NuvaRing

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What is the NuvaRing contraceptive ring?

NuvaRing is a small, flexible, plastic pessary device which contain two hormones – an oestrogen (ethinyl estradiol), and progestin (etonogestrel).

It is inserted inside the vagina to be used as a contraceptive device.

NuvaRing releases 15 micrograms of ethinyl estradiol and 120 micrograms of etonogestrel over the course of 24 hours. These two hormones prevent ovulation (the release of an egg cell from the ovaries) from occurring while also increasing the viscosity of the vaginal fluids, making it difficult for sperm to travel to the womb.

It has an outer diameter of 54 mm and a cross-sectional diameter of 4 mm. It is flexible and can be manipulated to make insertion and removal easier. The vaginal ring is made of transparent plastic and is safe whilst inside the vagina.

With correct use, NuvaRing is up to 98% effective at preventing unwanted pregnancies.

How does NuvaRing work?

NuvaRing releases 15 micrograms of ethinyl estradiol and 120 micrograms of etonogestrel over the course of 24 hours.

These two hormones prevent ovulation (the release of an egg cell from the ovaries) from occurring while also increasing the thickness of the vaginal fluid, making it difficult for sperm to travel to the womb.

The combined action of NuvaRing prevents you from becoming pregnant.

It’s important to note that the NuvaRing does not protect you against STD’s. Only condoms can protect you from sexually transmitted infections.

How do I use NuvaRing?

NuvaRing is inserted once a month, preferably at the beginning of your usual monthly menstrual cycle. It is removed after 3 weeks (21 days). This is followed by a 7-day ring-free break, during which time you should experience a menstrual bleed.

A new NuvaRing is inserted immediately after the 7 days.

How to safely insert NuvaRing

1. Wash your hand and ensure they are clean and dry.
2. Compress the ring between your thumb and index finger.
3. Find a suitable and comfortable position – by sitting, standing, or lying down.
4. Insert NuvaRing using one hand, the other hand can be used to spread the labia to make insertion easier.
5. Push NuvaRing in slowly until it is comfortable and not causing you irritation or discomfort.
6. You can adjust the position of the device until it is comfortable.
7. Keep NuvaRing inserted for 3 weeks.

How to safely remove NuvaRing

1. Wash your hands and ensure they are clean and dry before removing NuvaRing.
2. Use your index finger and hook the device, gently pull and remove.
3. You can use your index finger and middle finger to grip it and gently remove.
4. Dispose of NuvaRing by putting it in the foil package provided and throw away in the bin. Do not flush the device down the toilet.

The NuvaRing website offers an in-depth guide on how to insert and remove the ring safely.

Side effects and cautions of NuvaRing

There are always side effects from using hormonal devices or medications in general.

The full list of NuvaRing side effects and cautions can be found in the patient information leaflet supplied with the device.

You can read the patient information leaflet for NuvaRing online.

Some common NuvaRing side effects are listed below, although their incidence and likelihood are low, as NuvaRing is normally well tolerated.

Some NuvaRing side effects may include, but are not limited to:

• Headache
• Vaginal or cervical irritation
• Vaginal discharge
• Vaginal discomfort – can move the ring into a more comfortable position
• Breast enlargement and tenderness
• Decreased libido (sexual desire)
• Breakthrough bleeding or spotting – usually transient and diminishes after a few months
• Increased blood pressure and blood sugar levels. Make sure the levels are within range before using the NuvaRing.

This is not an exhaustive list of side effects. Further information regarding the safety of NuvaRing, including a complete list of side effects, can be found within the enclosed patient information leaflet.

If you experience any side effects to NuvaRing, regardless of whether they are listed above or in the patient information leaflet, speak to a doctor or pharmacist for advice.

NuvaRing and other medications

NuvaRing releases hormones into the bloodstream. This could cause negative interactions when using NuvaRing alongside other medications.

Inform our prescriber if you are taking any of the following medicines:

• Anti-epileptics – Carbamazepine, Phenytoin, Topiramate
• St John’s Wort
• Rifamycin antibiotics
• Antiretrovirals
• Phenindione.

Other cautions

Always seek your doctor’s advice before buying NuvaRing online.

Do not use NuvaRing past the expiry date printed on the packaging.

Never throw away medicine via household or water waste. Take any unused or expired medicine to your pharmacy for them to dispose safely on your behalf.

Always store medicines out of sight and reach from children and pets.

Frequently asked questions

Will NuvaRing dissolve?

NuvaRing does not dissolve. After using NuvaRing for 3 weeks, you will need to remove NuvaRing, take a 7-day break, then insert a new NuvaRing device for another 3 weeks.

How do I store NuvaRing?

NuvaRing should be stored below 25 °C (room temperature) and used within 4 months. Always check the expiration date on the packaging before using the device.

What does NuvaRing feel like when inserted?

Some women can feel it is there, but many women do not feel the NuvaRing once it is in position. If you feel discomfort, try re-positioning the NuvaRing until it is comfortable.

You or your partner may feel NuvaRing during intercourse.

Can the NuvaRing get lost inside you?

No, the NuvaRing cannot get lost inside you. The cervix prevents NuvaRing from going too far. If you know the device is inserted but cannot feel it with your fingers, speak to your doctor immediately.

What should I do if NuvaRing breaks?

If the ring breaks but stays in your vagina, the effectiveness should remain the same, and you do not need to use additional contraception.

If the ring breaks and falls out of your vagina, throw the broken ring into the bin and insert a new ring as soon as possible.

Do not flush the broken NuvaRing down the toilet.

What should I do if my NuvaRing falls out?

NuvaRing can fall out or be expelled from your vagina during intercourse or strenuous bowel movements.

If the ring has been out for less than 3 hours, rinse the ring in cool to lukewarm water, dry it and reinsert it as soon as possible.

If it has been 3 hours, but you are in the first or second week of treatment, rinse the ring in cool to warm water and reinsert as soon as possible.

If your NuvaRing has been out for 3 hours or more, but you are in the third week of treatment, you can either:

1.) Insert a new ring and continue the 21-day course. You may not have a period, but you may experience spotting or bleeding, OR;

2.) Insert a new ring in no later than 7 days – you should use another form of contraception such as condoms for a week in this case.

Can I use tampons with NuvaRing?

Yes. Insert the NuvaRing before inserting your tampon. Be careful when removing your tampon as it may cause your NuvaRing to fall out. If this happens, wash your NuvaRing in cool to lukewarm water and reinsert it as soon as possible.