dosing and low exposure
Another important advantage of the vaginal route of administration is that the hormone dosage required to stop ovulation is lower than when the dose is administered orally. This is because the hormones are delivered directly to the main blood system. This is in contrast to the Pill, whereby the hormones are delivered into the blood system and pass through the liver before entering the main circulation, allowing hormone breakdown to occur. NuvaRing works like the combined Pill by preventing ovulation but achieves this by releasing just 15 micrograms of ethinylestradiol (EE) a day and 120 micrograms of etonogestrel (ENG) daily. Most commonly used Pills contain 30-35 micrograms of EE. This means that NuvaRing halves a woman's exposure to EE compared to the Pill. Minimising oestrogen exposure reduces the chance of oestrogen-related side effects.
Achieves steady hormonal levels
NuvaRing allows a slow and steady release of hormones throughout its period of use. In contrast, daily peaks and troughs of blood hormone levels are seen with the Pill.
Excellent cycle control
Although the incidence of breakthrough bleeding increases as the EE content of the Pill is reduced, NuvaRing has been shown to provide excellent cycle control, which is superior to a Pill containing 30 micrograms of EE.3 Vaginal administration therefore appears to uniquely allow lower and more stable EE dosing, lower exposure to EE, while also achieving excellent cycle control.
Contraceptive reliability unaffected by stomach disturbance
Vomiting does not interfere with the reliability of NuvaRing because the hormone it releases by-passes the gut. Vomiting is a factor which can be associated with contraceptive failure with the Pill (although missed pills are undoubtedly the most common cause of contraceptive failure).
Discretion of use
Finally, NuvaRing is very discreet.5 This factor is an important consideration for many female contraceptive users.
References
1. Van Den Heuvel M et al. Comparison of ethinyl estradiol pharmacokinetics in three hormonal contraceptive formulations: the vaginal ring, the transdermal patch and an oral contraceptive. Contraception 2005; 72 (30): 168-174.
2. Alexander N Baker E et al. Why consider vaginal drug administration? Fertility and Sterility, 2004; 82 (1): 1-12.
3. Oddsson K et al. Efficacy and safety of a contraceptive vaginal ring (NuvaRing) compared with a combined oral contraceptive: a 1-year randomised trial. Contraception 2005; 7: 176-182.
4. Novak A et al. The combined contraceptive vaginal ring, NuvaRing: an international study of user acceptability. Contraception 2003; 67: 187-194.
Laura Csortan, 30, has been using NuvaRing for the past few months. This is her story.
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