Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
Shopping Cart: ( empty )
You are here: Home > Journals > SH > SH05060
REVIEW
Contents Vol 3(3)

The vaginal ring and transdermal patch: new methods of contraception

Kathleen McNamee
+ Author Affiliations
- Author Affiliations

A Family Planning Victoria, 901 Whitehorse Rd, Box Hill, VIC 3128, Australia.

B Email: kmcnamee@fpv.org.au

Sexual Health 3(3) 135-142 https://doi.org/10.1071/SH05060
Submitted: 7 December 2005  Accepted: 11 April 2006   Published: 29 August 2006

Abstract

The most common method of reversible contraception used worldwide is the intrauterine device. However, in the Asia–Pacific the combined oral contraceptive pill and condoms, methods of contraception that require a high degree of day-to-day user compliance, are more popular. The combined vaginal ring and transdermal patch have been developed to overcome the need for daily compliance associated with combined pill use. They have the added advantages of non-oral delivery, thus avoiding gastro-intestinal interference with absorption, and in addition there is no hepatic first-pass effect. Both have been available internationally for some years and offer an alternative to the combined pill. This article reviews and summarises published data on these new methods.


References


[1] World contraceptive use 2003. New York: United Nations Population Division, Department of Economic and Social Affairs; 2004.

[2] Potter LS. How effective are contraceptives? The determination and measurement of pregnancy rates. Obstet Gynecol 1996; 88(3 Suppl): 13S–23S.
| Crossref | GoogleScholarGoogle Scholar | PubMed | [verified July 2006].

[14] Timmer CJ,  Mulders TM. Pharmacokinetics of etonogestrel and ethinylestradiol released from a combined contraceptive vaginal ring. Clin Pharmacokinet 2000; 39(3): 233–42.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[15] Mulders TM,  Dieben TO. Use of the novel combined contraceptive vaginal ring NuvaRing for ovulation inhibition. Fertil Steril 2001; 75(5): 865–70.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[16] van den Heuvel MW,  van Bragt AJ,  Alnabawy AK,  Kaptein MC. Comparison of ethinylestradiol pharmacokinetics in three hormonal contraceptive formulations: the vaginal ring, the transdermal patch and an oral contraceptive. Contraception 2005; 72(3): 168–74.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[17] Dieben TO,  Roumen FJ,  Apter D. Efficacy, cycle control, and user acceptability of a novel combined contraceptive vaginal ring. Obstet Gynecol 2002; 100(3): 585–93.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[18] Oddsson K,  Leifels-Fischer B,  de Melo NR,  Wiel-Masson D,  Benedetto C,  Verhoeven CH, et al. Efficacy and safety of a contraceptive vaginal ring (NuvaRing) compared with a combined oral contraceptive: a 1-year randomized trial. Contraception 2005; 71(3): 176–82.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[19] Medical eligibility criteria for contraceptive use. Geneva: World Health Organization; 2004. Available online at: www.who.int/reproductive-health/publications/mec/index.htm [verified July 2006]

[20] Westhoff C,  Osborne LM,  Schafer JE,  Morroni C. Bleeding patterns after immediate initiation of an oral compared with a vaginal hormonal contraceptive. Obstet Gynecol 2005; 106(1): 89–96.
| PubMed |

[21] Bracken MB. Oral contraception and congenital malformations in offspring: a review and meta-analysis of the prospective studies. Obstet Gynecol 1990; 76(3 Pt 2): 552–7.
| PubMed |

[22] Fine P,  Tryggestad J,  Meyers N.. Safety with the use of NuvaRing immediately following surgical of medical abortion. Obstet Gynecol 2005; 105(Suppl. 4): 16S.


[23] Verhoeven CHJ,  van den Heuvel MW,  Mulders TMT,  Dieben TOM. The contraceptive vaginal ring, NuvaRing(R), and antimycotic co-medication. Contraception 2004; 69(2): 129–32.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[24] Verhoeven CHJ,  Dieben TOM. The combined contraceptive vaginal ring, NuvaRing(R), and tampon co-usage. Contraception 2004; 69(3): 197–9.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[25] Haring T,  Mulders TM. The combined contraceptive ring NuvaRing and spermicide co-medication. Contraception 2003; 67(4): 271–2.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[26] Markowitz JS,  Donovan JL,  DeVane CL,  Taylor RM,  Ruan Y,  Wang J-S, et al. Effect of St John’s wort on drug metabolism by induction of cytochrome P450 3A4 enzyme. JAMA 2003; 290(11): 1500–4.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[27] Dickinson BD,  Altman RD,  Nielsen NH,  Sterling ML. Drug interactions between oral contraceptives and antibiotics. Obstet Gynecol 2001; 98(5 Pt 1): 853–60.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[28] FFPRHC Guidance Drug interactions with hormonal contraception. J Fam Plann Reprod Health Care 2005; 31(2): 139–51.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[29] Dogterom P,  van den Heuvel MW,  Thomsen T. Absence of pharmacokinetic interactions of the combined contraceptive vaginal ring NuvaRing with oral amoxicillin or doxycycline in two randomised trials. Clin Pharmacokinet 2005; 44(4): 429–38.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[30] Miller L,  Verhoeven CH,  Hout JI. Extended regimens of the contraceptive vaginal ring: a randomized trial. Obstet Gynecol 2005; 106(3): 473–82.
| PubMed |

