NuvaRing

NuvaRing is a brand of combined hormonal contraceptive that prevents the user from becoming pregnant. Similar to combined contraceptive pills like Eloine and Yasmin, and the contraceptive patch Evra, it releases oestrogen and progestin to prevent pregnancy. However, Nuvaring differs in that it is not taken orally, but inserted into the vagina.

Contraceptive vaginal rings are one of the simplest forms of hormonal contraceptives to use. Once inserted, you leave the ring in the vagina for 21 days, before removing it for the following 7 days.

Manufactured by Organon Pharmaceuticals, it was first approved for use in Europe in February 2001 and has since become one of the most reliable and easy-to-use forms of contraception.

Clinical trials show that the NuvaRing is over 99% effective with perfect use and about 92% effective with typical use.

A year-long study recorded 0.65 pregnancies per 100 women, equating to fewer than 1 pregnancy per 100 women.

This medication is not suitable for everyone. When you complete a consultation, our UK-registered doctors will determine whether NuvaRing is safe for you.

Who can use it?

To be prescribed the NuvaRing, you must be a woman over 18 years of age.

Who cannot use it?

Do not use NuvaRing if you:

• Smoke cigarettes and are over 35 years old
• Have ever had a blood clot in your legs
• Have a disorder affecting blood clotting (e.g. protein C deficiency)
• Are scheduled for surgery
• Have ever had a heart attack or stroke
• Have ever had angina pectoris (severe chest pain caused by a lack of oxygenated blood) or transient ischaemic attack (temporary stroke symptoms)
• Have a disease that increases the risk of a clot in the arteries (e.g. very high blood pressure)
• Have ever experienced migraine with aura
• Have had pancreatitis (inflammation of the pancreas)
• Have had severe liver disease
• Have had a tumour in the liver
• Have had cancer of the breast or genitals
• Have had unexplained vaginal bleeding

Cautions

Hormonal contraceptives like the NuvaRing can slightly increase the risk of blood clotting. Blood clots are rare (about 1 in 1,000), but they can cause serious health complications. If you notice any of the following symptoms, seek immediate medical help:

• Leg pain - swelling, tenderness, throbbing, or cramping in the leg.
• Chest pain - sharp or crushing chest pain.
• Shortness of breath - sudden and unexplained breathlessness.
• Coughing - a harsh cough that brings up blood.

Certain factors increase your risk of having a blood clot, including:

• Age (over 35 years old)
• Smoking
• Being overweight
• High blood pressure
• Immediate family who have had a heart attack or stroke at a young age
• Immediate family with high levels of fat in the blood
• Suffering from migraines (with aura)
• Diabetes

For a complete list of precautions, refer to the patient information leaflet.

Please disclose your health status during your online consultation with euroClinix. Our doctors will evaluate whether treatment is suitable for you and may adjust your medications if needed.

Inserting your NuvaRing correctly ensures effectiveness and lowers the possibility of contraceptive failure. Before you insert it, wash your hands with soap and water and check your ring is within the expiration date.

After you have done this, follow these steps to safely insert your NuvaRing:

How to apply NuvaRing

	1. Get into a position where you can comfortably insert the ring into the vagina
	2. Take the ring out of its sachet and compress it between your thumb and index finger
	3. Insert it into the vagina with one hand, using your other hand to spread the labia if necessary
	4. Insert it high enough for you to no longer feel it. The exact position is not important, as long as it is comfortable.
	5. Leave it in place for 3 weeks

Removing the ring

After 3 weeks, remove the ring and leave it out for a week. Follow these steps on how to do so:

1. Hook your index finger around the firm plastic of the ring 2. Carefully pull out the ring 3. Dispose of the ring via household waste

Remember: 3 weeks in, 1 week out. Try to remove the ring at the same time of day as you inserted it.

When should I insert it?

Insert the ring on the first day of your period. If you do this, it will be effective immediately.

If you insert it on days 2-5 of your period, use a barrier contraceptive, like condoms, for at least 7 days for reliable protection from pregnancy.

Your doctor’s advice will be different if starting after childbirth, or when switching between contraceptives.

What if it falls out?

If your ring falls out, rinse it in cool water, wash your hands, and put it back in right away.

If it has been less than 3 hours since it has fallen out, it should still be just as effective.

If it has been longer than 3 hours, your NuvaRing may not be as effective and should be replaced. In this case, use a backup method of contraception alongside the NuvaRing for at least 7 days (no female barrier methods).

If you need to use a new ring, make sure you stay on the same schedule. For example, if you were 12 days into your 3 weeks, keep the new ring in for 9 days before taking it out.

Your NuvaRing is more likely to fall out:

• When you take out a tampon
• When you go to the toilet
• During sex

What if I forget to put it in?

If you forget to insert your NuvaRing, insert it as soon as possible and use an additional method of contraception for the next 7 days. If you had sex while the ring was supposed to be inserted but wasn’t, there is a chance you could be pregnant. If you suspect you may be pregnant, take a pregnancy test to be sure.

Do not use female barrier contraceptives, such as female condoms, as these can interfere with the position of the NuvaRing.

If inserted within 5 days of the start of your period, the NuvaRing is effective straight away.

If inserted after this time, it may not be effective for up to 7 days, and you will have to use an additional form of contraception, like condoms.

To ensure effectiveness, you should make some changes to your lifestyle during treatment.

Lifestyle guide for NuvaRing users

Maintain a healthy diet

• Reduce sodium intake to help with water retention and bloating.
• Stay hydrated to promote vaginal health and minimise fluid retention.
• Maintain a diet rich in fibre, protein, and healthy fats to promote hormonal balance.

