NuvaRing is a flexible, colorless, odorless ring about the size of a silver dollar containing estrogen and progesterone, the same hormones used in oral contraceptives. The hormones are absorbed through the vagina into the blood stream to prevent pregnancy. The ring is inserted into the vagina and left in place for 21 days. It is then removed for seven days to allow for a period.
The ring is as effective in preventing pregnancy as birth control pills. The failure rate, if used correctly, is less than 1%.
The ring is generally safe for use by young healthy women. If you have any of the following conditions, be sure you discuss ring use with your provider, because special attention may be required:
The following symptoms can occur when one starts using the ring. If they do, they are usually mild and go away sometime during the first few cycles of use. If they do not stop or if they are too bothersome, it may be necessary to consider a change to another birth control method.
Counting the first day of your period as "day one," insert the ring any day up to day 5. Use condoms or abstain for the first seven days of ring use.
If you have been using a birth control pill containing both estrogen and progesterone, insert the ring any time in the seven days after taking the last active pill. You do not have to use a back up method of birth control.
Once the ring is inserted, leave it in place for three weeks. If you feel discomfort, the ring is probably not inserted far enough into the vagina. There is no danger of the ring being pushed too far into the vagina or getting lost.
Remove it on the same day of the week it was inserted at about the same time. Your period will usually start within 2 or 3 days after the ring is removed. Your period may be much lighter than it is when you are not taking hormones. This is normal. After seven days, reinsert a new ring on the same day of the week and at the same time of day as you inserted the first ring whether or not you are still having your period.
If the ring should come out and it has been out less than 3 hours, you should still be protected from pregnancy. The ring can be rinsed with cool or lukewarm (not hot) water and replaced in the vagina. If it has been out longer than 3 hours, you MUST use condoms or abstain until the ring has been in place for 7 consecutive days. You may want to discuss Emergency Contraception with your clinician or the consulting nurse.
If you leave the ring in too long (up to 4 weeks or less), remove it and insert a new ring on the day you would normally insert a new ring.
If you have left the ring in for more than 4 weeks, you should make sure you are not pregnant. Then insert a new ring and use an extra method of birth control or abstain until the new ring has been in place for 7 days.
The hormones in the NuvaRing can interact with other drugs or herbal remedies. Be sure to let your health care providers know you are using the ring. If surgery is anticipated it may be advisable to discontinue the ring a month before the operation. Be sure to discuss this with the surgeon.
Call the clinic immediately or consult with the emergency room if you experience any of the following:
These symptoms may be warning signs of a blood clot, heart attack or stroke.
NOTE: The NuvaRing does not protect against HIV infection and other sexually transmitted diseases.
If you have any questions, you may call a consulting nurse for further information:
Women's Clinic (206) 685-1031
Primary Care Clinic (206) 221-2517
After Hours Consulting Nurse (206) 744-2500
Authored by: Ingrid Helsel, RN