The Nuvaring is a form of hormonal contraceptive that is a ring shaped piece of flexible plastic. It is inserted into the vagina, and remains in place for three weeks, without being removed. During this time, it releases a low dose of two female hormones – oestrogen and progesterone. The chemicals released from the ring of plastic are both artificial versions of the hormones, and work in the same way as those found naturally in the body. After three weeks, the ring is removed, and a menstrual period will occur during the fourth week, when there is no ring in place. At the end of the fourth week, a new ring is inserted.
How does the Nuvaring work?
The hormones (oestrogen and progesterone) that are released by the ring are the same as those found in the combined contraceptive pill, and work in the same way. These hormones have two effects – they prevent eggs from being released by the ovaries (preventing the process of ovulation) and also make the cervical mucus thicker. The thicker layer of mucus across the cervix (found at the top of the vagina, at the entrance to the uterus) prevents the sperm cells from reaching any egg cells that may have been released, meaning that fertilization cannot happen.
As with any form of contraception, it needs to be used correctly if it is going to be effective at preventing pregnancy. If used as directed, the Nuvaring is over 99 percent effective. However, the risk of pregnancy is greater if the instructions are not followed precisely. In cases such as this, the effectiveness of Nuvaring is approximately 91 percent.
You should also be aware that some medications can make the Nuvaring less effective, and this also occurs with the contraceptive pill. If you have been taking antibiotic or antifungal medications, epilepsy drugs or HIV treatment, then it would be advisable to use an additional form of contraception, such as condoms. Speak to your doctor if you are concerned about the interactions.
What are the side effects of Nuvaring?
Nuvaring, just like any other medication, has a number of side effects that you should be aware of before you decide which form of contraceptive is the most appropriate for you. Many of the side effects are rare, and will not be experienced by the vast majority of women who use the Nuvaring, but they are worth bearing in mind.
- Changes in the levels of hormones can result in a number of different side effects. These can include bleeding between periods (while the ring is in place), breast tenderness and changes in vaginal secretions. There may be more discharge from the vagina than usual, and you may also experience irritation or infection of the area as a result.
- Any hormonal contraceptive changes the natural cycle that occurs in women, and this can alter sexual desire. This is a reasonably common side effect of hormonal contraceptives, but many women are embarrassed to talk about it, either with their partner or with their doctor. If you have noticed changes, then you should speak to your doctor, as Nuvaring may not be the most suitable contraceptive for you.
- Contraceptives containing oestrogen are generally considered to be more risky than those without this hormone. These side effects are extremely rare, but can be fatal if not spotted in time. They include increased risk of conditions such as heart attack, stroke and high blood pressure. It is also more likely that there will be blood clots forming in the veins, generally in the legs.
Is Nuvaring safe for me to use?
Nuvaring is generally considered safe for the majority of women. However, as it contains oestrogen, it may not be suitable for everyone, particularly if you have experienced certain medical conditions, either previously or now. The risk of serious side effects increases if you:
- Are aged over 35. This is the case for all hormonal contraceptives containing oestrogen, so your doctor may recommend that you switch to a progesterone-only method instead.
- Are overweight or obese. Again, progesterone-only contraceptives are safer, and your doctor is also likely to advise you to embark on a weight loss programme. After this, it is more likely that you will be able to use the Nuvaring, if this is your choice.
- Have certain inherited disorders that affect the clotting of the blood.
- Have high blood pressure.
Smoking is also a risk factor, and if you are a heavy smoker, it is likely that your doctor will be reluctant to prescribe oestrogen-containing contraceptives, including the Nuvaring.
There have, in the past, been claims that the Nuvaring leads to an increased risk of breast cancer. At present, there is no definitive link between the two, and research into this is still ongoing.
Is there anything else I should know?
It is possible for the ring to slip out of the vagina, and it is important to deal with this correctly in order to prevent pregnancy. If the ring does slip out, then you should wash it in lukewarm water (not hot water) and replace it as soon as possible. This should be within three hours to maintain the effectiveness of the contraceptive.
If you forget to remove the ring after three weeks, then what you need to do varies according to the length of time. If the ring has been in place for no more than four weeks, then you should simply continue as normal – remove it, leave a week where there is no ring in place, then insert a new one. Longer than four weeks means that you may have become pregnant accidentally. Remove the ring, and it would be advisable for you to take a pregnancy test. When you insert a new ring, use a back-up method of contraception (ideally, condoms) for the first week.