A Study to Evaluate the Effect of Vaginal Rings on Primary Dysmenorrhea (P08257/MK-8175A/MK-8342B-057)

• Change in Mean Total Impact Score [ Time Frame: Baseline to End of Cycle 2 (Day 56) ] [ Designated as safety issue: No ]
• Change in Number of Ibuprofen Tablets [ Time Frame: Baseline to End of Cycle 2 (Day 56) ] [ Designated as safety issue: No ]
• Change in Number of Days of Ibuprofen Intake [ Time Frame: Baseline to End of Cycle 2 (Day 56) ] [ Designated as safety issue: No ]

The study investigates four vaginal ring groups with respect to relief of primary dysmenorrhea, and should identify at least one vaginal ring that shows clinically relevant treatment efficacy in relief of primary dysmenorrhea.

The study investigates four vaginal ring groups with respect to relief of primary dysmenorrhea, and should identify at least one vaginal ring that shows clinically relevant treatment efficacy in relief of primary dysmenorrhea. The intake of ibuprofen rescue medication and the impact on daily life is investigated: change from baseline data of these two variables will be compared between each of the four active ring groups, separately, and the placebo ring group. Furthermore, the study assesses the measurement characteristics and psychometric properties of a newly developed Dysmenorrhea Daily Dairy. Vaginal bleeding pattern and general safety and tolerability will also be evaluated.

• Drug: Nomegestrol acetate contraceptive vaginal ring (NOMAC-CVR)
  Either 700 or 900 μg NOMAC and 300 μg E2 intravaginal ring for two 28-day cycles
  Other Names:

  • SCH900121
  • MK-8175A
• Drug: Etonogestrel containing contraceptive vaginal ring (ENG-CVR)
  Either 100 or 125 μg ENG and 300 μg E2, intravaginally for two 28-day cycles
  Other Names:

  • SCH900432
  • MK-8342B
• Drug: Placebo
  Placebo to match vaginal ring, intravaginally for two 28-day cycles
• Drug: Ibuprofen
  Ibuprofen 400 mg will be dispensed throughout the entire study as needed as rescue medication for treating menstrual cramping pain. The maximum daily ibuprofen dose is 3200 mg (8 tablets)
  Other Name: Motrin

• Experimental: 700 μg NOMAC/300 μg E2
  Administered for two 28-day treatment periods, each period (cycle) consisting of 21 days of vaginal ring use followed by 7 vaginal ring-free days
  Interventions:

  • Drug: Nomegestrol acetate contraceptive vaginal ring (NOMAC-CVR)
  • Drug: Ibuprofen
• Experimental: 900 μg NOMAC/300 μg E2
  Administered for two 28-day treatment periods, each period (cycle) consisting of 21 days of vaginal ring use followed by 7 vaginal ring-free days
  Interventions:

  • Drug: Nomegestrol acetate contraceptive vaginal ring (NOMAC-CVR)
  • Drug: Ibuprofen
• Experimental: 100 μg ENG/300 μg E2
  Administered for two 28-day treatment periods, each period (cycle) consisting of 21 days of vaginal ring use followed by 7 vaginal ring-free days
  Interventions:

  • Drug: Etonogestrel containing contraceptive vaginal ring (ENG-CVR)
  • Drug: Ibuprofen
• Experimental: 125 μg ENG/300 μg E2
  Administered for two 28-day treatment periods, each period (cycle) consisting of 21 days of vaginal ring use followed by 7 vaginal ring-free days
  Interventions:

  • Drug: Etonogestrel containing contraceptive vaginal ring (ENG-CVR)
  • Drug: Ibuprofen
• Placebo Comparator: Placebo
  Administered for two 28-day treatment periods, each period (cycle) consisting of 21 days of vaginal ring use followed by 7 vaginal ring-free days
  Interventions:

  • Drug: Placebo
  • Drug: Ibuprofen

Inclusion Criteria:

• Body mass index (BMI) ≥18 and ≤35
• Established diagnosis of primary dysmenorrhea
• If of child-bearing potential must agree to use condoms for contraception during the entire screening period, treatment period, and post-treatment period until the final study visit, unless she or her partner are surgically sterilized
• Agree to stop using hormonal contraceptive (combined or progestin-only), or a non hormonal intrauterine device (IUD)
• Regular menstrual cycles ranging from 24 to 35 days in length

Exclusion Criteria:

• Any of the following contraindications to the use of contraceptive steroids including: presence or a history of venous or arterial thrombotic/thromboembolic events or cerebrovascular accident (stroke, history of migraine with focal neurological symptoms, diabetes mellitus with vascular involvement, severe or multiple risk factor(s) for venous or arterial thrombosis, severe dyslipoproteinemia, severe hypertension, pancreatitis or a history thereof if associated with severe hypertriglyceridaemia, presence or history of severe hepatic (liver) disease, including benign or malignant tumors, known or suspected sex steroid-influenced malignancies, and/or undiagnosed vaginal bleeding
• Pregnant or breastfeeding
• Secondary dysmenorrhea
• Has not had spontaneous menstruation following a delivery or abortion
• Participated in an investigational drug study within 30 days
• History of malignancy ≤5 years
• Documented abnormal cervical smear result within 6 months
• Use of recreational or illicit drugs
• Consumes >2 alcoholic drinks per day or >14 alcoholic drinks per week, or engages in binge drinking
• Allergy/sensitivity to ibuprofen, or any contraindication to its use, or has experienced asthma, urticaria, or allergic-type reactions after taking aspirin, or other nonsteroidal anti inflammatory drugs
• Has been sterilized using a fallopian tube occlusion device
• Is receiving, or has received sex hormones for any purpose other than contraception within 2 months or injectable hormonal contraception within 6 months