Ring Edges Out the Pill in Compliance Among College Women

Neither popular for long-term use

March 1, 2010

Of the many types of birth control available, oral contraceptive pills (OCP) are the most popular method among young women.

Yet, according to a randomized controlled trial published in the March issue of Obstetrics & Gynecology, female college and graduate students at Midwestern colleges and universities were more likely to have perfect short-term compliance using a contraceptive vaginal ring rather than those taking contraceptive pills.  

Melissa Gilliam, MD, MPH, chief, family planning, University of Chicago Medical Center, and Emily Godfrey, MD, MPH, assistant professor, department of family medicine, University of Illinois at Chicago, conducted the Acceptability of the NuvaRing (ACCEPT) study to determine adherence to and acceptability of the two methods among this population.

A trial sample size of 273 women (137 using the pill; 136 using the contraceptive vaginal ring) participated. All were healthy women ages 18 to 45 years, and full-time college or university students.

While both groups of users were very satisfied with their contraceptive method, perfect compliance at the three-month mark among vaginal ring users was 57 percent, while OCP users was 45 percent.

At the 90-day mark, 52 percent of the pill users said they planned to continue using that method, while 43 percent of the contraceptive ring users said they would continue use. Surprisingly, by six months, less than 30 percent of women in either group continued the method. Condom use or no contraception were reported by almost half of both groups.

"The largest proportion of 3 million women who have unintended pregnancies occurs among women ages 20 to 24 years," said Gilliam. "College and graduate students are vulnerable to unintended pregnancy because of high rates of sexual activity and difficulties with contraceptive adherence. An unintended pregnancy among this population may be particularly problematic given full-time schoolwork, employment and other extracurricular commitments."

To prevent pregnancy, strategies should focus on improving continuation and consistency of birth control use among young women, according to Gilliam. ACCEPT study data also suggests that students consider nondaily methods such as intrauterine device (IUD) and implants. "The findings of nonuse at six months suggest that studies of long-lasting reversible methods are also needed in this population," Gilliam said.