[31] Novak A,  de la Loge C,  Abetz L,  van der Meulen EA. The combined contraceptive vaginal ring, NuvaRing: an international study of user acceptability. Contraception 2003; 67(3): 187–94.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[32] Roumen FJ,  Apter D,  Mulders TM,  Dieben TO. Efficacy, tolerability and acceptability of a novel contraceptive vaginal ring releasing etonogestrel and ethinyl oestradiol. Hum Reprod 2001; 16(3): 469–75.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[33] Bjarnadottir RI,  Tuppurainen M,  Killick SR. Comparison of cycle control with a combined contraceptive vaginal ring and oral levonorgestrel/ethinyl estradiol. Am J Obstet Gynecol 2002; 186(3): 389–95.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[34] Rosenberg MJ,  Waugh MS,  Meehan TE. Use and misuse of oral contraceptives: risk indicators for poor pill taking and discontinuation. Contraception 1995; 51(5): 283–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[35] Oddsson K,  Leifels-Fischer B,  Wiel-Masson D,  de Melo NR,  Benedetto C,  Verhoeven CHJ, et al. Superior cycle control with a contraceptive vaginal ring compared with an oral contraceptive containing 30 microg ethinylestradiol and 150 microg levonorgestrel: a randomized trial. Hum Reprod 2005; 20(2): 557–62.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[36] Veres S,  Miller L,  Burington B. A comparison between the vaginal ring and oral contraceptives. Obstet Gynecol 2004; 104(3): 555–63.
| PubMed |

[37] Nugent RP,  Krohn MA,  Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of Gram stain interpretation. J Clin Microbiol 1991; 29(2): 297–301.
| PubMed |

[38] Waldbaum AS,  Funk S,  Alexander NJ. An open-label noncomparative study to evaluate the vagina and cervix of NuvaRing(R) users. Fertil Steril 2002; 78(Suppl. 1): S25.
| Crossref | GoogleScholarGoogle Scholar |

[39] Kaptein M,  Zampaglione E.. Expulsion of NuvaRing is low. Obstet Gynecol 2005; 105(Suppl. 4): 56S.


[40] Kemmeren JM,  Algra A,  Grobbee DE. Third generation oral contraceptives and risk of venous thrombosis: meta-analysis. BMJ 2001; 323(7305): 131–4.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[41] Baker E,  Ahrendt H.. A one-year randomixed trial comparing body weight and user acceptability with NuvaRing and Yasmin. Obstet Gynecol 2005; 105(Suppl. 4): 53S.


[42] Holt VL,  Cushing-Haugen KL,  Daling JR. Body weight and risk of oral contraceptive failure. Obstet Gynecol 2002; 99(5): 820–7.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[43] Holt VL,  Scholes D,  Wicklund KG,  Cushing-Haugen KL,  Daling JR. Body mass index, weight, and oral contraceptive failure risk. Obstet Gynecol 2005; 105(1): 46–52.
| PubMed |

[44] Westhoff C.. Higher body weight does not affect NuvaRing’s efficacy. Obstet Gynecol 2005; 105(Suppl. 4): 56S.


[45] Faculty of Family Planning. Faculty statement from the CEU on a new publication: WHO selected practice recommendations for contraceptive use Update. Missed pills: new recommendations. J Fam Plann Reprod Health Care 2005; 31(2): 153–5.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[46] NuvaTime. Available online at: http://www.nuvaring.com/Consumer/patientSupport/nuvaTime/index.asp [verified July 2006].

