Menstrual pattern with the monthly contraceptive ring – ETN@
study
I. Lete
Santiago Apostol Hospital, Vitoria, Spain
Background Previous
experience with combined oral contraceptives and other methods of hormonal
contraception shows that heavy or prolonged withdrawal bleeding is not readily
accepted by users.
Objective To evaluate menstrual pattern with the monthly
contraceptive ring
Methods A total of 896 Spanish women attending their family
planning centre, hospital or private centre to request contraceptive advice were
recruited to this 6-month observational, multi-centre, prospective, open study.
On study completion, women were asked about the intensity and duration of
bleeding day at the initial or baseline visit, after 3 cycles and after 6 cycles.
There were two types of users: those starting hormonal contraception and those
changing from another hormonal method (mainly the pill) to the monthly ring. The
intensity of bleeding was classified as light (1-3 towels or tampons per day),
normal (4-6 towels or tampons per day) or heavy (7 or more towels or tampons per
day) and duration was classified as short (< 4 days), normal (4-6 days) or long (> 6 days).
Results Of the 805 women (mean age = 29 ± 6 years) who
started using the NuvaRing, 722 (90%) completed cycle 3 and 595 (74%) completed
cycle 6. As expected, most women (70%) who had not been using hormonal
contraception before had normal periods and only 17% had light periods. 54% of
women changing from another hormonal method had light bleeding. After 6 cycles
of using the ring, bleeding was already light in 50% of the former group of
women and 60% of the latter. The initial duration of bleeding was normal in 73%
of the former group of women and short in 16%. 48% of the women changing from a
different hormonal method had short periods. After 6 cycles of use, the
proportion of women in whom periods were short had risen to 50% in the group who
had not been using hormonal treatment before and 60% in the group who had
changed from another hormonal treatment.
Conclusion The intensity and duration
of withdrawal bleeding decreased with use of the NuvaRing from the first cycles
of use, both in the group of women who started hormonal contraception and in the
group who had changed to the ring from another method.