The progestagen releasing vaginal ring.
The results of the Manchester study and its reinforcement from data from the multicenter study indicate that the ring is a well-tolerated delivery system for low-dose progestagens.  The expulsion rate is low and vaginal tolerance satisfactory.  The pregnancy rate and bleeding pattern is of the same order as oral low-dose progestagens.  Indeed, there is an indication that the pregnancy rate and abnormal bleeding rate may be even lower.  Data from other more extensive phase 3 studies will be required to confirm this impression.  The subjective assessment is that the majority of patients are enthusiastic about this method of contraception, bearing in mind that many of them had become disenchanted with existing marketed contraceptive methods.  Because of its high level of acceptability, the gap between theoretical and use-effectiveness in narrowed and once inserted, a high degree of motivation is not required since the existing ring only needs to be reinserted after 90 days of use.  The acceptability of vaginal methods of contraception as evidenced by the rapid uptake of the vaginal sponge suggests that there is considerable potential for increased use of vaginal methods.  In the present state of knowledge, it would appear that the woman for whom the progestagen only conception is particularly appropriate is the one who is lactating or for the older woman whose fertility is on the wane.  For the woman who wishes to space her family, the progestagen only contraceptive is also appropriate.  With increased refinements and experience of this method, there is a likelihood that the ring may extend the use and application of progestagen only contraception to a wider range of potential patients.
Elstein
M
M
Nuttall
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ID
D001695:Biology; D003267:Contraception; D003268:Contraception Behavior; D003270:Contraceptive Agents; D003271:Contraceptive Agents, Female; D003274:Contraceptive Devices, Female; D003710:Demography; D003933:Diagnosis; D004703:Endocrine System; D005069:Evaluation Studies as Topic; D005193:Family Planning Services; D005298:Fertility; D006728:Hormones; D016912:Levonorgestrel; D010342:Patient Acceptance of Health Care; D010808:Physical Examination; D010827:Physiology; D011153:Population; D011157:Population Dynamics; D012725:Sexual Behavior
D003270:Contraceptive Agents; D003271:Contraceptive Agents, Female; D006728:Hormones; D016912:Levonorgestrel
Biology; Contraception; Contraception Termination; Contraceptive Agents, Female; Contraceptive Agents, Progestin--administraction and dosage; Contraceptive Agents--administraction and dosage; Contraceptive Methods--history; Contraceptive Usage; Demographic Factors; Endocrine System; Evaluation; Examinations And Diagnoses; Family Planning; Fertility; Hormones; Levonorgestrel--administraction and dosage; Method Acceptability; Physical Examinations And Diagnoses; Physiology; Population; Population Dynamics; Reproductive Behavior; Vaginal Rings--history