Cigarette smoking increases the risk of serious cardiovascular side effects from combination oral contraceptive use. This risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in women over 35 years of age. Women who use combination hormonal contraceptives, including NuvaRing®, should be strongly advised not to smoke.
NuvaRing® (etonogestrel/ethinyl estradiol vaginal ring) is a non-biodegradable, flexible, transparent, colorless to almost colorless, combination contraceptive vaginal ring containing two active components, a progestin, etonogestrel (13-ethyl-17-hydroxy-11-methylene-18,19-dinor-17(alpha)-pregn-4-en-20-yn-3-one) and an estrogen, ethinyl estradiol (19-nor-17(alpha)-pregna-1,3,5(10)-trien-20-yne-3, 17-diol). 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® is made of ethylene vinylacetate copolymers (28% and 9% vinyl acetate) and magnesium stearate and contains 11.7 mg etonogestrel and 2.7 mg ethinyl estradiol. NuvaRing® has an outer diameter of 54 mm and a cross-sectional diameter of 4 mm.
NuvaRing® is indicated for the prevention of pregnancy in women who elect to use this product as a method of contraception. Like oral contraceptives, NuvaRing® is highly effective if used as recommended in this label.
Media Articles Related to Nuvaring (Etonogestrel / Ethinyl Estradiol Vaginal Ring)
Give Teens Access to Emergency Contraception, Pediatricians Say
Source: MedicineNet Miscarriage Specialty [2012.11.26]
Title: Give Teens Access to Emergency Contraception, Pediatricians Say
Category: Health News
Created: 11/26/2012 10:35:00 AM
Last Editorial Review: 11/26/2012 12:00:00 AM
Plan B: Obama Administration to Drop Age Limits on OTC Sales
Source: MedPage Today OB/Gyn [2013.06.10]
WASHINGTON (MedPage Today) -- The Obama administration signaled its intent late Monday to stand down in the emergency contraception fray, announcing that it was dropping plans to appeal a Federal judge's decision to allow broad access to Plan B One-Step.
Published Studies Related to Nuvaring (Etonogestrel / Ethinyl Estradiol Vaginal Ring)
A randomized controlled trial of NuvaRing versus combined oral contraceptive pills for pretreatment in in vitro fertilization cycles. [2011.09]
OBJECTIVE: To determine whether use of the NuvaRing (Merck) for pretreatment in IVF cycles would result in better cycle control and patient satisfaction versus a 30-mug oral contraceptive (OC) pill.
Efficacy and safety of a contraceptive vaginal ring (NuvaRing) compared with a combined oral contraceptive: a 1-year randomized trial. [2005.03]
This open-label, randomized, Phase III study compared the efficacy and tolerability of and compliance with NuvaRing, a combined contraceptive vaginal ring releasing 15 microg of ethinylestradiol (EE) and 120 microg of etonogestrel daily, with those of and with a combined oral contraceptive (COC) containing 150 microg of levonorgestrel (LNG) and 30 microg of EE...
Absence of pharmacokinetic interactions of the combined contraceptive vaginal ring NuvaRing with oral amoxicillin or doxycycline in two randomised trials. 
BACKGROUND: Two pharmacokinetic studies were performed to investigate whether there is any interaction between etonogestrel or ethinylestradiol released from the combined contraceptive vaginal ring NuvaRing and concomitant treatment with orally administered amoxicillin or doxycycline... CONCLUSION: The results from these studies demonstrate the absence of pharmacokinetic interactions between etonogestrel and ethinylestradiol released from NuvaRing and the oral antibiotics amoxicillin and doxycycline, suggesting that contraceptive efficacy would also be unaffected.
A comparative study on the effects of a contraceptive vaginal ring NuvaRing and an oral contraceptive on carbohydrate metabolism and adrenal and thyroid function. [2004.09]
OBJECTIVES: To compare carbohydrate metabolism, adrenal and thyroid function during use of a combined contraceptive vaginal ring (NuvaRing, NV Organon, Oss, The Netherlands) with those of a combined oral contraceptive... CONCLUSIONS: Both the vaginal ring and the oral contraceptive have no clinically relevant effects on carbohydrate metabolism, adrenal or thyroid function.
The combined contraceptive vaginal ring, NuvaRing, and tampon co-usage. [2004.03]
We investigated the effect of tampon co-usage on systemic exposure to etonogestrel (ENG) and ethinylestradiol (EE) from the combined contraceptive vaginal ring, NuvaRing. One cycle of ring use consists of 3 weeks of ring use followed by a 1-week ring-free period...
