Generic name: Etonogestrel and Ethinyl estradiol vaginal ring
What is NuvaRing?
NuvaRing is a small, flexible ring that is inserted into the vagina to prevent pregnancy.
The ring contains two hormones, etonogestrel and ethinyl estradiol, which are released
into the body over a three-week period. The ring must be removed for one week to allow
for a menstrual period. It can then be reinserted for another three weeks of use.
Health Benefits
NuvaRing is more than 99% effective at preventing pregnancy. It works by releasing hormones
that prevent ovulation (the release of an egg from the ovary). NuvaRing also thickens the
mucus around the cervix, which makes it difficult for sperm to enter the uterus and fertilize
an egg.
NuvaRing may also offer some non-contraceptive health benefits. For example, it can help
to regulate menstrual cycles, reduce period pain and premenstrual symptoms, and protect
against pelvic inflammatory disease and ectopic pregnancy. Additionally, NuvaRing does not
interfere with lactation and can be used safely by nursing mothers.
Side Effects
The most common side effects associated with NuvaRing are mild and include nausea,
headache, dizziness, vaginal discharge and irritation. These side effects usually go away
within a few days to weeks of starting treatment. Serious side effects are rare but can
include blood clots, heart attack, stroke and cancer. If you experience any severe side
effects after starting NuvaRing, stop using the ring and speak with your doctor right away.
Dosage and Administration
NuvaRing is a once-a-month contraceptive that is inserted into the vagina and left in place
for three weeks. It must then be removed for one week to allow for a menstrual period. The
ring can then be reinserted for another three weeks of use.
If you are using NuvaRing for the first time, insert the ring on the first day of your menstrual
period or on the first Sunday after your period begins. If you have already been using another
form of birth control, you can switch to NuvaRing at any time. Just be sure to remove your old
method of contraception before inserting NuvaRing.
Interactions
NuvaRing may interact with certain medications, including antibiotics, antifungals,
HIV/AIDS medications, barbiturates and Hepatitis C medications. To avoid interactions,
tell your doctor about all other medications you are taking before starting NuvaRing. You
should also not use NuvaRing if you are pregnant or breastfeeding.
Pregnancy and NuvaRing
NuvaRing is not recommended for use during pregnancy. If you become pregnant while using
NuvaRing, stop using the ring and speak with your doctor right away. NuvaRing may
increase the risk of serious birth defects if used during early pregnancy. Additionally,
NuvaRing may be harmful to a developing fetus if used during the later stages of pregnancy.
If you are trying to conceive, you should stop using NuvaRing and speak with your doctor.
It may take up to one year for fertility to return after stopping contraception. Therefore, it
is important to use another form of birth control during this time.
Mechanism of Action
NuvaRing works by releasing the hormones etonogestrel and ethinyl estradiol into the body
over a three-week period. These hormones prevent ovulation (the release of an egg from the
ovary) and thicken the mucus around the cervix, which makes it difficult for sperm to enter
the uterus and fertilize an egg. NuvaRing is more than 99% effective at preventing pregnancy.
Pharmacokinetics
After insertion, NuvaRing slowly releases etonogestrel and ethinyl estradiol into the body
over a three-week period. Peak levels of these hormones are reached after about 24 hours.
NuvaRing is then removed for one week to allow for a menstrual period. The ring can then be
reinserted for another three weeks of use.
Etonogestrel and ethinyl estradiol are both rapidly metabolized in the liver. They are
excreted in the urine and feces as metabolites. The half-life of etonogestrel is about 30 hours
and the half-life of ethinyl estradiol is about 48 hours.