Stay active

• Engage in regular physical activity to maintain cardiovascular health.
• Move regularly to improve blood flow.
• Combine cardio and weight training to help regulate hormones.

Avoid oil-based lubricants

• Oil-based lubricants can weaken the ring's integrity or cause it to slip out.
• Try a water-based lubricant instead.

Practice safe sex

• NuvaRing does not protect against STIs. Use condoms if at risk.
• Regularly test for STIs to ensure reproductive health.
• Do not use female barrier methods of contraception, such as diaphragms or female condoms, as these can dislodge your NuvaRing.

Maintain proper hygiene

• Wash your hands with soap and water before inserting or removing the ring.
• If the ring falls out, rinse it in cool or lukewarm water before reinserting it.
• Do not use hot water or harsh soaps, as these can damage the ring's material.

Staying hydrated and eating omega 3-rich foods is key to maintaining vaginal health while using NuvaRing. Aim for at least 8 glasses of water daily and include foods such as salmon, linseeds, and walnuts to support natural lubrication and reduce irritation.

Silvia Fonda Nutritionist

Like all prescription medications, NuvaRing can cause side effects.

Most are mild and should subside shortly.
Tell your doctor about any side effects you experience, including the following.

Common side effects

These side effects may affect up to 1 in 10 people:

• Abdominal pain; feeling sick (nausea)
• Vaginal yeast infection (such as thrush)
• Headache or migraine
• Depressive mood
• Lower sex drive (libido)
• Breast pain; pelvic pain; painful menstrual periods
• Acne
• Weight gain

Uncommon side effects

These side effects may affect up to 1 in 100 people:

• Visual disturbances; dizziness
• Swollen abdomen; vomiting, diarrhoea or constipation
• Feeling tired, unwell, or irritable
• Fluid retention (oedema)
• Bladder or urinary tract infection
• Difficulty or pain passing urine; passing urine more often
• Pain, bleeding or discomfort during intercourse
• Increased blood pressure
• Increased appetite
• Back pain; muscle spasms; pain in legs or arms
• Less sensitive skin
• Sore or larger breasts
• Inflammation of the cervix
• Changes to menstrual periods
• Vaginal infection
• Hair loss, eczema, itching, rash or hot flushes
• Hives

Rare side effects

These side effects may affect up to 1 in 1,000 people:

• Blood clots in the leg, foot, lung, or liver, which can cause:
• Heart attack
• Stroke
• Mini-stroke

How to manage side effects

Some side effects, like headache and nausea, can be effectively managed by drinking plenty of water, resting enough, and eating a healthy and nutritious diet.

If side effects are persistent or get worse with time, consult your doctor for personalised advice on how to manage them. They may adjust your medications.

Hormonal birth control affects everyone differently, and mood changes can be one of the most noticeable side effects. If you're experiencing low mood, anxiety, or mood swings, track your symptoms and discuss them with your doctor. Sometimes, switching to an alternative contraceptive can mitigate these side effects.

Dr. Caroline Fontana Lead Prescribing Doctor

For more detailed information on side effects, please refer to the patient information leaflet.

The following medicines affect how the liver processes drugs and may reduce NuvaRing’s effectiveness or increase side effects.

Tell your doctor about all medicines you take, including:

• Antiepileptics (e.g., phenytoin, carbamazepine)
• Antibiotics (e.g., rifampicin)
• Antifungals (e.g., griseofulvin)
• HIV medicines (e.g., ritonavir)
• HCV medicines (e.g., boceprevir)
• Pulmonary hypertension medicine (e.g., bosentan)
• Blood pressure medicine (e.g., diltiazem)
• Herbal preparations containing St. John’s Wort

This list does not cover all possible interactions. For a comprehensive list, please check the NuvaRing interactions on the BNF website.

Follow these guidelines when storing your rings:

• Store below 30°C in the original packaging
• Keep away from direct light and moisture
• Keep this medicine out of the sight and reach of children
• Do not use after the expiry date

Disposal

• Dispose of your used ring via normal household waste inside the reclosable sachet.
• Take any unused rings to your local pharmacy if you wish to dispose of them.
• Do not flush NuvaRings down the toilet

No, you cannot buy NuvaRing over the counter. This medication can only be obtained with a prescription from a licensed healthcare provider.

Prescriptions are necessary because they:

• Ensure appropriate use for your specific condition.
• Prevent potential misuse and associated health risks.
• Allow for monitoring of side effects and interactions with other medications.

Ordering NuvaRing online from euroClinix is convenient.

Follow these simple steps:

• Complete a quick online consultation to check your eligibility.
• UK-registered doctors review your responses to ensure the medication is right for you.
• Upon approval, an e-prescription will be issued.
• Enjoy free delivery from our licensed pharmacy with tracking details.

Your privacy is our top priority. euroClinix uses secure, encrypted transactions and complies with UK medical standards to keep your information confidential.

Start your online consultation today to enjoy professional care from the comfort of your home.

euroClinix is trusted by thousands of users in the UK for its safe and convenient service. Here’s why:

• Experienced doctors manage your consultations and prescriptions.
• Online consultations, swift approvals, and discreet doorstep delivery make ordering quick and convenient.
• A supportive team is on hand to answer treatment-related questions or concerns.
• Patients can manage their prescriptions hassle-free through our secure platform.

Join thousands who trust euroClinix for their healthcare needs and take control of your health today.

At euroClinix, the NuvaRing costs *insert price here*.

The price of Nuvaring at euroClinix includes everything you need:

• Free online consultation with our experienced doctors
• Free prescription, if approved
• Free delivery straight to your door

Our pricing is transparent, with no hidden fees. Order today and benefit from our complete, all-inclusive service.

There are many types of contraception available if NuvaRing is not suitable for you.