Clinical Trials Related to Nuvaring (Etonogestrel / Ethinyl Estradiol Vaginal Ring)
Effect of the Etonogestrel 0.12mg/Ethinyl Estradiol 0.015mg Vaginal Ring on Vaginal Innate and Inflammatory Biomarkers [Recruiting]
It is not known if the use of NuvaRing« alters these innate and inflammatory biomarkers of
The hypothesis is that NuvaRing« will alter inflammatory biomarkers of inflammation, such as
vaginal defensin and cytokine levels, resulting in an overall anti-inflammatory milieu in
Specific aims of this study are to:
1. Determine biomarkers of inflammation, including defensins and cytokines, concentrations
in women with normal vaginal flora (Nugent Score 0 - 3) before and after NuvaRing┬« use
2. Determine changes in the integrity of cervicovaginal epithelium and leukocytic
concentration before and after treatment with NuvaRing┬«
3. Monitor for changes in the Nugent score before and after NuvaRing┬« use
4. Assess the antimicrobial activity of vaginal fluid before and after NuvaRing┬« use
5. Assess HIV infectivity ex vivo on biopsy specimens before and after NuvaRing┬« use
Methods This is a prospective, open-label, nonrandomized study. Participants will serve as
their own controls. The Clinical Research Center of Eastern Virginia Medical School,
Norfolk, Virginia, U. S.A. will be the only study site.
NuvaRing Versus Marvelon in the Coordination of In Vitro Fertilization Cycles [Recruiting]
Presently, a long protocol in an In Vitro Fertilization (IVF) cycle, patients need to take
Marvelon, a drug that inhibits the follicular development at the beginning of the cycle in
order to better control and also plan the onset of the ovary stimulation with gonadotropin.
Marvelon is taken daily as soon as menstruation starts for a period of 14 to 21 days.
Ideally, it has to be taken at the same time everyday and not be forgotten. This may cause
higher stress level for some users. Presently on the market, there is a ring-shaped
contraceptive device inserted in the vagina at day 1 of the cycle called NuvaRing. The
purpose of this device is similar to an oral contraceptive. However, the benefit of NuvaRing
is that it can be left in place for a period of up to 35 days without any other manipulation
and keep an adequate rate of hormone for contraception. Moreover, NuvaRing shows better
hormone stability in the blood. Although the side effects and the benefits are comparable
for the two treatments, some studies have shown that more patients would respect the
treatment with NuvaRing and that the level of satisfaction would be higher in women using
NuvaRing when contraception is needed.
The purpose of the study is to compare the rate of satisfaction as well as the level of
stress in women using Marvelon daily or NuvaRing with single insertion in a long protocol.
Moreover, this study allow us to verify if using NuvaRing, a vaginal contraceptive releasing
constant daily doses for up to 35 days will allow us to facilitate the planning of In Vitro
Fertilization cycles in long protocol.
A Study to Evaluate the Effectiveness of NuvaRing´┐Ż to Prevent Pregnancies in Chinese Women (P06450 AM4) [Recruiting]
This is a study to assess the effectiveness of NuvaRing« (SCH 900702) for the prevention of
pregnancy in fertile Chinese women. The acceptability and safety of NuvaRing« will also be
assessed and compared with that of Yasmin.
Management of Breakthrough Bleeding During Extended Therapy Use With NuvaRing« [Completed]
The purpose of this research study is to evaluate the best way to manage breakthrough
spotting and bleeding during an extended use regimen of NuvaRing«. Ease of use and
acceptability of a flexible regimen of NuvaRing« will also be evaluated. A comparison of
cyclic mood symptoms, pelvic pain, and headaches will be made between a standard 21/7 regimen
and an extended regimen.
Comparison of Serum Contraceptive Hormone Levels Between Normal Weight and Obese Users of the NuvaRing« [Recruiting]
There are over 60 million women of reproductive age in the U. S. and a majority of these women
qualify as overweight or obese. Evidence suggests that there is an association between
increased body weight and decreased contraceptive efficacy. Studies with the combined
hormonal contraceptive patch (Evra«) and the subdermal contraceptive implant (Norplant«)
demonstrate higher failure rates in heavier versus lighter women.
