Multicenter Study of Contraceptive Vaginal Ring (NuvaRing®) in Normal Daily Practice in Indian Women

Pandit, Suchitra; Chauhan, Anahita; Anagani, Manjula; Reddy, Shilpa; Birla, Ashish; Ray, Subrat

doi:10.1007/s13224-014-0559-7

Cited by 11 publications

(26 citation statements)

References 10 publications

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“…Our results indicate that some women express initial concerns about ring use, but that these concerns can be overcome once individuals commit to using the method and avail themselves of necessary and accurate information. The findings support previous work suggesting that once most users complete an adjustment phase, they are quite satisfied with the method and are highly willing to recommend it to others . This is also consistent with data published in 2016 from an early clinical trial of ring use for HIV prevention, which found that ring‐related concerns declined or resolved with use .…”

Section: Discussionsupporting

confidence: 89%

“…The fi ndings support previous work suggesting that once most users complete an adjustment phase, they are quite satisfi ed with the method and are highly willing to recommend it to others. 22,23 This is also consistent with data published in 2016 from an early clinical trial of ring use for HIV prevention, which found that ring-related concerns declined or resolved with use. 60 Anticipating and addressing women' s initial concerns and the inconveniences they may experience are potential intervention strategies for promoting use of and preventing early discontinuation of the ring.…”

Section: Discussionsupporting

confidence: 84%

“…In studies that have compared them to oral contraceptive pills, rings have yielded similar rates of acceptability and higher rates of continuation and adherence . In clinical and intervention trials, most women were satisfied with investigational rings (>80%) and were willing to recommend them to a friend (>90%) . However, aggregate reports of satisfaction from quantitative surveys may obscure potentially important information that may help explain why high acceptability does not necessarily translate to high rates of uptake and use.…”

mentioning

confidence: 99%

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A Qualitative Systematic Review of Women's Experiences Using Contraceptive Vaginal Rings: Implications for New Technologies

Vargas

Midoun

Guillen

et al. 2019

Perspect Sexual Reproductive

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CONTEXT Vaginal rings are available for contraception and hormone replacement, and are being developed as HIV/STD or multipurpose prevention technologies. A comprehensive understanding of women's expectations of and experiences with rings is urgently needed to inform product development and to optimize ring use. METHODS Three databases (PubMed, Global Health and CINAHL) were searched for English‐language, peer‐reviewed articles published between January 1996 and November 2017 that reported qualitative data on barriers to and facilitators of use of female‐controlled contraceptive methods. Data on study methods, findings and conclusions pertaining to contraceptive rings were extracted, organized and analyzed. RESULTS Twenty‐six articles, all published since 2008, met the inclusion criteria. Seven studies focused largely or entirely on rings (and involved current, former or potential users), while the others focused on other contraceptive methods but included ring‐specific data. Familiarity with the ring was low, and women commonly had initial concerns about the method—often related to insertion and removal, cleanliness and discomfort with touching their vagina—that were typically overcome over time. Other major themes were issues related to ring use and discontinuation, the importance of ring‐related properties and characteristics, and considerations related to sexual partners and health care providers. CONCLUSIONS Qualitative data have the potential to inform ring design and promotion. Future research should further explore women's expectations and experiences with the ring, the value of involving male partners in ring evaluation, and evaluation of interventions to improve patient–provider communication concerning ring choice and use.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 84%

mentioning

confidence: 99%

See 1 more Smart Citation

A Qualitative Systematic Review of Women's Experiences Using Contraceptive Vaginal Rings: Implications for New Technologies

Vargas

Midoun

Guillen

et al. 2019

Perspect Sexual Reproductive

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“…Studies in Europe, North America and India have shown that there are no differences in the types and frequencies of systemic side effects in NuvaRing® users compared to oral contraceptive users [ 2 – 4 , 17 – 21 ]. Some of the systemic side effects that were commonly reported in those studies, and are often attributed to oestrogens, were either not reported at all by our Rwandan participants (emotional liability, breast tenderness, and acne) or were infrequently reported (nausea).…”

