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Obstetrics & Gynecology 2008;111:267-277
© 2008 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Multicenter Comparison of the Contraceptive Ring and Patch

A Randomized Controlled Trial

Mitchell D. Creinin, MD1, Leslie A. Meyn, MS1, Lynn Borgatta, MD, MPH2, Kurt Barnhart, MD, MSCE3, Jeff Jensen, MD, MPH4, Anne E. Burke, MD, MPH5, Carolyn Westhoff, MD, MS6, Melissa Gilliam, MD, MPH7, Caryn Dutton, MD, MS8 and Susan A. Ballagh, MD9

From the 1Department of Obstetrics, Gynecology and Reproductive Sciences and Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Departments of Obstetrics and Gynecology, 2Boston University, Boston, Massachusetts; and 3Epidemiology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania; 4Oregon Health and Science University, Portland, Oregon; 5Johns Hopkins University, Baltimore, Maryland; and 6Mailman School of Public Health, Columbia University, New York, New York; 7University of Chicago, Chicago, Illinois; 8University of Wisconsin, Madison, Wisconsin; and 9Eastern Virginia Medical School, Norfolk, Virginia.

OBJECTIVE: To understand if the contraceptive ring or patch was more acceptable, as measured primarily by continuation, to women using an oral contraceptive and interested in a nondaily, combined hormonal contraceptive.

METHODS: Five hundred women were randomly assigned to use the contraceptive ring (n=249) or contraceptive patch (n=251) for four consecutive menstrual cycles, starting with their next menses. Participants returned for a single follow-up visit during the fourth cycle for an evaluation, which included a questionnaire to assess acceptability and adverse effects.

RESULTS: Rates of completion of three cycles were 94.6% (95% confidence interval [CI] 91.0–97.1%) and 88.2% (95% CI 83.4–92.0%) for ring and patch users, respectively (P=.03). Of these women, 71.0% (95% CI 64.8–76.6%) and 26.5% (95% CI 21.0–32.6%), respectively, planned to continue their method after the study (P<.001). Women switching to the patch were significantly more likely than women switching to the ring to experience longer periods (38% compared with 9%), increased dysmenorrhea (29% compared with 16%), frequent nausea (8% compared with 1%), frequent mood swings (14% compared with 8%), and frequent skin rash (12% compared with 2%) and were less likely to experience frequent vaginal discharge (8% compared with 17%). Ring users preferred the ring to the oral contraceptive (P<.001), and patch users preferred the oral contraceptive to the patch (P<.001). Nugent scores increased only in patch users (P=.01), although most of these women were asymptomatic.

CONCLUSION: Women satisfied with combined oral contraceptives and interested in a nondaily method are more likely to continue using the contraceptive ring than the contraceptive patch.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00269620

LEVEL OF EVIDENCE: I




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 JWatch Women's HealthHome page
Ring or Patch?
Journal Watch Women's Health, March 27, 2008; 2008(327): 1 - 1.
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