From the Guidelines
NuvaRing should be inserted vaginally and left in place for 3 weeks (21 days), followed by a 1-week ring-free period before inserting a new ring, releasing a daily dose of 0.120 mg etonogestrel and 0.015 mg ethinyl estradiol. To begin using NuvaRing, insert the first ring during the first 5 days of your menstrual cycle; no backup contraception is needed if started within this window 1. If starting after day 5, use backup contraception (like condoms) for the first 7 days. For continuous contraception without a period, you can remove the ring after 3 weeks and immediately insert a new one without a ring-free week. The ring should remain in place during intercourse, but if it's accidentally expelled, rinse it with cool water and reinsert within 3 hours to maintain effectiveness 1. If the ring is out for more than 3 hours during the 3-week period, use backup contraception until the ring has been in place for 7 consecutive days. Some key points to consider when using NuvaRing include:
- The ring releases a combination of estrogen and progestin, and has the same eligibility criteria for use as combined oral contraceptives (COCs) 1
- The ring is an excellent method for extended use, and can be replaced once every calendar month 1
- Sexually active patients may be reassured to know that most men were not bothered by its presence, if it was noted at all 1 NuvaRing works by releasing hormones that prevent ovulation, thicken cervical mucus to block sperm, and thin the uterine lining to prevent implantation. It's also important to note that combined hormonal contraceptives, including NuvaRing, do not protect against STDs; consistent and correct use of male latex condoms reduces the risk for STDs, including HIV 1.
From the FDA Drug Label
When placed in the vagina, each ring releases on average 0.120 mg/day of etonogestrel and 0.015 mg/day of ethinyl estradiol over a three-week period of use. NUVARING® (etonogestrel/ethinyl estradiol vaginal ring)delivers 0.120 mg/0.015 mg per day
The dosing for NuvaRing is 0.120 mg/day of etonogestrel and 0.015 mg/day of ethinyl estradiol over a three-week period of use 2 2.
- The ring releases a consistent amount of hormones per day.
- The total content of the ring is 11.7 mg etonogestrel and 2.7 mg ethinyl estradiol 2.
From the Research
NuvaRing Dosing Information
- The NuvaRing is a combined contraceptive vaginal ring that releases 15 microg of ethinylestradiol and 120 microg of etonogestrel per day 3, 4, 5.
- Each ring is designed for a single 3-week use, followed by a 1-week ring-free period 3, 5, 6.
- The ring works by inhibiting ovulation, and its use has been shown to be effective in preventing pregnancy, with a Pearl Index of 0.65 3, 5.
- The dosing regimen for NuvaRing is as follows:
Key Points to Consider
- NuvaRing has been shown to be a highly effective and well-tolerated method of hormonal contraception 3, 4, 5.
- Commonly reported adverse events include vaginitis, leukorrhea, headaches, and device-related events such as discomfort 3, 6.
- Serious adverse events are rare 6.
- NuvaRing is a reversible method of contraception, and ovulation is prevented at least until the stage of a 13 mm dominant follicle 7.