Abstract

PIP: The main hormonal contraceptive method of the future may well be an intravaginal, progestin-releasing ring. Such devices have the advantages of operating locally and avoiding the side effects associated with systemic administration of steroid compounds. They can administer longterm contraception and be removed at any time for immediate reversibility. There is low risk associated with the use of such devices. Progestagen-only contraception had been widely known and accepted for many years. The synthesis of the 19-nor steroids provided an impetus to its use. Several methods of delivery of slow-release progestagen are available. Unfortunately, most suffer form the common problem of progestagen-only administration--i.e., breakthrough bleeding. The development process for the contraceptive vaginal rings is described. A WHO (World Health Organization)-sponsored test is being conducted to determine the effectiveness and acceptability of progestagen-releasing rings. Trials in 8 centers showed the pregnancy rate with norethisterone-releasing rings to be unacceptably high. The tests continue with levonorgestrel-releasing rings to be unacceptably high. The tests continue with levonorgestrel-releasing rings. These rings have produced no pregnancies in the tests so far. It is hoped that the vaginal rings will be generally available within a few years.