الفهرس 
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Abstract
The first part of this work investigated the possibility of using combined contraceptive pill per vaginum instead of oral use. Neovlar (Schering) containing levonorgestrel 0.25 mg and ethinyl estradiol 0.05 mg was used for contraceotion via the oral route by 51 healthy fertile women and per vaginum by 49 women,the allocation to either group was random., all subjects were recruited from amongst the attendees of the family planning clinic of EL-minia university hospital, they were having no contraindication to steroid therapy. Both groups were clinically comparable at admission as regarding age, weight, height, parity and menstrual pattern, and they used the pills for 21 days alternating with 7 dats of pill free period.
The second part of this study aimed to investigate whether the continuous administration would have any accessibility merits over the intermittent administration.
The third part of this study was a pharmacokinetic one aiming at comparing serum levels of LNG and SHBG following oral and vaginal administration of the contraceptive pills used in the first and second parts of this study neovlar (schering), in addition we compared serum levels of its specific binding protein namely SHBG.
We can conclude theses points:
1- The use of the vaginal route for administration of combined pills is a highly acceptatable option for female contraception in our locality.
2- The high accessibility is due to the easiness of its use, and the lower incidences of side effects like headache, gastric upsets and menstrual troubles in addition to its high efficacy.
3- The vaginal route of combined pills use should be added as an important member to the armamentarium of family planning services.
4- The continuous regimen users showed higher incidence of discontinuation due to the fact that amenorrhoea and break through bleeding were significantly commoner amongst them.
5- LNG levels found in the vaginal group were nearly comparing to oral group and this can explain the contraceptive efficacy of combined steroid contraceptive pills given via the vaginal route.
6- Studies with larger numbers of subjects are needed to evaluate the impact of the vaginal route on thepharmaco-kinetic parameters of both lng and eez as well as hepatic markers such as shbg.