Does NuvaRing Stop Periods?
NuvaRing does not completely stop periods in most users, but it typically results in lighter, more regular withdrawal bleeding during the ring-free week, with approximately 98.8% of users experiencing some form of withdrawal bleeding. 1
Standard Bleeding Pattern with NuvaRing
NuvaRing follows a cyclic regimen where the ring is inserted for 3 consecutive weeks, followed by a 1-week ring-free period during which withdrawal bleeding typically occurs. 2 This withdrawal bleeding is not a true menstrual period but rather a response to hormone withdrawal.
Expected Bleeding Characteristics:
- Withdrawal bleeding occurs in 98.8% of cycles during the ring-free week 1
- Blood loss is typically reduced compared to natural menstruation 3
- Menstrual pain and length of bleeding are often decreased during NuvaRing use 4
- Irregular bleeding during the 3 weeks of ring use is uncommon, occurring in only 4.4% of cycles on average and consisting mainly of spotting 1
Extended Use for Amenorrhea
If the goal is to eliminate periods entirely, NuvaRing can be used continuously without the ring-free interval. 2 The American Academy of Pediatrics guidelines specifically note that the ring contains sufficient medication to be used for up to 35 days (rather than the labeled 28 days), allowing for extended or continuous use by replacing the ring once every calendar month. 2
Indications for Extended/Continuous Use:
Extended cycles may be particularly useful for treating: 2
- Anemia
- Severe dysmenorrhea
- Endometriosis
- Heavy menstrual bleeding
- Von Willebrand disease and other bleeding disorders
- Conditions that worsen cyclically (migraine without aura, epilepsy, irritable bowel syndrome)
The most common adverse effect of extended or continuous cycles is unscheduled breakthrough bleeding. 2
Important Caveats
Patients should be instructed to insert a new ring after 7 days even if bleeding has not ceased when using the standard cyclic regimen. 2 This is critical for maintaining contraceptive efficacy.
While NuvaRing provides excellent cycle control compared to combined oral contraceptives—with significantly fewer instances of irregular bleeding and more women experiencing an "ideal intended bleeding pattern" 1—complete amenorrhea with standard cyclic use is uncommon. For patients specifically seeking amenorrhea, continuous use without the ring-free interval is the appropriate strategy, though they should be counseled about the likelihood of unscheduled breakthrough bleeding. 2