Contraceptive ring gets FDA approval. (Widely Available by Next Summer).

NuvaRing, a new intravaginal ring that provides a steady release of etonogestrel and ethinyl estradiol, is being hailed by contraception experts as a welcome addition to the array of birth control options now available.

The device, made by Organon Inc., was approved by the Food and Drug Administration last month and should be widely available by next summer. The approval of NuvaRing is a welcome event in an otherwise slow year for new developments in contraception.

"I think this is a fabulous new option for young women, as well as many older women," said Dr. Vanessa Cullins, an ob.gyn. in New York City who is also medical director for the Planned Parenthood Federation of America. "I like the fact that because it is inserted intravaginally and bypasses the gastrointestinal system, some of the side effects associated with oral contraceptives, such as nausea and vomiting, can be avoided."

The flexible polymer ring is 2 inches in diameter, with a cross-sectional diameter of 1/8 inch. A woman can insert the ring herself by compressing it between her thumb and forefinger and placing it high in the vagina, just under the cervix. It is designed to release 120 [micro]g etonogestrel and 15 [micro]g ethinyl estradiol daily, a dose that is actually lower than the 150 [micro]g desogestrel and 20 [micro]g ethinyl estradiol provided by the lowest-dose daily combination oral regimen.

The disposable ring should be inserted on or about day 5 of the menstrual cycle and worn continuously for 3 weeks at which point the patient can remove the device.

Peak hormone levels are achieved within 7 days of initial insertion, and contraception is continuous so long as the patient remembers to reinsert a fresh ring at the end of the fourth week.

Dr. Cullins cited a number of potential advantages with the NuvaRing: The once-monthly change means that patients do not have to remember their birth control daily, and since it is worn internally, it allows for sexual spontaneity And compared with oral contraceptives, NavaRing may reduce the incidence of early breakthrough bleeding and spotting.