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 a person places it 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.

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

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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

A person must correctly position it in the vagina to be effective. Once they have inserted it, the ring 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.

An individual typically wears the device for 3 weeks, and they then remove it to allow menstruation. A regular menstrual period will typically start within 2 or 3 days after removal. After 7 days, the person can insert a new ring.

Typically, if an individual inserts a ring within the first 5 days after their period starts, they have immediate protection. If menstruation lasts more than 5 days, they can still insert their ring at this time.

If a person inserts the ring after 5 days, they will need to wait another 7 days to acquire protection from pregnancy. In this case, they can use a condom or spermicide until protection begins.

It is best to speak with a doctor about these timings.

Additionally, individuals should not use a cervical cap, diaphragm, or sponge, as this can affect the placement of the ring. It is safe to use a condom with a Nuvaring, and health experts recommend using condoms to prevent HIV and other STIs.

When a person stops using the device, they can become pregnant at once. However, it typically takes 1 to 2 months for the menstrual cycle to return to its typical processes.

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

Inserting a NuvaRing

To insert a NuvaRing, a person needs to:

  1. Wash and dry their hands.
  2. Hold the ring between the 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. Remove the ring after 3 weeks by hooking the index finger under the forward rim and pulling it out.

The advocacy group Planned Parenthood states that the NuvaRing has an effectiveness of 99% with correct use. This means that it is as effective as the contraceptive pill.

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

As long as they insert it at the right time, it works immediately.

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

There may be some discomfort when someone uses the ring for the first time, as the body needs to get used to the hormonal changes. These may include bleeding between periods, breast tenderness, and nausea. However, they should disappear after 2–3 months of use.

Health considerations also make combination hormones unsuitable for some people.

Blood clotting issues

The NuvaRing 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 people with a history of blood clotting.

People should not use the NuvaRing if they:

Additionally, smoking severely increases the risk of serious cardiovascular side effects in people who use a combination contraceptive such as NuvaRing.

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

In 2011, the Food and Drug Administration (FDA) published a study showing that NuvaRing could increase the risk of blood clots by 56% 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 2,000 lawsuits because of blood-clotting complications that have resulted in amputations, pulmonary embolisms, stroke, and death.

Other adverse effects

Other risks that have links to NuvaRing include:

  • Strokes and heart attacks: The device can increase the risk of strokes or heart attacks, especially if someone who smokes and is over 35 years uses it.
  • High blood pressure: Like other combination hormonal contraceptives, NuvaRing can raise blood pressure levels.
  • Cancer: There is a small increase in the risk of breast cancer associated with using NuvaRing.
  • Diabetes: A female who has diabetes with kidney, eye, nerve, or blood vessel damage should not use the device.

Other people who should not use the NuvaRing include people who have:

  • 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

Pregnant people should also avoid using the device.

Adverse effects of the NuvaRing 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 person 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 a person regularly uses oil-based medications 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 health experts do not yet know.

It is important to talk with a healthcare 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 $200 a month to use. A person will need a prescription, and health insurance may be able to provide coverage.

The NuvaRing is a vaginal ring that people use for birth control. The device releases the hormones estrogen and progesterone after a person places it into the vagina.

While it is as effective as the pill, the NuvaRing is not suitable for everyone, including those with certain conditions. There are also side effects, which may negatively affect individuals with blood-clotting conditions. Therefore, a person should speak with a doctor to discuss their birth control options.