Weight related differences in the effectiveness of NuvaRing« need further study. A single
secondary analysis of pooled data from Phase III clinical trials of NuvaRing« noted no
difference in pregnancy rates among women in the highest weight decile (>166#) versus the
rest of the study population using the ring. (Westhoff, 2005) The finding of no difference,
however, was influenced by too few obese subjects in the analysis which contributed to wide
confidence limits. Additional studies are needed to explore how well the contraceptive ring
functions to maintain effective serum steroid concentrations to suppress ovarian activity in
This investigation will focus on evaluating mean serum concentrations of hormones released
in obese and normal weight women using the NuvaRing┬« . This study is a prospective
clinical trial. Normal weight women are defined as women with a BMI 19-24. 9 and obese women
are those with a BMI 30-39. 9. We will recruit forty adult women interested in initiating the
combined hormonal contraceptive ring to two months of use to complete analysis of 34 subjects
(17 normal weight, 17 obese). We will compare mean serum concentrations of ethinyl estradiol
(E2) and etonogestrel (ENG) along with additional markers for ovarian suppression. These
markers include sonographic evidence of follicular development and ovulation as well as
circulating E2 levels which strongly correlate with follicular development and endometrial
proliferation during the second month of NuvaRing┬« use. Assessment of these parameters will
translate to understanding contraceptive-mediated suppression of ovarian function in these
two groups. We will also have subjects log patterns of ring use and bleeding patterns during
the study period.
Reports of Suspected Nuvaring (Etonogestrel / Ethinyl Estradiol Vaginal Ring) Side Effects
Pulmonary Embolism (880),
Deep Vein Thrombosis (553),
Ovarian Cyst (158), more >>
PATIENT REVIEWS / RATINGS / COMMENTS
Based on a total of 27 ratings/reviews, Nuvaring has an overall score of 6.44. The effectiveness score is 9.41 and the side effect score is 6.81. The scores are on ten point scale: 10 - best, 1 - worst. Below are selected reviews: the highest, the median and the lowest rated.
Nuvaring review by 23 year old female patient
|Overall rating:|| || |
|Effectiveness:|| || Highly Effective|
|Side effects:|| || No Side Effects|
|Condition / reason:|| || Contraceptive|
|Dosage & duration:|| || 1 Ring (dosage frequency: once a month) for the period of For about 2 years|
|Other conditions:|| || None|
|Other drugs taken:|| || None|
|Benefits:|| || Treatment benefits were pregnancy prevention and regulation of menstrual cycle.|
|Side effects:|| || There were no know side effects caused by the treatment. I was very happy with the absence of side effects and the overall simplicity of the drug.|
|Comments:|| || The NuvaRing was inserted once a month and kept in place for three weeks. After the third week, the ring was removed so that a menstrual cycle could ensue. After 7 day, a new ring was inserted. There was no pain associated with the insertion or removal of the ring, nor was there any discomfort during sexual intercourse. Overall I am very pleased with the NuvaRing and will continue to use it until I decide to become pregnant. |
Nuvaring review by 22 year old female patient
|Overall rating:|| || |
|Effectiveness:|| || Considerably Effective|
|Side effects:|| || Mild Side Effects|
|Condition / reason:|| || Acne and birth control|
|Dosage & duration:|| || one ring inserted monthly (dosage frequency: once a month) for the period of 4 months|
|Other conditions:|| || none|
|Other drugs taken:|| || none|
|Benefits:|| || I switched from Diane 35, a birth control pills recommended specifically for acne and was very worried that the nuva ring would cause an acne flair up, as switching from Diane to Yasmine had. Fortunately my skin stayed just as clear and as a plus no more taking pills nightly|
|Side effects:|| || slight vaginal irritation at the end of a cycle, nothing even moderately serious though.|
|Comments:|| || Nuva Ring is a brand name birth control method which releases hormones through the vaginal walls. You insert a flexible plastic ring once a month for three weeks and it acts as birth control.|
Nuvaring review by 46 year old male patient
|Overall rating:|| || |
|Effectiveness:|| || Moderately Effective|
|Side effects:|| || Extremely Severe Side Effects|
|Condition / reason:|| || Birth Control|
|Dosage & duration:|| || Standard NuvaRing Insert (dosage frequency: inserted once each month) for the period of 2 months|
|Other conditions:|| || None|
|Other drugs taken:|| || None|
|Benefits:|| || None|
|Side effects:|| || Within 2 months, I developed deep vein thrombosis in my left leg and pulmonary emboli in my lungs. Multiple blood clots in my lungs almost killed me. I was lucky to live because the clot lodged in parts of my lungs that were not fatal.|
|Comments:|| || Doctor inserted the NuvaRing during the office visit. No literature was provided so was not given the easy opportunity to read about side effects. There was no discussion with the doctor about side effects.|
Page last updated: 2013-06-10