The use of a contraceptive vaginal ring governed by the pattern of individual uterine bleeding

Abstract

Contraceptive vaginal rings (CVR) releasing levonorgestrel and estradiol were used for contraceptive purposes in eight women. They were instructed to remove the CVR for five days only, in the case of bleeding. Three selected subjects were followed by plasma sampling during the first 60 days of treatment. Plasma concentrations of levonorgestrel, progesterone, estradiol and gonadotropins were determined. All subjects kept bleeding records and were controlled clinically in the course of treatment. The subjects were protected an average of 163 days by the CVR. Three subjects used the CVR 170--180 days without removing it and two subjects had to remove the CVR only once. Two subjects experienced quite regular bleedings, and metrorrhagic bleeding was present in one case. No pregnancies were observed during the follow-up period of 1304 days. Clinical examination revealed no pathological findings. The vaginal mucosa tolerated the treatment well. Out of those subjects who were followed by plasma sampling, pituitary suppression was more marked in the subject with continuous use of CVR.

PIP: In the attempt clinically to evaluate the bleeding signaled method for the levonorgestrel and estradiol contraceptive vaginal ring (CVR), the patient acceptance, the bleeding pattern, and the local tolerance of long-lasting continuous use of the CVR, endocrine parameters in selected patients were determined by measuring plasma levonorgestrel, estradiol, progesterone, LH and FSH concentrations. The CVR were used for contraceptive purposes in 8 women who were instructed to remove the CVR for 5 days only, in the case of bleeding. 3 selected subjects were followed by plasma sampling during the first 60 days of treatment. All subjects kept bleeding records and were controlled clinically in the course of treatment. The subjects were protected an average of 163 days by the CVR. 3 subjects used the CVR 170-180 days without removing it and 2 subjects had to remove the CVR only once. 2 subjects experienced quite regular bleedings, and metrorrhagic bleeding was present in 1 cases. There were no pregnancies during the 1304 days follow-up. Clinical examination showed no pathological findings. The vaginal mucosa tolerated the treatment well. In the subjects followed by plasma sampling, pituitary suppression was more marked in the subject with continuous CVR use.