Oral versus vaginal administration of a combined hormonal contraceptive Pill: a comparative study of efficacy, acceptability and side effects

ABSTRACT

This work investigate the possibility of using combined contraceptive pill per vaginum instead of oral use. Neovlar [0.25 mg Levonorgestrel and 0.05 mg of ethinyl estradiol was used for contraception via the oral route by 51 healthy fertile women and per vaginum by 49 women, the allocation to either groups was random. Both groups were clinically comparable at admission and used the pills for 21 days alternating with 7 days of pill free period. They were monthly followed up for one year. The first year continuation rates were 92.1 +/- 3.8 [rate +/- S.E. and 93.8 +/- 3.4 for the oral and vaginal routs respectively; a statistically insignificant difference. The first year net cumulative pregnancy rate was 2/100 women for the oral pill users and 4.2/100 women for women who used the vaginal route. Headaches, gastric upsets and menstrual disturbances were significantly commoner among the women who used the pills orally. These results indicate that for some women vaginal administration of combined pills may be a welcome substitute to oral route, having nearly the same efficacy and lower incidence of certain side effects usually associated with the oral use