Does NuvaRing Contain Estrogen?
Yes, NuvaRing contains estrogen—specifically, it releases 15 μg of ethinyl estradiol daily along with 120 μg of etonogestrel (a progestin). 1, 2
Composition Details
NuvaRing is a combined hormonal contraceptive vaginal ring that releases both an estrogen and a progestin component, making it pharmacologically equivalent to combined oral contraceptives (COCs) in terms of hormonal content. 1
The specific hormones released are:
Clinical Implications
Because NuvaRing contains estrogen, it has the same eligibility criteria, contraindications, and risks as combined oral contraceptives. 1
Key considerations include:
Contraindications: NuvaRing should not be used in patients with severe uncontrolled hypertension, current or history of thromboembolism or thrombophilia, migraines with aura or focal neurologic symptoms, complicated valvular heart disease, or ongoing hepatic dysfunction. 1
Thrombotic risk: The estrogen component increases the risk of venous thromboembolism from 1 per 10,000 to 3-4 per 10,000 woman-years, similar to other combined hormonal contraceptives. 5
Estrogen exposure: Despite containing estrogen, NuvaRing delivers approximately half the systemic estrogen exposure compared to a 30 μg ethinyl estradiol oral contraceptive pill due to vaginal absorption avoiding hepatic first-pass metabolism. 4
Common Pitfall to Avoid
Do not assume NuvaRing is progestin-only because it is a vaginal ring. 1 The vaginal ring formulation contains both estrogen and progestin, making it a combined hormonal method with all the associated benefits and risks of estrogen-containing contraceptives. 1