Do Women Find the Progesterone Vaginal Ring Acceptable? Findings from Kenya, Nigeria, and Senegal

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Do Women Find the Progesterone Vaginal Ring Acceptable? Findings from Kenya, Nigeria, and Senegal
Publication Date: 02/11/2018

The progesterone vaginal ring (PVR) is a contraceptive designed for use by breastfeeding women in the first year postpartum. This Report presents results of an acceptability study of the PVR in Kenya, Nigeria, and Senegal. Women seeking postpartum family planning services were offered various contraceptive options including the PVR. Of the 174 participating women, 110 (63 percent) used one ring and 94 (54 percent) completed the study by using two rings over a six‐month period. Women were interviewed up to three times: at the time they entered the study, at 3 months (the end of the first ring cycle), and at 6 months (the end of the second ring cycle or when they exited if they had discontinued earlier). Many participants found the ring to be acceptable, with over three‐quarters reporting that it was easy to insert, remove, and reinsert. While a small proportion of women experienced ring expulsion, the majority did not. These findings suggest that even in countries with little or no use of vaginal health products, contraceptive vaginal rings offer women a new option that they are able and willing to use.

Contraceptive vaginal rings are a new product category in many developing countries. There are two contraceptive vaginal rings on the market: a three‐monthly progesterone‐containing ring available in a few countries in Central and South America under the brand name Progering®; and a monthly etonogestrel/ethinyl estradiol ring sold under the brand name NuvaRing® in Europe, the United States, and other industrialized countries. Contraceptive vaginal rings offer particular benefits to users and health systems: users can self‐insert and remove the ring, giving them greater control over how the product is used, while health systems benefit from the limited need for extensive clinical training, equipment, and supplies.

Contraceptive vaginal rings differ from other contraceptives, both those for self‐use such as pills, condoms, and other barrier methods, and those clinically provided, such as implants, intrauterine devices (IUDs), injectables, and sterilization. Since contraceptive vaginal rings are a new product category for both users and family planning providers, it is important to understand their acceptability among these critical stakeholders. In many developing countries, use of any vaginal product including tampons and female condoms is limited or non‐existent. Given the low level of exposure to vaginal products in such contexts, not much is known about the level of comfort that users will have with vaginal rings, their concerns, use practices, and reactions of their partners and others around them.

This Report presents the results of a study on the acceptability of a progesterone vaginal ring (PVR) conducted in Kenya, Nigeria, and Senegal. The PVR is not currently available in these countries. Women's reports of their experiences with using the PVR are included. Implications of esults for introducing the PVR in these countries and others with similarly low levels of use of vaginal products are discussed.

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Studies in Family Planning