If this should occur, simply rinse the ring in cool to lukewarm not hot water and immediately reinsert it. Use of spermicides or vaginal yeast products will not reduce the contraceptive efficacy of NuvaRing. Some women miss periods on hormonal birth control, even when they are not pregnant. Consider the possibility that you may be pregnant if:.
If you know or suspect you are pregnant, do not use NuvaRing. See your health care provider as soon as possible. When you use NuvaRing you may have bleeding and spotting between periods, called unplanned bleeding. Unplanned bleeding may vary from slight staining between menstrual periods to breakthrough bleeding, which is a flow much like a regular period. Unplanned bleeding occurs most often during the first few months of NuvaRing use, but may also occur after you have been using NuvaRing for some time.
Such bleeding may be temporary and usually does not indicate any serious problems. It is important to continue using the ring on schedule.
If the unplanned bleeding or spotting is heavy or lasts for more than a few days, you should discuss this with your health care provider. Do not use more than one NuvaRing at a time. Too much hormonal birth control medicine in your body may cause nausea, vomiting, or vaginal bleeding.
Before inserting NuvaRing, always check the expiration date on the label. Do not insert if the expiration date has passed. Store NuvaRing at room temperature for up to 4 months after you receive it and throw it away if the expiration date on the label has passed. Dispose of NuvaRing by placing the used ring in the re-sealable foil pouch and properly dispose of it in a waste receptacle out of the reach of children and pets.
Do not throw it in the toilet. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www. The physician Prescribing Information also is available. By clicking on this link, you will be leaving this site. This link will take you to a site outside of Organon. Organon does not review or control the content of any non-Organon site. Organon does not endorse and is not responsible for the accuracy, content, practices, or standards of any non-Organon site.
Are you a health care professional? This section contains information intended for health care professionals in the United States only and is not intended for the general public. Yes, I am. No, I am not. Please take me back. All rights reserved. Please be informed that effective August 1, , Merck will no longer offer the applicator for NuvaRing.
We encourage you to direct any questions regarding the applicator for NuvaRing or other questions related to NuvaRing to your health care provider. Who should not use NuvaRing? NuvaRing is not for pregnant women Have or have had breast cancer or any cancer that is sensitive to female hormones Are allergic to etonogestrel, ethinyl estradiol or any of the ingredients in NuvaRing.
See the list of ingredients in NuvaRing in the Patient Information. Before you use NuvaRing tell your health care provider if you: Have any medical conditions Smoke Are pregnant or think you are pregnant Recently had a baby Recently had a miscarriage or abortion Have a family history of breast cancer Have or have had breast nodules, fibrocystic disease, an abnormal breast x-ray, or abnormal mammogram Use tampons and have a history of toxic shock syndrome Have been diagnosed with depression Have had liver problems including jaundice during pregnancy Have or have had elevated cholesterol or triglycerides Have or have had gallbladder, liver, heart, or kidney disease Have diabetes Have a history of jaundice yellowing of the skin or eyes caused by pregnancy also called cholestasis of pregnancy Have a history of scanty or irregular menstrual periods Have any condition that makes the vagina become irritated easily Have or have had high blood pressure Have or have had migraines or other headaches or seizures Are scheduled for surgery.
NuvaRing may increase your risk of blood clots after surgery. You should stop using NuvaRing at least 4 weeks before you have surgery and not restart it until at least 2 weeks after your surgery.
Are scheduled for any laboratory tests. Certain blood tests may be affected by hormonal birth control methods. Are breastfeeding or plan to breastfeed. Hormonal birth control methods that contain estrogen, like NuvaRing, may decrease the amount of milk you make.
A small amount of hormones from NuvaRing may pass into your breast milk. Consider another non-hormonal method of birth control until you are ready to stop breastfeeding. Some medicines and herbal products may make hormonal birth control less effective, including, but not limited to: Certain anti-seizure medicines such as barbiturates, carbamazepine, felbamate, oxcarbazepine, phenytoin, rufinamide and topiramate.
