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NuvaRing for contraception

NuvaRing is the trade name for a combined hormonal contraceptive vaginal ring manufactured by Organon that is available by prescription. It is a flexible plastic (ethylene-vinyl acetate copolymer) ring that releases a low dose of a progestin and an estrogen over 3 weeks.

HOW NuvaRing® WORKS

NuvaRing® contains 2 types of hormones: estrogen and progestin, which work together to prevent your ovaries from producing mature eggs. These are the same hormones found in the Pill, and they work the same way in your body even though they are administered differently with NuvaRing®.

With NuvaRing®, hormone release is activated once the ring comes into contact with your vagina. The hormones are then absorbed and distributed into your bloodstream.

When used as directed, NuvaRing® works as well as the Pill—it is 99% effective in preventing pregnancy.

NuvaRing® works with your cycle

Over the course of 3 weeks, NuvaRing® releases a continuous low dose of estrogen and progestin. Higher estrogen and progestin levels signal your brain not to release the hormones that cause egg maturation. Without an egg ready to be released into the fallopian tube, ovulation cannot occur.

A few days after you remove NuvaRing®, the lining of the uterus begins to shed and you get your period.

Your new cycle begins again on the 29th day, which is the first day you insert your new ring after being ring-free for a week. It is important that you insert your new ring on the same day of the week each month.

How to use NuvaRing®

NuvaRing® is a small, comfortable vaginal ring that’s easy to insert and remove. The exact position of NuvaRing® is not important for it to be effective. Once inserted, NuvaRing® molds to your body and should stay in place—even during exercise.

NuvaRing

NuvaRing

How to insert NuvaRing®

After washing and drying your hands, remove NuvaRing® from the foil pouch. Holding NuvaRing® between your thumb and index finger, press the sides together while lying down, squatting, or standing with one leg up—whatever is most comfortable for you.

Gently push the folded ring into your vagina. If you feel discomfort after inserting NuvaRing®, slide it farther 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.

How to remove NuvaRing®

Remove the ring 3 weeks after insertion on the same day of the week it was inserted at about the same time. Hook your index finger under the forward rim or hold the rim between your index and middle finger.

NuvaRing schedule

NuvaRing schedule

Gently pull out NuvaRing®. Dispose of NuvaRing® in a waste receptacle out of the reach of children and pets. Do not throw it in the toilet. To continue to have pregnancy protection, you must insert a new ring 1 week after the last one was removed even if your period has not stopped.

Possible Side Effects and Risks

The common side effects reported by NuvaRing® users are:

  • Vaginal infections and irritation,
  • Vaginal secretion,
  • Headache,
  • Weight gain,
  • Nausea.

In addition to the risks and side effects listed above, users of combination hormonal birth control methods have reported the following side effects:

NuvaRing

NuvaRing

  • Vomiting,
  • Change in appetite,
  • Abdominal cramps and bloating,
  • Breast tenderness or enlargement,
  • Irregular vaginal bleeding or spotting,
  • Changes in menstrual cycle,
  • Temporary infertility after treatment,
  • Fluid retention (edema),
  • Spotty darkening of the skin, particularly on the face,
  • Rash,
  • Weight changes,
  • Depression,
  • Intolerance to contact lenses,
  • Nervousness,
  • Dizziness,
  • Loss of scalp hair.

IMPORTANT SAFETY INFORMATION:

  • The use of combination oral contraceptives is associated with increased risks of several serious side effects, including blood clots, stroke or heart attack. NuvaRing is not for women with a history of these conditions. The risk of getting blood clots may be greater with the type of progestin in NuvaRing than with some other progestins in certain low-dose birth control pills. It is unknown if the risk of blood clots is different with NuvaRing use than with the use of certain birth control pills
  • Cigarette smoking increases the risk of serious cardiovascular side effects when you use combination oral contraceptives. This risk increases even more if you are over age 35 and if you smoke 15 or more cigarettes a day. Women who use combination hormonal contraceptives, including NuvaRing, are strongly advised not to smoke.
  • NuvaRing® is not for women with certain cancers or those who may be pregnant.
  • NuvaRing® does not protect against HIV infection and other sexually transmitted diseases.
  • The most common side effects reported by NuvaRing® users are: vaginal infections and irritation, vaginal secretion, headache, weight gain, and nausea

Call your doctor right away if you get any of the symptoms listed below. They may be signs of a serious problem:

