Gynecol Endocrinol. 2013 Aug 30.

Counseling on vaginal delivery of contraceptive hormones: implications for women's body knowledge and sexual health

Nappi RE; the Italian Nuvaring Study Group Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Section of Obstetrics and Gynecology, Research Center for Reproductive Medicine, IRCCS San Matteo Foundation, University of Pavia , Italy

Background: Healthcare providers (HCPs) have an important role in helping women select the contraceptive method that best matches their needs and lifestyle. Recent surveys outline the need of women to be informed about all available choices, including the newest methods (particularly those not requiring daily administration), such as vaginal contraception.

Results: HCPs should explain the main characteristics of the combined contraceptive vaginal ring including the anatomical and physiological implications that make the vagina an ideal route of hormonal administration and the basic notions about functional modifications of the vagina during reproductive life. Clinical data on the vaginal ring should be summarized with regard to efficacy, tolerability, pharmacokinetics, cycle control and user acceptability, including recent findings on extra-contraceptive benefits (also compared to other hormonal contraceptives) on the vaginal flora and on sexual function.

Conclusion: Vaginal contraception offers various benefits and should always be discussed during contraceptive counseling. An open dialogue about vaginal contraception will also help enhance body knowledge and sexual health.

Comment: Counseling about vaginal hormonal contraception should focus on the ease of use and the once monthly administration, instead of primarily on the placement in the vagina. If providers handle the counseling in a normal way, then also women will be more comfortable talking about and handling their genitals. (HMV)