[47] Abrams LS,  Skee DM,  Natarajan J,  Wong FA,  Anderson GD. Pharmacokinetics of a contraceptive patch (Evra/Ortho Evra) containing norelgestromin and ethinyloestradiol at four application sites. Br J Clin Pharmacol 2002; 53(2): 141–6.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[48] Abrams LS,  Skee DM,  Wong FA,  Anderson NJ,  Leese PT. Pharmacokinetics of norelgestromin and ethinyl estradiol from two consecutive contraceptive patches. J Clin Pharmacol 2001; 41(11): 1232–7.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[49] Zieman M,  Guillebaud J,  Weisberg E,  Shangold GA,  Fisher AC,  Creasy GW. Contraceptive efficacy and cycle control with the Ortho Evra/Evra transdermal system: the analysis of pooled data. Fertil Steril 2002; 77(Suppl. 2): 13–8.
| Crossref | GoogleScholarGoogle Scholar |

[50] Abrams LS,  Skee D,  Natarajan J,  Wong FA. Pharmacokinetic overview of Ortho Evra(TM)/Evra(TM). Fertil Steril 2002; 77(Suppl. 2): 3–12.
| Crossref | GoogleScholarGoogle Scholar |

[51] Ortho Evra prescribing information. Ortho Evra; 2005. Available online at: http://www.orthoevra.com/prescribing

[52] Jick SS,  Kaye JA,  Russmann S,  Jick H. Risk of nonfatal venous thromboembolism in women using a contraceptive transdermal patch and oral contraceptives containing norgestimate and 35 mug of ethinyl estradiol. Contraception 2006; 73(3): 223–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[53] Stewart FH,  Kaunitz AM,  Laguardia KD,  Karvois DL,  Fisher AC,  Friedman AJ. Extended use of transdermal norelgestromin/ethinyl estradiol: a randomized trial. Obstet Gynecol 2005; 105(6): 1389–96.
| PubMed |

[54] Abrams LS,  Skee D,  Natarajan J,  Hutman W,  Wong FA. Tetracycline HCL does not affect the pharmacokinetics of a contraceptive patch. Int J Gynaecol Obstet 2000; 70(Suppl. 1): 57.
| Crossref | GoogleScholarGoogle Scholar |

[55] Audet MC,  Moreau M,  Koltun WD,  Waldbaum AS,  Shangold G,  Fisher AC, et al. Evaluation of Contraceptive Efficacy and Cycle Control of a Transdermal Contraceptive Patch vs an Oral Contraceptive: A Randomized Controlled Trial. JAMA 2001; 285(18): 2347–54.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[56] Smallwood GH,  Meador ML,  Lenihan JP,  Shangold GA,  Fisher AC,  Creasy GW. Efficacy and safety of a transdermal contraceptive system. Obstet Gynecol 2001; 98(5 Pt 1): 799–805.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[57] Hedon B,  Helmerhorst F,  Cronje H,  Shangold G,  Fisher AC,  Creasy GW. Comparison of efficacy, cycle control, compliance, and safety in users of a contraceptive patch vs an oral contraceptive. Int J Gynaecol Obstet 2000; 70(Suppl. 1): 78.
| Crossref | GoogleScholarGoogle Scholar |

[58] Sibai BM,  Odlind V,  Meador ML,  Shangold GA,  Fisher AC,  Creasy GW. A comparative and pooled analysis of the safety and tolerability of the contraceptive patch (Ortho Evra/Evra). Fertil Steril 2002; 77(Suppl. 2): 19–26.
| Crossref | GoogleScholarGoogle Scholar |

[59] Archer DF,  Bigrigg A,  Smallwood GH,  Shangold GA,  Creasy GW,  Fisher AC. Assessment of compliance with a weekly contraceptive patch (Ortho Evra/Evra) among North American women. Fertil Steril 2002; 77(Suppl. 2): 27–31.
| Crossref | GoogleScholarGoogle Scholar |

[60] Zacur HA,  Hedon B,  Mansour D,  Shangold GA,  Fisher AC,  Creasy GW. Integrated summary of Ortho Evra/Evra contraceptive patch adhesion in varied climates and conditions. Fertil Steril 2002; 77(2, Suppl. 2): 32–5.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[61] Abrams LS,  Skee DM,  Natarajan J,  Wong FA,  Leese PT,  Creasy GW, et al. Pharmacokinetics of norelgestromin and ethinyl estradiol delivered by a contraceptive patch (Ortho Evra/Evra) under conditions of heat, humidity, and exercise. J Clin Pharmacol 2001; 41(12): 1301–9.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[62] Archer DF,  Cullins V,  Creasy GW,  Fisher AC. The impact of improved compliance with a weekly contraceptive transdermal system (Ortho Evra) on contraceptive efficacy. Contraception 2004; 69(3): 189–95.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[63] Rubinstein ML,  Halpern-Felsher BL,  Irwin CE. An evaluation of the use of the transdermal contraceptive patch in adolescents. J Adolesc Health 2004; 34(5): 395–401.
| PubMed |

[64] Harel Z,  Riggs S,  Vaz R,  Flanagan P,  Dunn K,  Harel D. Adolescents’ experience with the combined estrogen and progestin transdermal contraceptive method Ortho Evra. J Pediatr Adolesc Gynecol 2005; 18(2): 85–90.
| Crossref | GoogleScholarGoogle Scholar | PubMed |