The purpose of this review was to test
contraceptive efficacy, cycle control, tolerability, and acceptability as found in the non-comparative studies with
NuvaRing((R)) by those found in the randomized trials comparing
NuvaRing and
combined oral contraceptives (COCs). All large non-comparative studies and all relevant randomized controlled trials (RCTs) between
NuvaRing and a COC up to and including December 2006 were analyzed. Two large multi-center registration studies, 1 large daily clinical practice study, and 6 RCTs comparing
NuvaRing and a COC were identified. The findings in the non-comparative studies were confirmed in the RCTs.
Contraceptive efficacy was high showing no significant differences in comparison with the COC; cycle control was good and consistently better than that of the COC; compliance was high and comparable with that of the pill; the incidence of adverse events such as breast tenderness,
headache, and
nausea was low, but not lower than with the COC despite a halving of the systemic exposure to
ethinyl estradiol (EE) with
NuvaRing compared with a 30-mug EE-containing COC; the incidence of local and ring-related events was low but higher than with the COC, leading to higher discontinuation rates among
NuvaRing users; acceptability was high and comparable between both
contraceptives, resulting in a global improvement of sexual function with both methods. After study completion, women using
NuvaRing were more likely to continue with their method than women using a COC. The good results with respect to
contraceptive efficacy, cycle control, tolerability, and acceptability as achieved with
NuvaRing in the large non-comparative registration studies were confirmed in the RCTs comparing
NuvaRing with different COCs.