Section: Discussionmentioning

confidence: 99%

A randomised trial of a contraceptive vaginal ring in women at risk of HIV infection in Rwanda: Safety of intermittent and continuous use

et al. 2018

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BackgroundContraceptive vaginal rings could play a role in expanding the contraceptive method mix and in preparing communities for the introduction of HIV prevention and multipurpose rings.MethodsWe conducted an open label single-centre randomised clinical trial of intermittent versus continuous use of NuvaRing® in Kigali, Rwanda, in 2013–2014. We randomised 120 HIV-negative women 1:1 to intermittent use (three rings with a ring-free week in between rings) or continuous use (four rings without ring-free weeks). Women underwent an interview, counselling, and a speculum examination, and were tested for pregnancy, bacterial vaginosis (BV) by Nugent scoring, yeasts and trichomonads on wet mount, and sexually transmitted infections.FindingsOnly one woman withdrew early. Deliberate ring removals were rare, but spontaneous ring expulsions occurred during 14% of ring use periods. There were no incident pregnancies, serious adverse events, serious social harms, or early discontinuations for safety reasons. Systemic side effects were uncommon, and local side effects were not significantly differently distributed between groups except for lower abdominal pain (P = 0.013). The incidence of vaginal yeasts during ring use was high: 22% of intermittent users and 27% of continuous users had incident vaginal yeasts at one or multiple ring removal visits (P = 0.666), and symptomatic vaginal yeast cases were more common in the continuous than intermittent users (P = 0.031). In contrast, mean Nugent scores improved over time in both groups.ConclusionsIntermittent and continuous NuvaRing® use were safe in Rwandan women and improved Nugent scores over time. However, attention should be paid to ring expulsions and to a potential increased risk of vaginal candidiasis.

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“…60 It is effective (Pearl index, 1-3), 62 controls the menstrual cycles, 63 and has the advantage of a lower concentration of ethinyl estradiol compared with combined hormonal contraceptives, thus minimizing the adverse events related to ethinyl estradiol. 62,64,65 In a randomized trial, the vaginal ring group showed that exposure to ethinyl estradiol was significantly 3.4 times lower than in the patch group and 2.1 times lower than in the combined hormonal contraception group. Serum ethinyl estradiol levels of patients showed much lower variations with the vaginal ring than with the patch or combined hormonal contraceptives.…”

Section: The Vaginal Ringmentioning

confidence: 99%

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Yousif

Bridson

Halawa³

2016

Exp Clin Transplant

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There is a misconception among transplant clinicians that contraception after a successful renal transplant is challenging. This is partly due to the complex nature of transplant patients, where immunosuppression and graft dysfunction create major concerns. In addition, good evidence regarding contraception and transplant is scarce, with most of the evidence extrapolated from observational and case-controlled studies, thus adding to the dilemma of treating these patients. In this review, we closely analyzed the different methods of contraception and critically evaluated the efficacy of the different options for contraception after kidney transplant. We conclude that contraception after renal transplant is successful with acceptable risk. A multidisciplinary team approach involving obstetricians and transplant clinicians to decide the appropriate timing for conception is recommended. Early counseling on contraception is important to reduce the risk of unplanned pregnancies, improve pregnancy outcomes, and reduce maternal complications in patients after kidney transplant. To ascertain appropriate advice on the method of contraception, individualizing the method of contraception according to a patient's individual risks and expectations is essential.

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Multicenter Study of Contraceptive Vaginal Ring (NuvaRing®) in Normal Daily Practice in Indian Women

Abstract: The study demonstrated that NuvaRing(®) is a highly effective contraceptive method with an excellent cycle control. It is well tolerated and accepted by Indian women.

Cited by 11 publications

References 10 publications

A Qualitative Systematic Review of Women's Experiences Using Contraceptive Vaginal Rings: Implications for New Technologies

A Qualitative Systematic Review of Women's Experiences Using Contraceptive Vaginal Rings: Implications for New Technologies

A randomised trial of a contraceptive vaginal ring in women at risk of HIV infection in Rwanda: Safety of intermittent and continuous use

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