Population Council Research that makes a difference

Assessing the Acceptability of the Progesterone Vaginal Ring in Sub-Saharan Africa

To expand contraceptive options for women in sub-Saharan Africa we are evaluating the acceptability of the progesterone vaginal ring, a user-controlled contraceptive method for lactating women, and exploring strategies for how to introduce the new technology.

A vaginal ring.
Photo by Karen Tweedy-Holmes, courtesy of the Population Council.

Breastfeeding provides very effective contraception for new mothers. However, once her infant is six months old or a woman begins supplementing her infant's diet or has her first postpartum period, the contraceptive protection of lactation decreases. A woman who does not want to get pregnant must then consider safe contraceptive alternatives to avoid unintended pregnancy.

To help meet this need, the Population Council developed a hormonal contraceptive vaginal ring technology for lactating women that is easy to use and reversible. The progesterone vaginal ring (PVR; not to be confused with the combination Nestorone® and ethinyl estradiol, NES/EE, ring for nonlactating women) can be inserted by a nursing woman to delay pregnancy. Made of silicone rubber, the ring slowly releases the natural hormone progesterone, which is absorbed into the bloodstream to regulate a women's fertility. An individual ring lasts for up to three months, and a woman can use the method for one year. Contraceptive effectiveness is ensured as long as the woman continues to breastfeed at least four times per day.

Already proven safe and effective in clinical trials, the progesterone vaginal ring has been identified as a potential method for use by lactating women in sub-Saharan Africa.

This three-year project seeks to evaluate the acceptability of the PVR by women in Kenya, Nigeria, and Senegal. In addition, researchers will develop approaches to introducing the method in settings where women want to use it. A similar effort is ongoing in India.

With the addition of the PVR, the range of contraceptive options for breastfeeding women will be expanded, promoting spacing between children and consequently improving maternal and newborn health (Millennium Development Goals 4 and 5).

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