Vaginal Contraceptive Ring (NuvaRing)
What is it?
The Ring is a flexible, transparent contraceptive ring that is inserted by a woman into her vagina. The product, NuvaRing, releases a continuous low dosage of the synthetic hormones estrogen and progestin.
How does it work?
The ring stops ovulation. (It is not a barrier device like a diaphragm.) The ring is inserted by the user and remains in the vagina for 3 weeks. The ring is then removed for one week during which bleeding will occur. A new ring is used each month.
How do I get started?
If you haven’t used a hormonal birth control method or have only been using condoms, a diaphragm or other barrier method of birth control in the past month, you can Insert NuvaRing on the first day of your cycle, (i.e., the first day of menstrual bleeding). NuvaRing will work immediately, it is not necessary to use an additional contraceptive method. You may also start on Day 2 to 5 of your cycle, but in this case make sure you use an extra method of birth control (barrier method), such as male condoms or spermicide for the first seven days of NuvaRing use in the first cycle.
If you are switching from using a combination birth control pill, you can start NuvaRing on any day—but the latest day you can begin on is the day after taking your last “inactive” (hormone-free) pill. If you have been using your birth control consistently and correctly, you should not need an extra birth control method when you transition.
If you are switching from using the Ortho Evra Patch, you can start NuvaRing on any day—but the latest day you can begin on is the one following your usual patch-free week. If you have been using your hormonal birth control consistently and correctly, you should not need an extra birth control method when you transition.
If you are switching from a progestin-only method such as the mini pill, implant, injection or the Mirena IUD, you may switch on any day from the mini-pill. You should switch from an implant or the IUD on the day of its removal and from an injectable on the day when the next injection would be due. In all of thesecases you should use an additional method of birth control, such as a male condom, for the first seven days of ring use.
Will I feel NuvaRing?
Although some women may be aware of NuvaRing, most can’t feel it once it’s in place, If you feel discomfort after inserting NuvaRing, slide it further in until it feels comfortable. The exact position of NuvaRing is not important for it to be effective. Once inserted, keep Nuvaring in place for 3 weeks in a row.
What are the advantages unique to the ring?
- The woman does not have to take a pill every day.
- It is monthly rather than daily routine.
What are the disadvantages unique to the ring?
- Possible vaginal discharge and irritation
- Some women dislike placing and removing ring
What are the side effects of NuvaRing?
The most common side effects reported by NuvaRing users are:
- vaginal infections and irritation
- vaginal discharge
What are possible complications?
Hormones increase the risk of blood clots in veins and arteries. The risk of a blood clot is extremely small in young, healthy women. The highest risk is seen in older smokers. However, pregnancy confers an even greater risk of blood clots than does using a hormonal method. Clots in the veins can cause thrombophlebitis (mostly in the leg) and pulmonary embolism (a blood clot that travels to the lungs.) Clots in arteries cause heart attacks or strokes. Know the warning signs of these problems (see below) and get medical evaluation immediately.
Use of NuvaRing may also cause elevated blood pressure, migraines, gall bladder problems and very rarely a benign liver tumor.CALL YOUR PHYSICIAN/CLINICIAN IF YOU HAVE:
- A - Abdominal pain (severe) that cannot be explained by food intake or stomach flu
- C - Chest pain (severe or sudden) or shortness of breath
- H - Unusual or suddenly severe headaches with dizziness or vomiting
- E - Eye problems (blurred vision, flashing lights or blindness)
- S - Severe leg pain, one-sided weakness or numb-ness (calf or thigh)
We advise women to quit smoking if they want to use NuvaRing.
What should I do if Nuva Ring slips out?
NuvaRing may slip out when removing a tampon, straining during a bowel movement, or having intercourse. If NuvaRing does slip out, follow the directions below:
- If NuvaRing is out for less than 3 hours: Rinse NuvaRing with cool-to-lukewarm (not hot) water and reinsert it as soon as possible, within 3 hours at the latest. You should still be protected from pregnancy. If you’ve lost NuvaRing, insert a new NuvaRing and continue on the same schedule you had been following
- If NuvaRing is out for more than 3 continuous hours during the first 2 weeks of starting a new NuvaRing: Contraceptive effectiveness may have been reduced, so you might not be protected from pregnancy. Reinsert the ring as soon as possible and use an extra method of birth control, such as condoms, until you have used NuvaRing for 7 days in a row
- If NuvaRing has been out for more than 3 continuous hours during the third week of using a new NuvaRing: Throw the ring away and choose 1 of the 2 options below:
- Insert a new ring immediately. This begins the next 3-week use period. You may not have a period but you may experience breakthrough spotting or bleeding.
- Have your period and insert a new ring no later than 7 days from the time the previous ring was removed or expelled. This option should be chosen only if the ring was used continuously for the preceding 7 days.
- In addition, in order to prevent pregnancy, you must use a barrier method, such as condoms, until you have used NuvaRing again for 7 days in a row.
Note: Women with conditions affecting the vagina, such as a prolapsed (dropped) uterus, may be more likely to have NuvaRing slip out. If NuvaRing slips out repeatedly, please consult your doctor.
Will my partner or I feel NuvaRing during intercourse?
During intercourse, some sexual partners may feel NuvaRing in the vagina. However, in clinical studies, 9 of 10 (90%) couples did not find this to be a problem.
How effective is the Ring?
The ring is as effective as oral contraceptives:
- Typical use: 92%
- Perfect Use: 99.7%