The vagina is one of the best ways of delivering contraceptive hormones, say doctors

Main Category: Public Health
Article Date: 26 Jul 2004 - 12:00 PDT


Writing in the medical journal Fertility and Sterility this month, doctors say the vagina offers 'an ideal route' of drug delivery for contraceptive hormones offering advantages that other routes cannot match.

"The benefits of the vaginal administration of hormonal contraceptives are unquestionable," commented Dr Leslie Miller (Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington, USA). "Vaginal delivery overcomes some of the key limitations associated with oral contraceptives, the most important of which is to liberate women from daily pill taking."

NuvaRing - the only contraceptive vaginal ring currently available - provides women with the first self-administered once-a-month contraceptive. It is a flexible transparent ring that is placed into the vagina and releases estrogen and progestogen. After three weeks, the ring is removed and a new ring inserted a week later. Like the combined pill, it works by preventing the release of an egg and is highly reliable. [1]

"Women greatly value the availability of a once-a-month contraceptive that is very reliable and crucially is administered by them. In trials, women found NuvaRing highly acceptable primarily because they don't have to think about it every day and because of its 'ease of use'. NuvaRing is a great new option and many women trying the ring will not go back to pills." commented Dr Miller. [2]

In addition, vaginal delivery allows the use of a lower dose of estrogen than found in most commonly used oral contraceptives but without compromizing bleeding patterns. Dr Miller explained: "The hormones released from the ring are absorbed directly across the vaginal wall and enter the blood stream steadily throughout its duration of use. They also bypass the liver, where normally hormones taken orally are broken down. The steady release and lack of initial liver breakdown allows the use of a lower hormonal dosage. Yet despite its ultra low estrogen dose, cycle control with NuvaRing is excellent and superior to that found with low dose oral contraceptives."

Vaginal administration also means that vomiting does not affect contraceptive efficacy, and the highs and lows in hormone levels that characterize daily dosing and which may contribute to side effects are avoided. [3] NuvaRing is a very well tolerated method of contraception, and is not associated with weight gain.

Co-author Dr Ulrich Karck (University of Stuttgart, Germany) added: "The vaginal ring is a very welcome new option with a number of very important advantages over other methods of contraception. It makes contraceptive administration easy and discreet for patients giving them complete control over the method and its reversibility."

However, he cautioned that the vaginal route is still quite novel and not as well accepted as other routes of drug administration. In addition, women are not very familiar with the anatomy or physiology of the vagina.

He said: "There is a pressing need to educate women about the vagina and address many of the misperceptions that exist about this part of the body. For example, women may ask if the ring can get lost inside them. Once inserted the flexible ring conforms to fit comfortably in the upper vagina where it remains in place until it is removed by the woman. Some women initially express concerns that they may feel the ring. However, unlike the lower part of the vagina, which is highly sensitive, the nerves of the upper part of vagina are not, which means that women are unaware of the ring or items such as tampons, when they are inside the vagina. "

Dr Karck also said that it was important women were aware that the flexible ring does not have to be fitted or placed in any particular position - it can be simply inserted into the vagina. In large clinical studies involving more than 2000 women, 96 % and 98% of women found NuvaRing easy to insert and remove respectively.

The ring itself - the result of a challenging 20-year development process - has been specially designed from a material that is flexible, inert and non-irritating so that it is safe to remain in the vagina during use and does not cause infection.

The benefits of NuvaRing

-- Once-a-month administration

-- Highly acceptable

-- Ultra low hormone dose

-- Predictable bleeding patterns

-- Avoids highs and lows in blood hormone levels

-- Well tolerated - no weight gain

-- Vomiting does not compromize efficacy

-- Discreet

-- User controlled

-- No initial breakdown of hormones in the liver

About the vaginal ring

Organon's vaginal ring, NuvaRing®, is a new once-a-month method of ultra-low dose hormonal contraception that is used to prevent pregnancy. The flexible vaginal ring which is inserted and removed by the woman herself is easy to use, highly reliable and well tolerated. After three months of use more than 80% of women preferred this method over other methods of contraception, including the Pill.

Organon - headquartered in Roseland, NJ, USA - creates and markets prescription medicines that improve the health and quality of human life. Through a combination of independent growth and business partnerships, Organon strives to become or remain one of the leading pharmaceutical companies in each of its core therapeutic fields: reproductive medicine, psychiatry and anesthesia.

Organon products are sold in over 100 countries, of which more than 60 have an Organon subsidiary. Organon is the human health care business unit of Akzo Nobel.

http://www.organon.com/news

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