What Is the NuvaRing? The NuvaRing is a flexible ring that is about two inches in diameter. It contains hormones similar to the natural hormones in a woman’s body (estrogen and progestin). These hormones are also used in the Pill. The hormones in the NuvaRing stop the release of an egg from the ovaries; it also changes the mucus produced by the cervix, which slows the movement of sperm. Does It Work? • With perfect use, the NuvaRing is 99% effective. This means that in a year, 1 in
every 100 women gets pregnant using the NuvaRing.
• With typical use, the NuvaRing is 92% effective. This means that in a year, 8 women
in every 100 get pregnant using the NuvaRing.
How Is It Used? • The NuvaRing is inserted into the vagina and remains in place for 21 days. The
vaginal wall absorbs the hormones and distributes them in the bloodstream.
• The NuvaRing should be inserted during the first five days of a period or within the
• To insert the NuvaRing find a comfortable position. Some women find it helpful to
lie down, squat or stand with one knee bent and one leg raised. Hold the NuvaRing between your thumb and index finger and press the sides together. Gently push the folded ring into your Vagina Note: The exact position of the NuvaRing is not important; the vagina wall muscles should keep the NuvaRing securely in place. Once inserted, keep it in place for three weeks (21 days).
• After three weeks, the ring is removed for seven days, during which time you should
• After seven days you insert a new ring and begin again. You will always insert a new
NuvaRing on the same day of the week as you inserted the last one and at about the same time. For example, if you inserted your first Nuva Ring at 7:00pm on a Wednesday you should insert your next one at 7:00pm on a Wednesday.
• To remove the NuvaRing, hook a finger under the rim or squeeze the rim between
your fingers and pull out. Discard in the garbage. Do not throw it in the toilet.
• You are not protected from pregnancy during the first month you use the NuvaRing. You will need to use back up contraception such as condoms and spermacide during this time. Once you insert your second NuvaRing you will be protected from pregnancy.
• Unused NuvaRings should be stored in the refrigerator. They will not be effective if
Can the NuvaRing Fall Out? • The NuvaRing is unlikely to fall out. Your vaginal muscles will keep it in place. It
can sometimes fall out if it is not inserted properly, when you remove a tampon, during intercourse or when you have a bowel movement. If the NuvaRing does slip out, wash it in cool water (not hot) and reinsert it as soon as you can.
• If it is replaced within 3 hours you should still be protected from pregnancy. • If the NuvaRing is out for longer than 3 hours, insert it as soon as you notice.
Assume that for the rest of the month you can get pregnant and use back up contraception such as condoms and spermacide.
• If you are late inserting your NuvaRing after your seven-day break, insert it as soon
as you remember. However, because you can ovulate if you are even one day late in inserting your NuvaRing, use back up contraception such as condoms and spermicide for the rest of that month.
• If you forget to remove your NuvaRing after 21days, remove it as soon as you
remember. You will start your period as your normally would, however DO NOT wait 7 days before inserting a new NuvaRing. Insert a new one on the day that you inserted the ring before. For example, if you insert your NuvaRing on a Wednesday and you forgot to remove it until Friday, you will still insert a new one the following Wednesday.
What Are The Advantages? • Convenient and easy to remember. • Private. • It may help lessen menstrual cramps. • It makes periods more regular and lighter. • It lowers the chance of some kinds of cancer. How Will I feel On the NuvaRing? • You will probably feel the same. • Your period may be lighter or shorter. • You may have spotting for the first 1 to 3 months, but this happens less with the
o nausea (upset stomach) o mild headaches o sore breasts o mood swings o weight gain of 1 to 2 kilograms (3-5 pounds)
• If you experience these side effects for a prolonged period of time, talk to your
Things To Think About: • Most women don’t feel the NuvaRing once it is in place. If it is uncomfortable when
you first insert it, the ring may not be inserted far enough into the vagina try pushing it up higher. Even if women are aware of it, most find that it does not bother them.
• About 68% of men will NOT be aware of the NuvaRing during intercourse. It is
important that you keep it in place during sex. For those men who do feel it, less than 10% found that it bothered them.
• The NuvaRing cannot get lost inside you. It can only be inserted as far as the cervix
(the opening of the uterus) as the cervix will prevent it from going any further.
• Some women should not use the NuvaRing, especially those with high blood
pressure, liver disease, severe headaches, breast cancer and circulation problems. Check with your doctor.
• Severe side effects and risks are very rare. Watch for these Danger Signs:
o Abdominal pain (severe) o Chest Pain (severe), cough, shortness of breath o Headache (severe), dizziness, weakness and numbness o Eye Problems (vision loss or blurring), speech problems o Severe leg pain (calf or thigh)
If you experience any of these call your doctor or clinic right away.
• Risks increase in your 30’s especially if you smoke. Women who are over 35 and
Sexual Decision Making: • You have the right to choose to have or not have sexual intercourse. • If you choose to have sex you may want to think about the risk of STD’s. The
NuvaRing does not protect against STD’s, including HIV/AIDS. One of the best methods is to use a condom when having sexual intercourse.
• It can be helpful to talk to your partner about these choices before you have sex. • It is also important to get a yearly pap test to check for cervical cancer, especially if
Medications and the NuvaRing: Some medications can interfere with the NuvaRing. A list is given on the back of this page. If you are uncertain about whether a medication will interfere with the NuvaRing ask a pharmacist or use a condom until you get your period. For More Information Call: The Birth Control Centre www.cwhn.ca
Society of Obstetricians and Gynecologists of Canada
THE FOLLOWING MEDICATIONS MAY INTERFERE WITH THE
Seizure Medications Phenobarbital, Luminal, Carbanazebine, Tegertol, Esthosuximide, Zarotin, Phenytoin, Dilantin, Pimidone, Mysoline Sleeping Pills Barbituates, Secobaritol, Seconal, Tuinal, Pentobarbital, Nembutal, Anobarbital, Amytal, Chlorahydrate, Equanal, Miltown Antibiotics Ampicillin, Ampicin, Penbriten, Penicillin, Bicillin, Crystapen, Griseofulvin, Chloramphenicol, Metronidazole, Flagyl, Neomycin, Neo-Medrol, Neo-Decadron, Nitrofurantoin, Sulfonimides, Gantanol, Sulfadits, Dragenan, Novosoxizoli, Tetracycline, Rifampicin To Prevent Swelling Phenylbutazone, Butazoloidine, Phenbuff Antihistamines, Cold or Allergy Pills/Liquid Benadryl, Insommol, Atarax, Chlortripolon, Actified, Antistine, Claritin, Contact C, Cold FX, Corsym, Dimetane, Dametapp, Drixoral, Hismonal, Histaspan, Ornade, Multipax, Optime, Pancetyl, Periactin, Phenesgen, Seldane, Sinutab, Tavist, Trinalin, Umicon, Neocitron, Reactin, Herbal Remedies Anything that speeds up your metabolism may affect the absorption of your pill for example: Hydroxycut, Xendrine, and Ephedrine; any herbal or natural cleanses. Also: Antimigrane products, Vitamin E Always check with your doctor, pharmacist, or herbalist when taking a medication in addition the NuvaRing. If you are ever unsure of the effect of another medication, use a back-up method of contraception.
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Understanding NICE guidance Information for people who use NHS services Drug treatments for neuropathic pain This booklet is about the care and treatment of people with neuropathicpain in the NHS in England and Wales. It explains guidance (advice) fromNICE (the National Institute for Health and Clinical Excellence). It is writtenfor people with neuropathic pain but it may also be usef