NuvaRing is also known as the vaginal ring. It's a form of hormonal contraception in the shape of a small, plastic ring, which is placed inside the vagina.
NuvaRing works in a similar way to the combined pill. It releases synthetic oestrogen and progesterone hormones into the womb to prevent ovulation from taking place each month. It also thins the womb lining, making it difficult for a fertilised egg to attach itself and thickens the mucus surrounding the cervix so that sperm have a difficult time entering.
With typical use, NuvaRing is 91% effective. This means that out of 100 women using NuvaRing over the course of a year, 9 will fall pregnant. If it is used perfectly (i.e. it is inserted correctly and on time and there are no instances of it falling out or being forgotten about) then it is 99% effective.
If you insert NuvaRing on the first day of a natural period it will start to work right away. You can also start using it at any other time during your cycle if you are sure you are not pregnant, but you will need to use condoms for 7 days to avoid the risk of pregnancy. You should avoid using a diaphragm or cap as these devices can dislodge the ring.
Due to the hormones it contains, NuvaRing may help to ease heavy, painful periods and symptoms of PMS and may result in lighter, less painful periods.
The active ingredients within NuvaRing are etonogestrel 11.7mg and ethinylestradiol 2.7 mg. These are released at a steady rate of 0.12mg/0.015mg per day over a three week period.
The inactive ingredients in NuvaRing are ethylene vinylacetate copolymers (28% and 9% vinylacetate) and magnesium stearate.
Each ring will stay in the vagina for 21 days. After insertion, you leave it inside the vagina for 21 days before removing it. You then wait 7 days before inserting a new one, in a similar way to having a pill-free week if you were on the combined pill. You are still protected from pregnancy during these 7 days and most women will experience withdrawal bleeding during this time.
The best time to start using NuvaRing is on the first day of your period as you will be protected against pregnancy right away. You can start using NuvaRing at any time during your cycle if you are sure you are not pregnant, but you will need to use an additional barrier method of contraception for the first seven days.
NuvaRing is inserted into the vagina and left in for 21 days. When you are ready, wash your hands and take the ring out of the packaging. Squeeze it between your thumb and finger before inserting it into the vagina. Carefully push it upwards as far as you can, until you can no longer feel it, as you would do with a tampon. It does not need to cover the cervix to work as it is not a barrier method of contraception such as a diaphragm or cap. It may take a bit of time to get the hang of it so ensure you give yourself plenty of time and do not rush.
The ring is then removed after 21 days, leaving a 7-day gap before inserting a new one. This is when you will have your period. The new one should always be inserted on time, even if you are still bleeding.
After 21 days, NuvaRing should be removed. Wash your hands before beginning and get into a position that is comfortable for you. Gently insert a finger into the vagina and hook it around the edge of the ring to carefully pull it out. NuvaRing comes with bags that you can use to dispose of the ring. The ring should be discarded in the bin, it should not be flushed down the toilet. If you have trouble removing it or experience discomfort or bleeding, see a nurse or GP as soon as possible.
If your ring has been left in for up to 7 days more than it should be, remove it as soon as you can. Wait 7 days before inserting another ring as usual. Your bleed will be delayed slightly but your contraception will not be affected.
If your ring has been left in for more than 28 days, take it out right away and insert a new ring immediately. You will need to use condoms for an additional 7 days as your protection may be affected. If you have had unprotected sexual intercourse after the 28th day following the ring being inserted, you should see a GP or pharmacist right away as you may require emergency contraception.
If you forget to insert NuvaRing on time after the 7 day break, put it in as soon as you can. You will need to use additional contraception, such as condoms, for the next 7 days to ensure you are protected against pregnancy. If you insert a new ring more than 48 hours after you should have and have had sex during this time you should seek emergency contraception.
Occasionally, NuvaRing may come out on its own. This is most likely to happen during sex or if the ring wasn't inserted properly. The action you should take will depend on where you are in your cycle and how long the ring has been out for:
Use one NuvaRing at a time. Each one should be left in for 21 days.
Common side effects include:
Uncommon side effects include:
Rare, serious side effects may include:
If you experience any of the following signs of toxic shock syndrome (TSS) seek immediate medical assistance:
Do not use NuvaRing if:
Tell your doctor or pharmacist before using NuvaRing if:
Certain medications can cause NuvaRing to be less effective. These include:
NuvaRing works in a similar way to the pill as it contains the same type of hormones (oestrogen and progestogen). NuvaRing is easy to use and you do not have to think about it everyday like the pill as long as you remove it and insert a new one on time. Unlike the pill, vomiting or severe diarrhoea will not interfere with it but there is a slight risk of NuvaRing being expelled from the vagina.
NuvaRing is a hormonal contraceptive, like the combined pill. Each one lasts for 28 days and must be removed and replaced once a month. The IUD, also known as the copper coil, is a long term reversible contraceptive, which is inserted by a doctor or nurse. Once it's in, it lasts for 5–10 years depending on the type. It's non-hormonal and works by being toxic to sperm. It does not produce the side effects of hormonal contraceptives but it does increase the risk of pelvic inflammatory infection and ectopic pregnancy should the contraceptive fail. The copper coil may also make your periods heavier and more painful. This may be a better option if you find it difficult to remember to take NuvaRing in and out.
The combined pill contains the same hormonal components as NuvaRing and works, in the same way, to protect against unwanted pregnancy. It's taken every day for 21 days and then you usually have a 7-day break before starting the next pack. NuvaRing is not suitable for all women however as it can pose health risks for those with high blood pressure, heart problems or anyone at risk of a blood clot.
The mini pill, also known as the progestogen-only pill, might be a suitable alternative. It does not produce as many side effects due to the lack of oestrogen. It must be taken on time every day for it to be effective. Long term reversible contraceptives are available from your GP or family planning clinic. These include the implant, IUD (copper coil), IUS (hormonal coil) or injection.
NuvaRing can be used for period delay. Simply take out your NuvaRing on day 21 as normal, but instead of having a 1 week break, replace it immediately with a new NuvaRing. You can leave this ring in for a maximum of three weeks, then you should remove it and have a 1 week break. You may experience some breakthrough bleeding when using NuvaRing to delay your period. If you want to delay your period for more than 3 weeks, you should discuss this with your doctor.
NuvaRing will not stop your period. It replaces your natural menstrual cycle with an artificial one but you will still have a monthly withdrawal bleed that is similar to a period.
Acne is a potential side effect of NuvaRing but the hormones contained in the contraceptive may actually help to reduce the appearance of acne. However, NuvaRing is not specifically prescribed for the treatment of acne.
NuvaRing cannot be used as emergency contraception. If you have had unprotected sex, you can either take the morning after pill or have an IUD fitted. The IUD is the only type of regular contraception that can be used in this manner.
NuvaRing is still effective during the 4th week while the ring is out as long as you have used it correctly. Your NuvaRing should stay inside the vagina for 21 days before removing it. The ring free week is the same as the 7-day break between contraceptive pills and you are still protected from pregnancy during this time.
You can still use tampons while using NuvaRing. The ring should always be inserted first and you should take extra care when removing tampons to ensure the ring does not get pulled out by accident. If this happens, rinse it with cool water and reinsert it.
NuvaRing should not feel uncomfortable but if it is not inserted correctly then you may be able to feel it. It may take a bit of practice to get the technique right so try to relax and adjust it if you need to.
In most cases, NuvaRing will not be felt by your partner during sexual intercourse.