The NuvaRing is the brand name of a type of vaginal ring. It is a flexible plastic ring that releases the hormones estrogen and progesterone after being placed into the vagina, up near the cervix.

The release of these hormones prevents the ovaries from producing eggs.

Around 1.5 million women around the world use the device as a means of contraception and there were 44 million prescriptions for it in the United States from 2004 to 2014.

NuvaRing does not protect against HIV and other sexually transmitted infections (STIs), and it is not suitable for all women.

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The NuvaRing is a small plastic ring that aids contraception.

The NuvaRing is a small, flexible ring that is easy to insert and remove.

It must be correctly positioned in the vagina to be effective. Once inserted, it should stay in place and not move around.

It works by releasing estrogen and progesterone.

These hormones both stop the eggs from leaving the ovaries and make the cervical mucus thicker so that the sperm cannot reach the eggs.

The device is normally worn for 3 weeks, and then it is removed to allow menstruation. A regular menstrual period will typically start within 2 or 3 days after removal. After 7 days, a new ring can be inserted.

Normally, if a woman inserts a ring within the first 5 days after her period starts, she is immediately protected. If menstruation lasts more than 5 days, the ring can still be inserted at this time.

If a woman inserts the ring after 5 days, she will need to wait another 7 days to be protected. In this case, a condom or spermicide should be used until protection begins.

It is best to speak to a doctor about the timing.

A cervical cap, diaphragm, or sponge should not be used, as this can affect the placement of the ring. It is safe to use a condom with a Nuvaring. A condom is recommended to prevent HIV and other sexually transmitted diseases.

When a woman stops using the device, she can become pregnant at once, although it normally takes 1 to 2 months for the menstrual cycle to return to how it was before.

A woman who previously had irregular periods may find this disruption lasts for up to 6 months

Inserting a NuvaRing

To insert a NuvaRing:

  1. Wash and dry your hands.
  2. Hold the ring between your thumb and index finger.
  3. Press the sides of the ring together.
  4. Lie down, squat, or stand up on one leg, whichever is most comfortable.
  5. Carefully push the ring inside the vagina as far as possible. It cannot go too far, as it cannot pass the cervix.
  6. Keep the ring in place for 3 weeks.
  7. After 3 weeks, remove the ring by hooking index finger under the forward rim and pulling it out.

NuvaRing is said to be 99 per cent effective when used correctly. This means that it is as effective as the contraceptive pill.

It is easy to use, and the user does not have to think about it every day.

As long as it is inserted at the right time, it works immediately.

NuvaRing is an effective means of contraception, but the user must follow the instructions. Around 9 percent of users become pregnant each year because they do not do this.

There may be some discomfort when the ring is first used while the body gets used to the hormonal changes. These may include bleeding between periods, breast tenderness, and nausea. They should disappear after 2 to 3 months of use.

Health considerations also make combination hormones unsuitable for some women.

Blood clotting issues

The device secretes hormones that can cause changes in the blood-clotting system. Using it can cause blood to clot more easily, so it is not suitable for women with a history of blood-clotting.

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The NuvaRing has been proven as effective as the contraceptive pill.

Women should not use the NuvaRing if they:

Smoking severely increases the risk of serious cardiovascular side effects in women who use a combination contraceptive such as NuvaRing.

The manufacturer warns women not to use it if they smoke cigarettes and are over 35 years of age.

In 2011, the U.S. Food and Drug Administration (FDA) published a study showing that NuvaRing could increase the risk of blood clots by 56 percent and that 40 patients had died as a result of using the ring. This was higher than the risk involved when taking a low-dose estrogen pill for birth control.

The manufacturers have faced over 730 lawsuits because of blood-clotting complications that have resulted in amputations, pulmonary embolisms, stroke, and death.

Other adverse effects

Other risks associated with NuvaRing, include:

  • Strokes and heart attacks: NuvaRing can increase the risk of strokes or heart attacks, especially if used by a smoker or a woman over 35.
  • High blood pressure: like other combination hormonal contraceptives, NuvaRing can raise blood pressure levels.
  • Cancer: there is a small increase in the risk of cancer of the reproductive organs and breast associated with using NuvaRing.
  • Diabetes: a woman who has diabetes with kidney, eye, nerve, or blood vessel damage should not use the device.

Other conditions that it should not be used with include severe migraine headaches, liver disease or liver tumors, cardiovascular disease, unexplained vaginal bleeding, breast cancer or other types of cancer that are sensitive to hormonal changes. It should not be used if the woman may be pregnant.

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NuvaRing is a great option for birth control, but not without its risks.

Adverse effects include:

  • irritation to the vagina or cervix
  • vaginal infections
  • weight gain
  • headache, including migraine
  • mood changes and depression
  • vaginal discharge
  • changes in appetite
  • edema
  • dizziness, nausea, and vomiting
  • rash
  • breast pain or discomfort

The ring may also slip out or cause discomfort.

Planned Parenthood suggests that NuvaRing may help protect against a number of conditions, including acne, bone thinning, heavy and painful menstruation, and some infections.

However, the manufacturer, Merck, warns that it may worsen acne and menstrual pain.

Merck also says that some women may experience lowered libido or sexual desire. However, not having to think about contraception can also help a woman to feel more relaxed about sex.

Drug interactions

Just like other hormonal birth control options, some medications can interact with NuvaRing, making it less effective

These include:

  • rifampin, an antibiotic
  • griseofulvin, an antifungal drug
  • some HIV medications
  • some antiseizure drugs
  • St. John’s Wort

If oil-based medicines are regularly used in the vagina for fungal infections, this may increase the levels of hormones. It will not reduce the effectiveness of the ring, but it may have long-term effects that are not yet known.

It is important to talk with a health care professional before using this form of contraception.

The manufacturers encourage anyone who experiences a negative side effect to inform the FDA.

NuvaRing can cost between $0 and $80 a month to use. A prescription is needed and it may be covered by health insurance.