Adherence and Acceptability of the Contraceptive Ring Compared With the Pill Among Students: A Randomized Controlled Trial

Obstet Gynecol. 2010 Mar;115(3):503-10. doi: 10.1097/AOG.0b013e3181cf45dc.


Objectives: To compare satisfaction with and adherence to the contraceptive vaginal ring and a daily low-dose oral contraceptive pill (OCP) among college and graduate students using a novel method of electronic data collection.

Methods: We randomly assigned 273 women to the contraceptive vaginal ring (n=136) or OCP (n=137) for three consecutive menstrual cycles. Participants completed daily Internet-based, online diaries regarding method adherence and satisfaction during cycles of use. At 3 months, they completed an online survey regarding intention to continue their method and overall acceptability. At 6 months, we surveyed participants to see whether they continued using contraception and, if so, which method.

Results: Rates of loss to follow-up were similar between groups. Contraceptive vaginal ring users reported more perfect use in the first 2 months (P=.05). After the 3-month study period, 52 (43%) of 121 contraceptive vaginal ring users and 65 (52%) of 126 OCP users reported plans to continue their method (P=.16). However, at 6 months, only 31 (26%) of 117 contraceptive vaginal ring users and 36 (29%) of 123 OCP users had continued their assigned study method (P=.61). Almost 50% of both groups were using condoms or no method.

Conclusion: Contraceptive vaginal ring users were more likely to report perfect use during the 3-month trial period than were OCP users. Despite randomization, participants were equally satisfied with their assigned hormonal contraceptive method. At 6 months, less than 30% of participants were still using their assigned method.

Clinical trial registration:,, NCT00635570.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Contraceptives, Oral, Hormonal / therapeutic use*
  • Desogestrel / analogs & derivatives
  • Desogestrel / therapeutic use
  • Drug Combinations
  • Ethinyl Estradiol / therapeutic use
  • Female
  • Humans
  • Medication Adherence*
  • Patient Satisfaction*
  • Students
  • Universities
  • Young Adult


  • Contraceptives, Oral, Hormonal
  • Drug Combinations
  • NuvaRing
  • Ethinyl Estradiol
  • Desogestrel

Associated data