title: Contraceptive vaginal ring use for women has less adverse metabolic effects than an oral contraceptive.
abstract: BACKGROUND
  This study compared metabolic, hormonal and lipid profiles before and during use of a contraceptive vaginal ring (RING) releasing 15 mcg ethinyl estradiol (EE) and 120 mcg etonogestrel per day NuvaRing, Organon USA Inc., Roseland, NJ versus a low-dose oral contraceptive (PILL) containing 20 mcg EE and 100 mcg levonorgestrel daily (Aviane, Barr Pharmaceuticals Inc., Pomona, NY).
  
  
  METHODS
  Sixty-five women were randomized to either the RING or PILL treatment for five cycles. In the pretreatment cycle (Cycle Days 2-5) and during Weeks 2 and 3 of the fifth treatment cycle, a 75-g oral glucose tolerance test (OGTT) was performed. Baseline samples were used to evaluate basal hormonal, metabolic and lipid levels.
  
  
  RESULTS
  Forty-two women completed the study. Basal insulin resistance (HOMA-IR) was slightly decreased, whereas a significant reduction in the insulin sensitivity index (IS(OGTT)) was found in women on PILL therapy compared to those in the RING group (p<.035). Pancreatic beta-cell function was not significantly altered with either treatment.
  
  
  CONCLUSIONS
  The lower-dose, nonoral hormonal RING had a lesser impact on carbohydrate metabolism and greater reduction of free androgen and dehydroepiandrosterone sulfate levels than PILL treatment.
authors.affiliation: Woman's Health Research Institute, Woman's Hospital, Baton Rouge, LA 70815, USA. karen.elkind-hirsch@womans.org
authors.forename: Karen E
authors.initials: KE
authors.lastname: Elkind-Hirsch
authors.forename: Carmen
authors.initials: C
authors.lastname: Darensbourg
authors.forename: Beverly
authors.initials: B
authors.lastname: Ogden
authors.forename: Lauren F
authors.initials: LF
authors.lastname: Ogden
authors.forename: Philip
authors.initials: P
authors.lastname: Hindelang
mesh_terms: D000282:Administration, Intravaginal; D000284:Administration, Oral; D000328:Adult; D050260:Carbohydrate Metabolism / Q000187:drug effects*; D003271:Contraceptive Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D003274:Contraceptive Devices, Female / Q000009:adverse effects*; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D050356:Lipid Metabolism / Q000187:drug effects; D008055:Lipids / Q000097:blood
chemical_list: D003271:Contraceptive Agents, Female; D012739:Gonadal Steroid Hormones; D008055:Lipids