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Ring or Patch?

Women who had previously used OCs were more satisfied with the vaginal ring than the patch.

Although the contraceptive patch and the vaginal ring each have been compared with combined oral contraceptives (OCs) in clinical trials, head-to-head comparison of these two birth control methods has been lacking. In an industry-sponsored, randomized, controlled trial sponsored by the manufacturer of the vaginal ring (NuvaRing), satisfied current or recent OC users were assigned to four cycles of the ring (249 women) or the patch (251 women). At enrollment and the final visit (during the first week of the fourth cycle), participants completed visual analog scale assessment of satisfaction and adverse effects.

The participants’ average ages were 26 (ring group) and 25 (patch group). At study completion, 71.0% of ring users but only 26.5% of patch users intended to continue their assigned method after the study (P<0.001). The rate of completing three cycles was significantly different for the two groups (94.6% vs. 88.2% in ring and patch groups, respectively; P=0.03). Women who switched from OCs to the patch were more likely to complain of longer menses, increased dysmenorrhea, nausea, and mood changes but were less likely to complain of vaginal discharge than were women who switched to the ring. Ring users preferred the ring over OCs (P<0.001), whereas patch users preferred OCs over the patch (P<0.001).

Comment: Although these results favor the vaginal ring, transdermal contraception is an important option for many women. The data generated here might not apply to all women; for example, participants were willing to switch to a vaginally administered product to enroll in the study. In addition, patch continuation rates could have been affected by the 2005 FDA warning about higher estrogen exposure with patch use than with OC use (Journal Watch Women’s Health Nov 22 2005). Given that OC continuation rates in the general population are only 40% at 6 months, both the ring and the patch remain excellent choices.

— Ann J. Davis, MD

Published in Journal Watch Women's Health March 27, 2008

Citation(s):

Creinin MD et al. Multicenter comparison of the contraceptive ring and patch: A randomized controlled trial. Obstet Gynecol 2008 Feb; 111:267.

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