December 24, 2012

Contraceptive Series Part 6: NuvaRing, the Vaginal Ring

by novanilla

This is the sixth installment of my Contraceptive Series, in which I will provide accessible information about NuvaRing, the only vaginal ring available in America at this time. This article will provide information about the basics of NuvaRing— everything you need to know when making a decision about what contraceptive is best for you.

So how does it work?

NuvaRing contains 11.7 mg of etonogestrel (progestin) and 2.7 mg of ethinyl estradiol that it releases over the period of a month. It’s incredibly easy to use. The ring is inserted into the vagina and is left there for 3 weeks. It is removed for 1 week for withdrawal bleeding, and a new ring is inserted at the end of the bleeding week. It must be inserted and removed the same day of the week and around the same time, but if you can’t get to a pharmacy until the next day, it is easy to switch the insertion day one day at a time. While taking it for about 6 months, I switched between Sunday and Monday a couple of times and experienced no problems related to what day I inserted it. It works very similarly to a Pill, but you don’t have to remember it every day or even every week aside from bleeding week.

Who should use NuvaRing? Who shouldn't?

As with every birth control option, NuvaRing is not right for everyone. Some people who are attracted to NuvaRing are young people and college students because of how private, simple, and easy it is to use. It is less of a commitment than an IUD or even Depo-Provera and also has a cheaper upfront cost than other long-term methods for those without health insurance. If undesirable side effects are experienced, although it's best to wait until the end of the 3 weeks to remove it, it can be removed at any time by the user. However, there is more to consider than just these factors.

People who should consider NuvaRing: women who want a long-term option but are uncomfortable with devices that are provider-controlled, women who want privacy and ease of use, women who want estrogen, women with heavy periods or bad cramps looking to ease their periods, women who want a hormonal option.

People who should avoid NuvaRing: women who cannot/will not take estrogen, women who do not want to take hormones, women nervous to insert something themselves, women who don’t want monthly bleeding.

What happens once I get it?

NuvaRing comes with risks just like the Pill or any other hormonal option, and it is really on an individual basis. When I took it for 6 months, I had back pain, breast pain, extreme moodiness to the point of loss of self-control, extra cervical mucus (you know, that oozing thing that happens occasionally—a lot of that), and hot flashes. One friend of mine experienced morning sickness as if pregnant (she was not). However, I also know women who used it happily for years, and I recommend it often to people who want to control their birth control but also don’t want to deal with it everyday. It is a great choice for many people and does not cause these problems for everyone, but I think it is important to highlight personal experiences when possible. Women need to be warned about what could happen.

NuvaRing comes with risks of blood clots just like the Pill, but users report less nausea, depression, and weight gain than those of the Pill. There seem to be more problems with breast tenderness and vaginal infection or itchiness and other discomfort.

It is safe to use tampons or menstrual cups while wearing a NuvaRing, but since you remove it during the bleeding week, unless you have irregular bleeding, this should not be of concern. I had sex with the NuvaRing in and neither my partner nor I noticed the ring. However, if you find that it is distracting and that you can feel it, it can be removed for up to 3 hours for sex. It must be reinserted within those 3 hours, though, or you could be vulnerable to pregnancy. It can fall out, but it is not common. It is more common for it to fall out during tampon removal or sex than it is for it to be lost in the body, which is incredibly rare.

Although not endorsed by the manufacturer, some women decide to use the NuvaRing for 4 weeks instead of 3, skipping the withdrawal bleeding. This can be done occasionally to avoid bleeding during a certain occasion, or done more frequently. I did not do this, and my bleeding was light with no physical discomfort aside from extra breast tenderness. However, I always have had pleasant and happy periods until I took this contraceptive, so it could have been the reason why. I will say that since taking NuvaRing, my periods have never been the same—my breast size increases by quite a bit (I go from 32C to 36C), and experience some pain and sensitivity. This could also be age, but it doesn’t seem coincidental that these were my exact side effects on that birth control! This is an issue to consider with every hormonal birth control—how will it affect your body? Regardless, I’ve recommended NuvaRing to many women, and will continue to do so.

Next time, I will write about Ortho Evra, the birth control patch. If you have questions about NuvaRing that I did not answer here, please ask in the comments below or send me a message!