Would You Be Comfortable Using NuvaRing, the Vaginal Ring?

Somewhat surprising news from a study looking at Nuva Ring user characteristics--you don't have to be all that comfortable with touching your genital area to be a satisfied NuvaRing user:

At least 30% of women starting a reversible contraceptive method discontinue use within 6 months, and many women have difficulty using pills consistently. New delivery systems, including the vaginal ring, may be easier to use than traditional oral contraceptives because they require no daily action from users. The vaginal contraceptive ring cycle consists of 3 weeks of continuous ring use followed by 1 ring-free week. In observed trials, the vaginal ring has an efficacy and an adverse-effect profile similar to those of oral contraceptives.

Women's experience with their bodies may affect acceptability, satisfaction and continuation of contraceptives in a complex way. This may be especially salient for use of the vaginal ring, which requires women to touch their genitals for insertion and removal. Thus, clinicians may not offer the vaginal ring as an option because they believe that their patients would be uncomfortable touching their genitals to insert and remove the ring.

Anticipated discomfort may impede willingness to use the vaginal ring. Data from the National Health and Social Life Survey (NHSLS), with a probability sample of 3432 Americans, indicate that 58% of women report never masturbating. The NHSLS also found that 14% of women reported experiencing pain during intercourse. Women who do not masturbate or who report painful intercourse may have more discomfort with genital touching and be less willing to use the ring. Recent use of vaginal contraceptives has been extremely low in the United States; in the 2002 National Survey of Family Growth, less than 1% of current contraceptive users reported using a diaphragm, cervical cap, female condom, sponge or any other vaginal contraceptive. This suggests that vaginal contraception may not be attractive to many American women. This may be due to vaginal contraceptives' lower efficacy and to some women's unwillingness to touch their genitals.

We carried out this study to identify factors associated with vaginal ring satisfaction and continuation. We hypothesized that women who reported greater comfort in touching their genitals, greater frequency of masturbation, more comfort with intercourse and past use of vaginal contraceptives and products would be more likely than others to be satisfied with the ring and continue using it for birth control.

And yet, when it comes to continued NuvaRing use, the study found that:

High user satisfaction and continuation of the vaginal ring for birth control were not associated with prior use of vaginal contraceptives or products, masturbation, discomfort with intercourse or other behaviors that involve genital touching such as waxing and shaving pubic hair or having tattoos and/or body piercings. Neither demographic characteristics nor vaginal experiences identified successful ring users.

Some limitations of the study:

In this study, we did not collect data regarding frequency of vaginal intercourse; therefore, we do not know if this factor is related to satisfaction with ring use. Our findings indicate that most women who are willing to try the vaginal ring as part of a clinical trial are likely to be highly satisfied with the method and to continue using it. Women willing to participate in a randomized clinical trial are not, however, representative of average ring users, so these findings may not be generalizable.