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OBJECTIVE: To investigate whether contraceptive vaginal ring use results in si milar estimated genital symptoms, signs, examination, and laboratory findings co mpared with oral contraceptive use. METHODS: Women were randomly assigned to eit her contraceptive vaginal ring or a 20 μg ethinyl estradiol oral contraceptive pill use for 3 consecutive 28-day cycles, directly followed by 3 cycles of the study drug not initially assigned. Subjects scored genital symptoms on a daily d iary using a 0-4 scale and underwent a baseline, cycle 2, cycle 4, and exit pel vic examination including vaginal discharge evaluation, vaginal Gram stain and w hite cell count, and culture for yeast and Lactobacillus, including colony count and hydrogen peroxide production. RESULTS: Of the 40 subjects assigned to each arm, 33 (82.5%) subjects in the ring-first arm and 31 (77.5%) subjects in the pill-first arm completed all study visits (P = .58). Most subjects reported fe w genital symptoms with either method, but 63%of subjects reported vaginal wetn ess during ring use compared with 43%during pill use. During ring use larger nu mbers of Lactobacillus colonies present were positive for hydrogen peroxide prod uction (fold difference 2.67, 95%confidence interval 1.49, 4.78, P < .001). All other laboratory data, including yeast colony counts, Nugent Gram stain score, vaginal white blood cell count, vaginal pH, and discharge weight, were not signi ficantly different by method. CONCLUSION: Some women may notice an increase in v aginal wetness during contraceptive ring use yet the method is well tolerated an d appears to improve the vaginal flora.
OBJECTIVE: To investigate whether contraceptive vaginal ring use results in si milar estimated genital symptoms, signs, examination, and laboratory findings co mpared with oral contraceptive use. METHODS: Women were randomly assigned to eit her contraceptive vaginal ring or a 20 μg ethinyl estradiol oral contracptive pill use for 3 consecutive 28-day cycles, directly followed by 3 cycles of the study drug not initially assigned. Subjects scored genital symptoms on a daily d iary using a 0-4 scale and underwent a baseline, cycle 2, cycle 4, and exit pel vic examination including vaginal discharge evaluation, vaginal Gram stain and w hite cell count, and culture for yeast and Lactobacillus, including colony count and hydrogen peroxide production. RESULTS: Of the 40 subjects assigned to each arm, 33 (82.5%) subjects in the ring-first arm and 31 (77.5%) subjects in the pill-first arm completed all study visits (P = .58). Most subjects reported fe w genital symptoms with either method, bu t 63% of subjects reported vaginal wet n ess during ring use compared with 43% during pill use. During ring use larger nu mbers of Lactobacillus colonies present were positive for hydrogen peroxide prod uction (fold difference 2.67, 95% confidence interval 1.49, 4.78, P <.001). All other laboratory data, including yeast colony counts, Nugent Gram stain score, vaginal white blood cell count, vaginal pH, and discharge weight, were not signi ficantly different by method. CONCLUSION: Some women may notice an increase in v aginal wetness during contraceptive ring use yet the the method is well tolerated an d appear to improve the vaginal flora.