title: An open-label, multicentre trial to evaluate the vaginal bleeding pattern of the combined contraceptive vaginal ring NuvaRing.
abstract: OBJECTIVE
  The objective of this multicentre, non-controlled, open-label study is the evaluation of the bleeding patterns during the use of a vaginal combined contraceptive, its safety in relation to occurrence of adverse effects, its efficacy as a contraceptive method and user compliance.
  
  
  METHODS
  Healthy female volunteers (N=165), asking for contraception, were enrolled to participate in the study. Each subject was given seven vaginal rings, releasing an average amount of 120microg etonogestrel (ENG) and 15microg ethinylestradiol (EE) per day. Study period was 7 cycles. A total of 878 cycles was valid for statistical analysis. The primary parameter, (breakthrough bleeding and/or spotting), was recorded for each cycle. The subjects were asked to report any adverse effect experienced during the treatment period, general physical and gynaecological examinations were performed and haematological blood tests were taken.
  
  
  RESULTS
  Breakthrough bleeding/spotting occurred in 5.01% cycles (44 out of 878 cycles, of whom 37 were breakthrough spotting only). Absence of withdrawal bleeding during the ring-free period was reported in 1.94% cycles (17 out of 878). Forty-one subjects (24.8%) reported 66 events that were potentially drug-related. The most frequently drug-related events were weight increase (10 cases), headache (9 cases), nausea (4 cases). No pregnancy was reported during the study period. Haematology and chemical chemistry tests showed no clinically significant abnormality.
  
  
  CONCLUSIONS
  In the present study, NuvaRing has shown to be a valid contraceptive method to ensure optimal cycle control with low incidence of irregular bleeding and altered withdrawal bleeding. The low incidence of gastrointestinal side effects (nausea, vomiting) may be related the low hormonal dose and to the vaginal delivery of hormones which avoids the gastrointestinal tract.
authors: Obstetrics and Gynaecology Clinic, Careggi Hospital, University of Florence, Florence, Italy.
authors: Vincenzina
authors: V
authors: Bruni
authors: Valentina
authors: V
authors: Pontello
authors: Stefano
authors: S
authors: Luisi
authors: Felice
authors: F
authors: Petraglia
mesh_terms: D000293:Adolescent; D000328:Adult; D003274:Contraceptive Devices, Female / Q000009:adverse effects*; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects*; D017135:Desogestrel / Q000009:adverse effects / Q000031:analogs & derivatives; D004338:Drug Combinations; D004997:Ethinyl Estradiol / Q000009:adverse effects; D005260:Female; D006801:Humans; D008796:Metrorrhagia / Q000139:chemically induced*; D008875:Middle Aged; D010349:Patient Compliance
chemical_list: D003277:Contraceptives, Oral, Combined; D004338:Drug Combinations; C516519:NuvaRing; D004997:Ethinyl Estradiol; D017135:Desogestrel