Women on thyroid replacement therapy may need increased doses of thyroid hormone. Blood clots: Like pregnancy, combination hormonal birth control methods increase the risk of serious blood clots see graph below , especially in women who have other risk factors, such as smoking, obesity, or age greater than Some examples of serious blood clots are blood clots in the: Legs deep vein thrombosis Lungs pulmonary embolus Eyes loss of eyesight Heart heart attack Brain stroke To put the risk of developing a blood clot into perspective: If 10, women who are not pregnant and do not use hormonal birth control are followed for one year, between 1 and 5 of these women will develop a blood clot.
Use NuvaRing exactly as your health care provider tells you to use it. NuvaRing is used in a 4-week cycle. Insert 1 NuvaRing in the vagina and keep it in place for 3 weeks 21 days. Regularly check that NuvaRing is in your vagina for example, before and after intercourse to ensure that you are protected from pregnancy. Remove the NuvaRing for a 1-week break 7 days. During the 1-week break 7 days , you will usually have your period. Use of spermicides or vaginal yeast products will not make NuvaRing less effective at preventing pregnancy.
Use of tampons will not make NuvaRing less effective or stop NuvaRing from working. If NuvaRing has been left inside your vagina for more than 4 weeks 28 days , you may not be protected from pregnancy and you should see your health care provider to be sure you are not pregnant. Until you know the results of your pregnancy test, you should use an extra method of birth control, such as male condoms with spermicide, until the new NuvaRing has been in place for 7 days in a row.
Do not use more than 1 NuvaRing at a time. Continuous use regimens may be prescribed to insert a new vaginal ring every 3 or 4 weeks without a ring-free week. Patients that use a continuous use regimen omitting a ring-free week will likely not experience a withdrawal bleed. However, breakthrough spotting or unscheduled bleeding may be experienced with continuous use regimens. What is the evidence behind using the vaginal ring for four weeks instead of the usual three weeks?
The manufacturer states NuvaRing is still an effective hormonal contraception if inserted for 4 weeks instead of the usual three weeks , but the manufacturer recommends removing it for a ring-free week before inserting a new ring for maximum contraceptive effectiveness.
Ovulation inhibition to prevent pregnancy is maintained with insertion of the CVR for up to 4 weeks. However, the manufacturer recommends ruling out pregnancy for placements longer than 4 weeks before inserting a new ring. Some systemic side effects of the CVR are comparable to oral contraceptives with similar incidence of headaches and weight gain.
However, CVRs have an increased risk for local vaginal side effects like vaginitis Patients using CVR report less nausea and breast tenderness when compared with patients using oral contraceptives.
Side effects may be related to the serum level differences between CVRs and oral contraceptives. Bioavailability of ethinyl estradiol are similar between CVR versus oral contraceptives at The NuvaRing package insert includes precautions for carbohydrate and lipid metabolic effects, high blood pressure, headaches, uterine bleeding, vascular risks, liver disease, and Toxic Shock Syndrome.
The table below summarizes the evidence found in clinical studies of extended CVR use. Table 1. Summary of clinical studies of extended regimens of the contraceptive vaginal ring CVR. PubMed ID, Year Purpose Design Study size Results Conclusion Extended regimens of the combined contraceptive vaginal ring containing etonogestrel and ethinyl estradiol: effects on lipid metabolism.
Group 1 did not have ring-free days. Group 2 instructed to remove CVR for 4 days if bleeding occurs, and reinsert the same ring Group 2 experienced less days of bleeding compared to Group 1 A 4-day ring-free period helped resolve breakthrough bleeding better compared to continuous ring use without ring-free periods. About the Author:. You are commenting using your WordPress. You are commenting using your Google account. You are commenting using your Twitter account.
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This content does not have an English version. This content does not have an Arabic version. Sections for Vaginal ring About. Overview Vaginal ring Open pop-up dialog box Close. Vaginal ring A vaginal ring is a contraceptive device that contains the hormones estrogen and progestin.
Request an Appointment at Mayo Clinic. Vaginal ring placement Open pop-up dialog box Close. Vaginal ring placement A vaginal ring is a contraceptive device that contains the hormones estrogen and progestin.
Share on: Facebook Twitter. Show references Hatcher RA, et al. Contraceptive patch and vaginal contraceptive ring. In: Contraceptive Technology. Ayer Company Publishers; Kerns J, et al. Hormonal contraceptive vaginal rings. Accessed Oct. Melmed S, et al.
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