NuvaRing ("the ring") is a flexible contraceptive ring about two inches in diameter used to prevent pregnancy. The ring is inserted into the vagina for three weeks. During that time, it will slowly release a low dose of hormones which will work to prevent pregnancy. When 21 days are completed, you remove the ring to allow your body to menstruate. After a seven-day break, you will insert a new ring to continue to be protected against pregnancy.
What is NuvaRing?
How does the ring work?
The ring contains two types of hormones, estrogen and progestin, which prevent pregnancy by suppressing ovulation (no egg is released) and thickening the cervical mucus (making it more difficult for sperm to enter the uterus). The hormone release from the ring is activated by contact with the inside of the vagina. The walls of your vagina absorb the hormones and distribute them into your bloodstream.
How effective is the ring in protecting against pregnancy and STIs?
Like other hormonal birth control methods, the ring is 99% effective in preventing pregnancy. In fact, there is less possibility of user error with the ring because you don't have to remember to take it on a daily basis. Therefore, it is assumed that the ring may be more effective than birth control pills for users who are not consistent pill takers. The ring does not provide protection against STIs.
What are the benefits of using the ring?
Hormonal birth control methods regulate the menstrual cycle, and this is especially helpful for if your periods come too often or too infrequently.
Reduced menstrual cramps
Hormonal birth control methods can offer significant relief to those with painful menstrual cramps. They also reduce the amount of blood flow during the period. Less blood loss is helpful in preventing anemia.
Research has shown that hormonal birth control methods can improve acne. Some users have a marked improvement, others less. If this is a concern for you, discuss it with your medical provider.
Other important benefits
The risk of developing benign breast cysts, ovarian cysts, pelvic inflammatory disease, and tubal pregnancy are reduced by taking hormonal birth control methods. Hormonal methods are also associated with a decreased risk of uterine cancer and ovarian cancer.
What are the side effects of the ring?
Like other hormonal contraceptives, using the ring is associated with increased risk of several serious side effects, including blood clots, which may lead to stroke or heart attack. Side effects include headaches, nausea, breast tenderness and breakthrough bleeding.
If you have any of the following conditions, you should talk to your medical provider about whether or not the ring is right for you;
Pregnancy or suspected pregnancy
Blood clots in your legs (thrombosis), lungs (pulmonary embolism), or eyes (now or in the past)
Chest pain (angina pectoris)
Heart attack or stroke
Severe high blood pressure
Diabetes with complications of the kidneys, eyes, nerves, or blood vessels
Headaches with neurological symptoms
Known or suspected breast cancer or cancer of the lining of the uterus, cervix, or vagina (now or in the past)
Unexplained vaginal bleeding
Yellowing of the whites of the eyes or of the skin (jaundice) during pregnancy or during past use of oral contraceptives (birth control pills)
Liver tumors or active liver disease
Disease of the heart valves with complications
An allergic reaction to any of the components of NuvaRing
How do I know if I know if I have the ring in correctly?
To insert the ring, squeeze it between your thumb and index finger, and gently insert it into your vagina. The ring will conform to fit your body. You should not be able to feel the ring inside your vagina. If you do, simply slide the contraceptive ring farther into your vagina. The exact position is not important for the ring to work and the muscles of your vagina should keep the ring in place. To remove the ring, put your finger into your vagina, hook your finger around the ring, and pull it out.
What if the ring slips out?
In the rare instance that the ring does slip out follow the directions below:
Out for less than three hours: You should still be protected from pregnancy. Rinse the ring with cool-to-lukewarm (not hot) water and re-insert it as soon as possible, at the latest within three hours. If you've lost the ring you must insert a new contraceptive ring and stay on the same schedule you would have followed if you were still using the lost ring.
Out for more than three hours: If the ring has been out of your vagina for more than three hours, you may not be adequately protected against pregnancy. The ring should be rinsed in cool-to-lukewarm (not hot) water and re-inserted as soon as possible. You must use an extra method of birth control, such as male or female condoms, until the re-inserted contraceptive ring has been in place for seven consecutive days. If you have had unprotected sex during that time, call your medical provider to discuss whether you should consider emergency contraception. Brown students can call Health Services at 401.863-1330.
Will my sexual partner(s) feel the ring?
Depending on what type of sexual activity you are engaging in, your sexual partner(s) may or may not feel the ring. According to the manufacturer, 8 out of 10 partners report that they do not feel the ring during penile-vaginal penetrative sex. During sexual activity with finger insertion, there is a chance your partner may feel the ring. Although the muscles in the vagina hold the ring in place, it's recommended that you check to make sure the ring is still in place after sexual activity.
Where can I get the ring?
For you to receive a prescription for the ring, your medical provider will need to see you for a visit to take your medical history and perform an exam that may include a gynecological examination and Pap smear if you are 21 or older. If you have had such an exam within the last 12 months, you may not have to repeat it, but your medical provider will want to get a copy of the results. After you begin the ring, you will need to return for a brief appointment a few months later to see how you are doing and to check your blood pressure.
If you have never had a gynecological exam, call Health Services, at 401.863-3953, to schedule an appointment. Let our staff know this is your first exam. The medical providers are very sensitive to and supportive of patients having their first exams. The only charges during your visit will be for lab testing. You can choose to pay for any of our services directly if you don't want charges to appear on insurance bill or the Bursar's bill.
You can have your prescription filled at the Health Services pharmacy or at a local pharmacy. Some insurance plans cover the Nuvaring, some don't. Without insurance, the Nuvaring costs $186 per ring (a one month supply). If you use your insurance, co-pays will vary by carrier. If you have Brown's student health insurance, there is no co-pay for contraceptives, including the Nuvaring.
Click here for the current Health Services pharmacy schedule. You can call the pharmacy at 401.863-7882.