NuvaRing

The NuvaRing® is one of the newest ways for women to get the combination of hormones that have long been available in birth control pills.

nuvaring

WHAT IS IT?
The NuvaRing® is a clear, soft, flexible plastic ring with a diameter of 2 inches. The ring is inserted into the vagina where it remains for three weeks. The ring is infused with the female hormones estrogen and progestin and has microscopic holes through which the hormones are released over time. The hormones are absorbed into the rest of the body by the vaginal walls. These hormones stop the process of ovulation (the release of the egg). Without ovulation, a woman cannot become pregnant.

WHERE CAN I GET IT?
The NuvaRing® requires a prescription. Women who are interested in using this method should contact their doctor or reproductive health clinic. Most clinicians require that a woman have a full physical exam (including a pelvic exam and a Pap test) before starting on the NuvaRing®.

HOW DO I USE IT?
The health care provider who prescribed the NuvaRing® will give the woman specific instructions on how to begin using it. On the designated start day, the woman should remove the ring from the package, fold it, and insert it into her vagina. When the ring is properly in place, she should not be able to feel it. Depending on her comfort, she can either push inside her vagina until it reaches the cervix or leave it inside the vaginal canal. The ring will need to stay in place for three weeks (21 days). After 21 days have passed, the woman will need to insert a finger into her vagina and remove the ring. She should be ring-free for the next 7 days. At some point during her ring-free week, she should expect to have a period. After seven days without a ring, she should open a new package and begin the cycle over again.

The ring should not interfere with intercourse. If it is open at the top of the vagina around the cervix, the penis will never encounter it. If it is lying flat within the vagina, the penis should move over it during intercourse.
If the ring becomes dislodged, it can be rinsed (if necessary) and reinserted.

WHAT ARE THE POSSIBLE SIDE EFFECTS?
According to the manufacturer, the NuvaRing® has the lowest occurrence of unpleasant side effects of all the hormone methods. Side effects of the ring are similar to those of the birth control pill and other hormonal contraceptives and include:

o Periods that are lighter, shorter, more regular, and less uncomfortable
o Headaches
o Nausea (upset stomach)
o Breakthrough bleeding
o Breast tenderness
o Moodiness
o Appetite changes
o Weight gain (though some women do lose weight)

Generally, these side effects are mild and may go away after the first few months of ring use.

It is important for women to know that there are some potentially serious side effects that can occur as a result of using this method, like heart attack, stroke, and blood clots. These side effects are rare, and are more likely to occur in women who are over 35 years old and who smoke 20 (a pack) or more cigarettes a day. Although these side effects are rare, it is important for all women to be aware of the symptoms:

o Pain or swelling in the legs
o Vision problems (like blurriness)
o Sudden pain in the abdomen/chest/arm
o Worsening of depression
o Jaundice (yellowing of the skin or eyes)

If a woman has been using the ring and she notices any of these things, she should contact her health care provider immediately.

HOW WELL DOES IT WORK?
Perfectly used, the NuvaRing® is well over 99% effective in the prevention of pregnancy. User error can decrease the effectiveness, but since this method can be left in place for three weeks at a time, there is less opportunity to make mistakes using it. In order for this method to be most effective, it must be used exactly as directed. This method does not provide any protection against Sexually Transmitted Infections or HIV.

WHAT ARE SOME OF THE ADVANTAGES AND DISADVANTAGES OF THE METHOD?
Advantages:
o According to the manufacturer, this method has the lowest occurrence of negative side effects of all the hormone methods
o Only has to be remembered every three weeks

Disadvantages:
o Women who are not comfortable touching their vaginas may have a hard time using the method correctly

HOW MUCH DOES IT COST?
The cost of the exam that may be required before a woman starts on the NuvaRing® varies by provider. Some women may be able to get their exams for free, while others pay $20 to $150 or more, depending on their insurance coverage, if any.

The exact price of the NuvaRing® will vary by location. In general, a woman who obtains the ring from her pharmacy should expect to pay $30-$45 per ring, which will last for 28 days. If a woman obtains the ring from another source, like a reproductive health clinic, the price may be lower. Some insurance companies will cover the NuvaRing® , and some will not.