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NuvaRing gains ground in birth control market

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Many women prefer NuvaRing to oral contraceptives because they don't have to worry about taking a pill every day. (Courtesy of Organon USA)

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NuvaRing's growth is in part due to satisfied users spreading the word and telling their friends. (Courtesy of Organon USA)

When Ashton Guy, a college sophomore, began looking for a suitable birth control method, she couldn't afford to take any chances. Avoiding pregnancy was a concern, of course, but she also had other health issues to worry about.

Guy's mother had once suffered a severe blood clot when taking oral contraceptives and had been paralyzed for two weeks. According to Guy, her mother has had health problems ever since.

So when Guy, a communications and human relations major at the University of Texas, was ready to pick a contraceptive, she asked her doctor for the one with the lowest hormone dosage. The doctor recommended NuvaRing.

NuvaRing, which is about 2 inches in diameter, is made of a flexible plastic that is inserted into the vagina. It stays there for three weeks at a time, emitting a low dose of the hormones estrogen and progestin to prevent pregnancy.

More women are opting for the device because it is easier than taking a pill every day, is highly effective and has a low rate of side effects.

“It sounded like a really good idea, even though it's kind of a weird method,” Guy said.

The insertion technique may be off-putting to some, but the product has established a loyal fan base eager to spread the word. There is even a group on the social-networking site Facebook.com that claims 112 members who “are enthralled by the method of birth control called the NuvaRing.”

Since its approval by the Food and Drug Administration in 2001 and its introduction into the American market in 2002, NuvaRing prescriptions have risen to more than 4 million in 2006. Research by Organon USA, the company that manufactures NuvaRing, has shown that while about 50 percent of women prefer oral contraceptives, NuvaRing has gained a 6 percent to 7 percent market share, said Nicholas Hart, marketing director for contraceptives at Organon.

“We've grown pretty dramatically since 2004,” Hart said. “The trajectory has been pretty substantial.”

NuvaRing, however, did not take off overnight. The idea of inserting a plastic ring into the vagina makes some women uncomfortable, and was one of the initial obstacles in marketing the product.

"Overcoming the hurdle of vaginal administration takes a while and was what we focused on at first,” Hart said. The company encouraged health care professionals to discuss NuvaRing's advantages to counter potential users' resistance to the product.

The advantages include a 99 percent effectiveness when the device is used correctly. It also emits a lower daily dose of estrogen than oral contraceptives or a transdermal patch.

Robyn Duran, a college health nurse practitioner, agrees that at first, the product was a “tough sell” among patients.

“I find many women are uncomfortable with the idea of inserting the ring,” said Duran, who herself is a NuvaRing user.

“I saw the same resistance initially with the ring as I did with the patch. A lot of women didn't believe it would work because they weren't swallowing a pill,” Duran said. But in the past couple of years, more women have been asking about the product. Busy women in their 20s and 30s like it because of the convenience, said Duran, who has worked with patients of all ages.

When the product was first released, Duran had to throw away many free samples because they had expired and people just weren't interested. Now she estimates that it is prescribed to 15 percent of her clientele.

Nancy Petit, an obstetrician and gynecologist at the North Wilmington Women's Center in Wilmington, Del., has also seen a significant increase in the use of NuvaRing. When the product was initially introduced, Petit said about 3 percent to 5 percent of women were willing to try it. Now, she estimates, it constitutes 20 percent of her prescriptions. Petit also said the company's recent direct consumer advertising has led many women to request NuvaRing. Previously, the company had focused its advertising toward health care professionals and those in the medical field.

But like any contraceptive method, it isn't for everybody.

After hearing about NuvaRing from her roommate, Tristan Albin, a junior micromolecular biology major at University of Central Florida, decided to give it a try after being on the pill for almost two years. Albin quickly learned the ring wasn't right for her.

“I was irritated, depressed, and it killed my sex drive,” Albin said.

Albin, who frequently forgot to take the pill, wanted a more secure method. But she experienced strong side effects from NuvaRing.

“Anything would set me off,” she said. “I didn't want to be touched by anybody. I didn't even want to be hugged by anybody.”

Albin switched back to the pill.

Edio Zampaglione, senior medical director for women's health at Organon, said that everyone's sensitivity to hormones is different and that side effects like Albin's occur infrequently.

Albin also said that with NuvaRing's insertion method “you do have to get a little personal with yourself. And if you're not comfortable with that, it's definitely not for you.”

Although NuvaRing may not be suitable for everyone, Duran and others anticipate that sales of the product will continue to grow.

“I do find that women who start it, stay with it,” Duran said.

And those women tend to tell other women.

“Information women get from their peers or family members tends to be more influential and holds more weight than what they might hear from a clinician,” Duran said. “I think it has to do with trust. A woman will trust her friend, her sister, her aunt's advice.”

Guy, who has happily used the ring for almost a year, has helped spread the word to her friends.

“I was the first one, and now I've gotten three to switch,” she said.

E-mail: cjs2137@columbia.edu