  • Sharp chest pain, coughing blood, or sudden shortness of breath (possible clot in the lung);
  • Pain in the calf (back of lower leg; possible clot in the leg);
  • Crushing chest pain or heaviness in the chest (possible heart attack);
  • Sudden severe headache or vomiting, dizziness or fainting, problems with vision or speech, weakness, or numbness in an arm or leg (possible stroke);
  • Sudden partial or complete loss of vision (possible clot in the eye);
  • Yellowing of the skin or whites of the eyes (jaundice), especially with fever, tiredness, loss of appetite, dark-colored urine, or light-colored bowel movements (possible liver problems);
  • Severe pain, swelling, or tenderness in the abdomen (gallbladder or liver problems);
  • Sudden fever (usually 102°F or more), vomiting, diarrhea, dizziness, fainting, or a sunburn-like rash on the face or body (very rarely, toxic shock syndrome);
  • Breast lumps (possible breast cancer or benign breast disease);
  • Irregular vaginal bleeding or spotting that happens in more than 1 menstrual cycle or lasts for more than a few days;
  • Urgent, frequent, burning and/or painful urination, and cannot locate the ring in the vagina (rarely, accidental placement of NuvaRing® into the urinary bladder);
  • Swelling (edema) of your fingers or ankles;
  • Difficulty in sleeping, weakness, lack of energy, fatigue, or a change in mood (possible severe depression).

If you are switching to NuvaRing® from another hormonal birth control method

No matter which hormonal birth control you are currently using, it’s easy to make the switch to NuvaRing®. When exactly you begin NuvaRing® will depend on your specific birth control method. Below are some basic guidelines, but you should talk to your doctor and consult the Full Product Information for more details.

Switching from a pill (combination progestin and estrogen)
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.

Switching from a patch (combination progestin and estrogen)
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.

Switching from a mini-pill (progestogen-only)
You can start NuvaRing® on any day. During the first 7 days of using NuvaRing®, be sure to use an extra method of birth control (such as a condom or spermicide).

Switching from an injection (progestogen-only)
You should start NuvaRing® on the day when your next injection would be due. During the first 7 days of using NuvaRing®, be sure to use an extra method of birth control (such as a condom or spermicide).

Switching from an intrauterine system (IUS) or implant (progestogen-only)
You should start NuvaRing® on the day your IUS or implant is removed. During the first 7 days of using NuvaRing®, be sure to use an extra method of birth control (such as a condom or spermicide).

What Should be Avoided

Cigarette smoking increases the risk of serious cardiovascular side effects when you use combination oral contraceptives. This risk increases even more if you are over age 35 and if you smoke 15 or more cigarettes a day. Women who use combination hormonal contraceptives, including NuvaRing®, are strongly advised not to smoke.

Do not breastfeed while using NuvaRing®. Some of the medicine may pass through the milk to the baby and could cause yellowing of the skin (jaundice) and breast enlargement in your baby. NuvaRing® could also decrease the amount and quality of your breast milk.

The hormones in NuvaRing® can interact with many other medicines and herbal supplements. Tell your health care provider about any medicines you are taking, including prescription medicines, over-the-counter medicines, herbal remedies, and vitamins.

The blood levels of the hormones released by NuvaRing® were increased when women used a vaginal medication (miconazole nitrate) for a yeast infection while NuvaRing® was in place. The pregnancy protection of NuvaRing® is not likely to be changed by use of these products. The blood levels of these hormones were not changed when women used vaginal, water-based spermicides (nonoxynol or N-9 products) along with NuvaRing®.

Certain drugs and herbal supplements may interact with combined hormonal contraceptives to make them less effective in preventing pregnancy or cause an increase in breakthrough bleeding. Such drugs include rifampin, drugs used for epilepsy such as barbiturates (for example, phenobarbital), carbamazepine, and phenytoin, primidone, topiramate, phenylbutazone, modafinil, and some drugs used for HIV such as ritonavir. Pregnancies and breakthrough bleeding have been reported by users of combined hormonal contraceptives who also used the herbal supplement St. John’s Wort. You may need to use a nonhormonal method of contraception during any cycle in which you take drugs that can make oral contraceptives less effective. Be sure to tell your health care provider if you are taking or start taking any other medications, including nonprescription products or herbal products, while using NuvaRing®.

While using NuvaRing®, you should not rely upon a diaphragm when you need a backup method of birth control because NuvaRing® may interfere with the correct placement and position of a diaphragm. If you are scheduled for any laboratory tests, tell your doctor or health care provider you are using NuvaRing®. Contraceptive hormones may change certain blood tests results.

(information from http://www.nuvaring.com/Consumer/index.asp)


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