Change in reasons for rejecting to use the monthly contraceptive
ring. Three-year comparison
A. Casasús, I. Vila, J.M Marin, A. Martin, R.
Basque Contraception Society, Basque Country, Spain
market launch of a new contraceptive method inserted monthly into the vagina for
the administration of hormones entails a change in the cultural patterns
acquired by most of our society, accustomed for over 40 years to daily oral
Objective To ascertain the reasons for rejecting to use the
monthly contraceptive ring (MCR).
Methods A total of 948 women participate in
this cross-sectional, multicentre study carried out in the Basque Country in
2005. Women attending specific contraception consultations were recruited after
receiving advice about combined hormonal methods and being offered the
opportunity of using the MCR. Data were collected on the sociodemographic
characteristics of the women, contraception currently using, use of tampons,
their previous knowledge of the MCR, the source of this information, and the
reasons for refusing this method if they did reject it. The data were compared
with a study with the same characteristics, which recruited 1266 women in 2003.
Results The main reasons for rejecting were similar in both studies: distrusted
the efficacy (15% in 2003 vs. 7.9% in 2005), suspicion it would be uncomfortable
(10.3% vs. 20.4%), not wanting to have to manipulate the genitals (16.5% vs.
13.4%) and fear of putting a foreign body into the vagina (11.5% vs. 8.2%). A
comparison of the two studies showed that only two reasons for not agreeing to
use the ring had changed significantly: distrust of the efficacy had decreased
(p = 0.05) and suspicion that it would be uncomfortable had increased (p =
0.05). However, it should be emphasized that a significant percentage of women
who did not accept the MCR were recruited by the same investigator, which again
leads us to consider the importance of the health professional in giving
contraceptive advice.The source of information influence the acceptance of the
ring as a contraceptive method. Information obtained from friends and family
seemed to favour acceptance of the method while that obtained through the media
seemed to reduce it.
Conclusions The rate of acceptance of the ring by women
was greater in the 2005 study than in the 2003 study (58% vs. 64%), which was
statistically significant. The reasons to reject had similar rates in both
studies, except for two: distrust in the efficacy decreased although suspicion
that it would be uncomfortable increased. The source of information and health
professional advice are crucial for acceptance.