Providing a logical choice for your patient

Providing a logical choice for your patient

R. Nappi

The once-a-month regimen of NuvaRing® contributes to higher

overall satisfaction than traditional oral contraceptives (OCs) because it

requires no daily action from users. In addition, NuvaRing provides excellent

cycle control balanced with a low incidence of estrogen-related side effects,

both of which are key factors in influencing contraceptive acceptability and


The user-friendly aspect of the NuvaRing regimen has been

demonstrated in an open-label randomized trial that compared NuvaRing with a 25

µg ethinylestradiol (EE) triphasic combined OC (COC) using the “QuickStart”

protocol-the initiation of a woman’s contraceptive method on the same day of the

physician’s visit regardless of her menstrual cycle day. The likelihood of being

very satisfied with NuvaRing use were three times the likelihood of being very

satisfied with COC use (odds-ratio 3.0; CI 1.5-5.8). Furthermore, when women

were asked to choose a method of contraception for continuation during their

exit interviews, the likelihood of continuation with NuvaRing was eight times

the likelihood of continuation with the COC (odds-ratio 8.4; CI 3.9-18.6).

The high level of satisfaction during NuvaRing use has been well

established in various clinical trials, especially among women with an age range

of 18-40 years. Recently, a randomized study compared acceptability with

NuvaRing and a low dose COC (35 µg EE/0.25 mg norgestimate) in young women aged

15-21 years. The study showed that women preferred NuvaRing to COCs; NuvaRing

was also seen to be easier to use and resulted in fewer concerns about health

risks. Method approval was higher with NuvaRing use compared with COC use as

women liked the rings more and stated that they were more likely to recommend

NuvaRing to friends and use them in the future, compared with COCs.

NuvaRing’s high acceptability and ease of use in the clinical

study setting has been borne out by women’s positive experiences in daily

practice. In the many clinical experience programs that have now been carried

out around the world (in Europe, more than 22,000 women were included in 12

countries), women are unanimous in their satisfaction with the method,

preferring NuvaRing to other methods as the best contraceptive choice available.

Patient acceptability of a method can also be reflected by the

degree of follow-up care required by physicians. In the United States, two

physicians noticed that when they prescribed NuvaRing, women were less likely to

call their offices with questions or complaints. To quantify this finding, a

longitudinal observational study was undertaken involving over 200 women

starting a hormonal contraceptive method of their choice (COCs, the transdermal

patch and the vaginal ring). The number of phone calls per woman was least in

the NuvaRing group, followed by the group using COCs and then the patch group,

respectively. An analysis of the reasons for patient callbacks showed that

NuvaRing users made fewer callbacks for nausea, headache and breast pain

compared with the patch and the group using COCs. This lower rate of callbacks

provides yet another perspective to NuvaRing’s high patient acceptability and

illustrates the fact that NuvaRing allows physicians to provide women with

confidence for the contraceptive success that they seek.

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