Improvement of dysmenorrhoea and premenstrual syndrome in NuvaRing®
users-a clinical experience program in Spain
I Lete Lasa
Santiago Apóstol Hospital, Gynecology Department, Vitoria, Spain
Background One of the non-contraceptive benefits of oral
contraceptives (OCs) is an improvement of dysmenorrhoea, which is attributed to
ovulation inhibition and the reduction in prostaglandin production as a result
of less endometrial proliferation. OC treatment is also associated with an
improvement in premenstrual syndrome (PMS).
Objective To evaluate the incidence of patient-reported dysmenorrhoea
and PMS in users of the monthly contraceptive ring, NuvaRing®.
Methods A total of 896 Spanish women requesting contraceptive advice
from their family planning centre, hospital or private centre were invited to
participate in this observational, multi-centre, prospective, open study.
Evaluations were made at baseline and after three and six cycles of NuvaRing®
use. Women were classified as either new users of hormonal contraception (HC)-those
starting NuvaRing® treatment who were not previously using HC-or
switchers-those switching from another HC method (mainly OCs) to the monthly
contraceptive ring.
Results Of the 805 women (mean age = 29 ± 6 years) who started using
NuvaRing®, 722 (90%) completed cycle 3 and 595 (74%) completed cycle 6.
Dysmenorrhoea significantly decreased from 55% at baseline to 24% after cycle 3
(p<0.001) and 18% after cycle 6 (p<0.001 vs baseline; p<0.001 vs cycle 3) in the group of women who did not use HC prior to NuvaRing® use. For the group of women switching to the ring from another HC method, dysmenorrhoea also significantly decreased, from 26% at baseline to 21% after cycle 3 (p<0.05) and 19% after cycle 6 (p<0.05). PMS also significantly decreased: in the starter group, PMS decreased from 55% at baseline to 27% and 25% after cycles 3 and 6, respectively (p<0.001 vs baseline for both cycles 3 and 6); in the switcher group, it decreased from 38% at baseline to 27% after cycle 3 (p<0.001) and 20% after cycle 6 (p<0.001 vs baseline; p<0.05 vs cycle 3).
Conclusion The incidence of dysmenorrhoea and PMS was significantly
lower after 3 cycles of NuvaRing® use, both in women who used HC treatment
before NuvaRing® use, and in those who were new to HC. The improvement was
maintained and strengthened after 6 cycles. The lower incidence of these
cycle-related complaints can be attributed to the ring’s ovulation inhibition
and its low and steady release of hormones.