Multicenter comparison of the contraceptive ring and patch: a randomized controlled trial.
OBJECTIVE
To understand if the contraceptive ring or patch was more acceptable, as measured primarily by continuation, to women using an oral contraceptive and interested in a nondaily, combined hormonal contraceptive.


METHODS
Five hundred women were randomly assigned to use the contraceptive ring (n=249) or contraceptive patch (n=251) for four consecutive menstrual cycles, starting with their next menses. Participants returned for a single follow-up visit during the fourth cycle for an evaluation, which included a questionnaire to assess acceptability and adverse effects.


RESULTS
Rates of completion of three cycles were 94.6% (95% confidence interval [CI] 91.0-97.1%) and 88.2% (95% CI 83.4-92.0%) for ring and patch users, respectively (P=.03). Of these women, 71.0% (95% CI 64.8-76.6%) and 26.5% (95% CI 21.0-32.6%), respectively, planned to continue their method after the study (P<.001). Women switching to the patch were significantly more likely than women switching to the ring to experience longer periods (38% compared with 9%), increased dysmenorrhea (29% compared with 16%), frequent nausea (8% compared with 1%), frequent mood swings (14% compared with 8%), and frequent skin rash (12% compared with 2%) and were less likely to experience frequent vaginal discharge (8% compared with 17%). Ring users preferred the ring to the oral contraceptive (P<.001), and patch users preferred the oral contraceptive to the patch (P<.001). Nugent scores increased only in patch users (P=.01), although most of these women were asymptomatic.


CONCLUSIONS
Women satisfied with combined oral contraceptives and interested in a nondaily method are more likely to continue using the contraceptive ring than the contraceptive patch.


BACKGROUND
ClinicalTrials.gov, www.clinicaltrials.gov, NCT00269620.


METHODS
I.
Creinin
Mitchell D
MD
Department of Obstetrics, Gynecology and Reproductive Sciences and Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213-3180, USA. mcreinin@upmc.edu
Meyn
Leslie A
LA
Borgatta
Lynn
L
Barnhart
Kurt
K
Jensen
Jeff
J
Burke
Anne E
AE
Westhoff
Carolyn
C
Gilliam
Melissa
M
Dutton
Caryn
C
Ballagh
Susan A
SA
D000282:Administration, Intravaginal; D000328:Adult; D003267:Contraception / Q000379:methods*; D003271:Contraceptive Agents, Female / Q000009:adverse effects; D003274:Contraceptive Devices, Female / Q000009:adverse effects; D004343:Drug Implants; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008598:Menstruation / Q000187:drug effects / Q000502:physiology*; D008599:Menstruation Disturbances / Q000453:epidemiology* / Q000209:etiology; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D017060:Patient Satisfaction
D003271:Contraceptive Agents, Female; D004343:Drug Implants