Clinical performance and endocrine profiles with contraceptive vaginal rings containing a combination of estradiol andd-norgestrel

Abstract

Contraceptive vaginal rings (CVR's) impregnated with a combination ofd-norgestrel and estradiol were studied in a group of 10 subjects: five for three cycles and five for six cycles. The rings were inserted for three weeks and removed for one week to allow withdrawal bleeding. Clinical acceptance was good. Ovulation was inhibited in all treatment cycles and resumed within one month following completion of the trial. Bleeding control was excellent, with regular withdrawal bleeding, no episodes of failure of withdrawal bleeding, and only three days of breakthrough spotting. Serumd-norgestrel levels were relatively constant in each subject except for the first half of the first treatment cycle which had slightly higher levels. Serum estradiol levels rose rapidly following insertion of the ring to levels between 100 and 300 pg. per milliliter but then declined over the next few days to levels generally less than 50 pg. per milliliter. After treatment, mean levels of the binding capacity of corticosteroid-binding-globulin did not become significantly elevated and serum triglycerides declined, in contrast to the increases in both which take place in women ingesting oral contraceptive steroids. This method of administering combination estrogen-progestogen contraceptive steroids has the advantage of inhibition of ovulation and good control of bleeding without the disadvantage of producing some adverse metabolic effects.