NUVARING CONTRACEPTIVE DEVICE

Student Information Sheet

What is the NuvaRing Device?   NuvaRing is a flexible ring that when placed in the vagina releases estrogen and progesterone over a three week period to prevent pregnancy.

How does NuvaRing work?  Like birth control pills, NuvaRing delivers estrogen and progesterone into the blood stream.  These hormones, when delivered together, prevent ovulation.  They also thicken the mucous in the cervix which inhibits entry of sperm into the cervix and interfere with the build up of the uterine lining to prevent implantation of an egg.

How effective is the NuvaRing at preventing pregnancy?  When NuvaRing is used correctly, it is very effective at preventing pregnancy.  Like birth control pills, NuvaRing is approximately 97-99% effective.

Can NuvaRing protect me from getting a sexually transmitted disease?  No, NuvaRing DOES NOT protect you from sexually transmitted disease including AIDS.  Health services recommends using a condom, in addition to the ring, to decrease your chances of contracting a sexually transmitted disease.

What are the side effects of the NuvaRing?  The most common side effects of the NuvaRing are similar to those of the birth control pill and include: breast tenderness, nausea, headache, irregular vaginal bleeding and mood changes.  NuvaRing can also cause vaginal infections and irritation and vaginal discharge.  While these symptoms can be associated with NuvaRing,  if they persist or become bothersome you should notify your healthcare provider.

Are there any serious risks associated with the NuvaRing?  Yes, there are serious risks that are associated with the NuvaRing.   These risks, though rare, can be life threatening and include: blood clots, stroke or heart attacks.  Cigarette smoking has been linked to an even greater risk of these conditions and therefore women who use NuvaRing are strongly advised NOT to smoke.  Women who are over the age of 35 and smoke cigarettes SHOULD NOT use NuvaRing.

Women with the following medical conditions should not use NuvaRing:

·        Blood clotting disorders or history of blood clots such as deep vein thrombosis

·        Current or past history of heart disease or blockage of blood vessels

·        Severe high blood pressure


·        Diabetes with blood vessel complications

·        Headache with accompanying neurological symptoms

·        Recent surgery or other conditions requiring prolonged bedrest

·        Known or suspected cancer of the breast or personal history of breast cancer

·        Undiagnosed abnormal uterine or vaginal bleeding

·        History of jaundice (yellow pigmentation of the skin) during pregnancy or with prior hormonal contraceptive use

·        Acute or chronic liver disease with abnormal liver function

·        Liver tumors or cancer

·        Known or suspected pregnancy

How do I use the NuvaRing?  For the best protection from pregnancy, use NuvaRing exactly as directed.  Insert one NuvaRing into the vagina and keep it there for three weeks in a row.  Remove it for a one week break and then insert a new ring.  During the break you should get your period.

How do I start the NuvaRing?  There are several methods to starting NuvaRing, the method that is best for you will depend on your circumstances.

If you did not use a method of hormonal birth control in the past month:

 Counting the first day of your period as day #1, you may insert the NuvaRing on or between days #1-#5.  Day #5 is the last possible day to insert the NuvaRing.  Insert the NuvaRing even if you have not finished your period.  During the first cycle you are advised to use a back up method of birth control, such as condoms, during the first 7 days of NuvaRing use.

If you are switching from a progestin only method of birth control ( IUD, implant, injection or progestin only pill):

Progestin only pill:  Start using the NuvaRing on any day of the month.  Do not skip days between your last pill and NuvaRing use.

Implant:  Start using the NuvaRing the same day that you have your implant removed.

Injectable:  Start using the NuvaRing on the day that your next injection is due.

IUD:  Start using the NuvaRing the day that your IUD is removed.

In addition, after making the change, you are advised to use a back up method of birth control such as condoms during the first 7 days of NuvaRing use.

If you are switching from a combination oral birth control pill: 

Insert NuvaRing during the first 7 days after your last pill THAT CONTAINS HORMONES (Do not count your placebo pills as your last pill), no later than the day that you would have started a new pack of pills.  You do not need to use a back up method.

If you have had a termination of pregnancy: 

Insert the NuvaRing during the first 5 days after the termination.  You do not need to use a back up method of birth control.

How do I insert NuvaRing? 

1.      Each NuvaRing comes in a reclosable foil pouch.  After washing and drying your hands, remove the NuvaRing from the pouch.  Choose a position for insertion that is most comfortable for you.  Some possibilities are lying down, squatting, or standing with one leg up (on the toilet or a chair). 

2.      Hold the NuvaRing between your thumb and index finger and press the opposite sides of the ring together.

3.      Gently push the folded ring into the vagina.  Use your finger to gently push NuvaRing up in the vagina.  There is no danger of pushing the ring to far.

How do I remove the NuvaRing?   Remove the NuvaRing  by hooking the index finger under the forward rim and pulling it out.  NuvaRing is removed from the vagina three weeks after it was inserted on the same day of the week.  For example, if you insert your NuvaRing on a Sunday at approximately 10:00 p.m., you will remove it three weeks later on Sunday at approximately 10:00 p.m.  Your period should start 2-3 days after removing the NuvaRing.  Your period may not be finished when it is time to insert a new NuvaRing.  However, it is important that you do insert a new NuvaRing no later than 7 days after removing the last one even if your period has not stopped.

When do I insert a new NuvaRing?  After a one week free break, insert a new NuvaRing on the same day of the week as the day that it was inserted last cycle.  Using the previous example, insert a new NuvaRing after the one week break on Sunday at approximately 10:00 p.m.  

What if the NuvaRing slips out?   Rarely the NuvaRing does slip out if it has not been inserted properly, while removing a tampon or while straining with a bowel movement.  If the NuvaRing slips out and it has been out less than three hours, you should still be protected from pregnancy.  Simply rinse the NuvaRing off in lukewarm water and reinsert it as soon as possible, at the latest three hours later.  If NuvaRing has been out of the vagina for greater than three hours, you may not be adequately protected from pregnancy and you would need to use a backup method of contraception for seven days following reinsertion.  If NuvaRing continues to slip out then please notify your provider at the health services.

Can I take other medicines while using the NuvaRing?  Certain drugs may interact with hormonal contraceptives, including the NuvaRing, to make them less effective in preventing pregnancy or cause an increase in breakthrough bleeding.  Such drugs include Rifampin, drugs for epilepsy such as barbituates (for example, Phenobarbital), anticonvulsants such as topiramate (Topamax), carbamazepine (Tegetrol), phenytoin (Dilantin), phenylbutazone (Butazolidin), certain drugs used in the treatment of HIV or AIDS and possibly some antibiotics.  The herb known as St. Johns Wort may also make NuvaRing less effective.

As with all prescription products, you should tell your health care provider about any other medications you are taking.  You may need to use non-hormonal back up birth control methods when taking certain other medications.

When should I contact Health Services?

Call Health Services immediately if you have any of the following symptoms:

·        Unusual pain or swelling in the arms or legs

·        Sharp chest pain or shortness of breath

·        Severe abdominal pain

·        Severe headaches

·        Sudden change in vision

·        Fainting or dizziness

·        Heavy, prolonged vaginal bleeding

How do I store my NuvaRing?

A NuvaRing can be stored for up to 4 months at room temperature, 25 degrees celsius  (77 degrees fahrenheit).  NuvaRing should not be exposed to direct sunlight or at temperatures above 30 degrees celsius (86 degrees fahrenheit).

Source:  http://www.nuvaring.com/consumer/patient_information.asp

9/30/02-SRS

 

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Smith College Health Services // Northampton, Massachusetts 01063 // (413) 585-2800