Determinants of use of the monthly contraceptive ring – a study of the
Basque Society of Contraception
R. Lertxundi (1), I. Lete (2), E. López Arregui (1)
Department of Obstetrics and Gynaecology, Clínica Euskalduna, Bilbao,
Spain (1); Department of Obstetrics and Gynaecology, Hospital Santiago Apóstol,
Vitoria, Spain (2)
Introduction: Whether or not a woman starts using a new contraceptive
method depends on many variables, which may not only be related to the woman,
but also to her doctor. Investigating these determinants of use may help
prescribers in their daily practice.
Aim and Methods: To investigate the rate of acceptance of the
contraceptive ring (NuvaRing) when offered as their new contraceptive method to
Basque women and to investigate the determinants of use or non-use. We offered
the contraceptive ring to a total of 1241 Basque women who came to their usual
centre – family planning centre, hospital or private practice – for
contraceptive counselling or their annual check-up. The ring was presented
conform normal practice. Demographic details were collected of both the
investigator and the woman. Women were asked their actual form of contraception,
and whether or not they wished to use the ring. Reasons for non-acceptance were
registered. Descriptive analysis are presented.
Results: Data of 1241 women (mean age 26,9 years) were analysed. Most
women used the condom a their actual form of contraception (49,7%), while 41,2%
used the Pill. Tampon use, including both occasional and normal use was 88,4%,
which is higher than that reported previously. The acceptance rate of the ring
was substantially higher than anticipated; 56,9 % of the women accepted the ring
as their new method. The reasons for non-acceptance were mainly related to the
unfamiliarity of the anatomy of the vagina. The gender or the speciality of the
prescriber (gynaecologist, midwife, educator or family planning doctor) did not
seem to influence the acceptance rate of the ring. Of the 4 determinants
investigated, 3 seem to be interrelated, while 1 was not. Women using a Pill are
more likely to accept using the ring (61,5%) than women using condoms (54,6%).
Teenagers were less likely to accept the ring than women of 20 years and older,
although this may be related to the current contraceptive method; over 70% of
the teenagers uses condoms, and only 16,3 % the Pill. Women with a university
degree are more likely to opt for the ring than women with a lower education,
but they are also more likely to use the Pill. The use of tampons was related to
the acceptance of the ring: 61% of the women using tampons chose to use the
ring, while of the women not using tampons 25,5 % accepted the ring. Whether or
not tampon use is a discriminator for ring use, or that it is related to the
type of women who first start using a new method (innovators) cannot be
disentangled form these data.
Conclusion: Among Basque women the acceptance of monthly contraceptive
ring is high, over 50%. Determinants of acceptance are tampon use and the
current type of contraceptive, and interrelated with the latter age of the women
and the degree of education. Non-acceptance is mainly related to the
unfamiliarity of the anatomy of the vagina.
