Prescription Required 
Formulation : 
Description
Indications
Estrogen and progestin vaginal ring contraceptives serve the purpose of preventing pregnancy. These contraceptives are composed of two female sex hormones, namely estrogen (ethinyl estradiol) and progestin (etonogestrel), and fall under the class of combination hormonal contraceptives.
The mechanism of action of estrogen-progestin combination involves the inhibition of ovulation, alteration of the endometrial lining to impede pregnancy, and modification of cervical mucus to block the entry of sperm. Vaginal rings are an effective contraceptive method, however, they do not provide protection against sexually transmitted infections.
Uses and Dosage
Estrogen and progestin vaginal ring contraceptives are a flexible ring that is inserted into the vagina. The ring is typically left in place for three weeks, followed by a one-week break. Insert the vaginal ring at the end of the one-week break on the same day and time as the previous insertion or removal, even if bleeding has not stopped. Follow the prescription label carefully and seek clarification from your doctor or pharmacist for any unclear information.
Use the contraceptive ring precisely as directed. Do not use more than one contraceptive ring at a time, and insertion and removal should follow the schedule provided by your doctor.
Contraceptive vaginal rings are available in different brands, which may have varying medications or doses, usage instructions, and associated risks and benefits. You must know the specific brand of contraceptive vaginal ring you are using and the correct usage instructions. Obtain the manufacturer’s information for the patient and read it thoroughly, or seek clarification from your doctor or pharmacist.
Your doctor will advise you on when to insert the first contraceptive vaginal ring based on factors such as prior contraceptive use, pregnancy, or recent abortion or miscarriage. In some cases, backup birth control may be necessary during the first week of use, and your doctor will suggest appropriate methods, such as male condoms and/or spermicides.
Diaphragms, cervical caps, and female condoms should not be used while a contraceptive ring is in place.
The contraceptive ring should remain in the vagina until removal, although it may occasionally slip out during tampon use, intercourse, or bowel movements. Consult your doctor if the contraceptive ring slips out frequently.
Before and after intercourse, check for the presence of the vaginal ring.
Contraceptive vaginal rings are effective only if used consistently. Do not discontinue use of the contraceptive vaginal ring without consulting your doctor.
Side Effects
Some side effects may occur that usually do not need medical attention:
- swelling, redness, irritation, burning, itching, or infection of the vagina
- white or yellow vaginal discharge
- vaginal bleeding or spotting when it is not time for your period
- unusual breast tenderness
- headache
- nausea
- vomiting
- diarrhea
- weight gain or loss
- breast pain, tenderness, or discomfort
- vaginal discomfort or foreign body sensation
- stomach pain
- acne
- changes in sexual desire
Inform your healthcare provider immediately if you experience any serious side effects:
- pain in the back of the lower leg
- sharp, sudden, or crushing chest pain
- heaviness in chest
- sudden shortness of breath
- sudden severe headache, vomiting, dizziness, or fainting
- sudden problems with speech
- weakness or numbness of an arm or leg
- double vision, blurred vision, or other changes in vision
- dark patches of skin on forehead, cheeks, upper lip, and/or chin
- sudden high fever, vomiting, diarrhea, fainting or feeling faint when standing up, rash, muscle aches, or dizziness
- depression
- difficulty sleeping or staying asleep
- loss of energy
- rash
- swelling of the hands, feet, ankles, or lower legs; hives; or itching
Caution
Prior to using this product, inform your healthcare provider or pharmacist about any allergies you have to ethinyl estradiol, etonogestrel, other estrogens or progestins, or any other substances. This product may contain inactive ingredients that can cause allergic reactions or other issues.
Disclose your medical history, particularly if you have a history of blood clots, blood clotting disorders such as protein C or protein S deficiency, high blood pressure, abnormal breast exam, cancer (specifically endometrial or breast cancer), high cholesterol or triglyceride levels, depression, diabetes, angioedema, gallbladder issues, severe headaches/migraines, heart problems, a history of yellowing eyes/skin (jaundice) while using hormonal birth control, liver disease, stroke, swelling, thyroid problems, or vaginal conditions (such as unexplained vaginal bleeding, vaginal stenosis, prolapsed uterus) prior to taking this medication.
If you have diabetes, this medication may affect your blood sugar levels. Regularly check your blood sugar as directed and share the results with your healthcare provider. Notify your doctor immediately if you experience symptoms of high blood sugar, such as increased thirst or urination. Your doctor may need to adjust your diabetes medication, exercise regimen, or diet.
Inform your doctor if you have had surgery recently or will be confined to a bed or chair for an extended period, such as a long plane flight. These conditions increase your risk of developing blood clots, particularly if you are taking hormonal birth control. You may need to discontinue this medication for a period or take special precautions.
The hormones in this product may cause blotchy, dark areas on your skin, known as melasma. Sun exposure can exacerbate this effect. Limit your time in the sun, avoid tanning beds and sunlamps, and wear protective clothing and sunscreen when outdoors.
If you are nearsighted or wear contact lenses, you may experience vision problems or difficulty wearing your contact lenses. Contact your eye doctor if these issues arise.
This medication must not be used during pregnancy. If you become pregnant or suspect that you are pregnant, inform your doctor immediately.
If you have recently given birth or experienced a pregnancy loss/abortion after the first trimester, speak with your doctor about reliable forms of birth control and determine when it is safe to begin using birth control containing estrogen, such as this medication.
The hormones in this product may decrease breast milk production, and a small amount may pass into breast milk, potentially causing undesirable effects in nursing infants. Prior to breastfeeding, consult your doctor.
Form and Strength
Nuvaring is available in the following forms and strengths:
-
Nuvaring vaginal ring:
- 120/15mcg
FAQ
How effective is Nuvaring?
If used correctly the vaginal ring can be over 99% effective at preventing pregnancy. If you forget to put a new ring in, use it incorrectly or take certain medications, it might only be 93% effective.
Should I be able to feel my NuvaRing with my finger?
You should be able to feel the ring with your finger.
Resources
- https://shvic.org.au/for-you/contraception/nuvaring-vaginal-ring#:~:text=If%20used%20correctly%20the%20vaginal,might%20only%20be%2093%25%20effective
- https://www.everydayhealth.com/womens-health/vaginal-ring-faq/#:~:text=You%20should%20be%20able%20to,leg%20to%20help%20reach%20it
- https://www.nhs.uk/conditions/contraception/vaginal-ring/
- https://my.clevelandclinic.org/health/articles/24157-vaginal-ring
- https://www.webmd.com/drugs/2/drug-63410/nuvaring-vaginal/details
- https://medlineplus.gov/druginfo/meds/a604032.html
