What Is NuvaRing?
NuvaRing is the first, and only, vaginal birth control ring. Available only by prescription, this flexible plastic ring, about two inches in diameter, is placed in the vagina where it releases a continuous, low dose of hormones to prevent pregnancy. A NuvaRing is inserted for three weeks, after which it is removed and a new one can be inserted after a one-week interval.
The hormones in NuvaRing — estrogen (ethinyl estradiol) and progestin (etonogestrel) — prevent eggs from leaving the ovaries. As a secondary mechanism of birth control, they also create changes in cervical mucus, which inhibits sperm from penetrating eggs.
NuvaRing is a combined hormonal contraceptive (CHC), a class of drugs that includes birth control patches and pills. While patches must be replaced weekly and pills have to be taken daily, the once-a-month approach has made convenience a major marketing point for NuvaRing’s current manufacturer, Merck & Co., Inc.
Organon Biosciences receives FDA approval for NuvaRing
Schering-Plough acquires Organon BioSciences for $14.4 billion
Merck & Co. acquires Schering-Plough for $41.1 billion
Merck & Co. reports $88.5 million in sales from NuvaRing
Merck & Co. reports $777 million in annual sales of NuvaRing
How Effective Is NuvaRing at Preventing Pregnancy?
By 2010, 6 percent of U.S. women who used birth control reported using NuvaRing at some point in the previous four years. The Guttmacher Institute estimates 759,000 women were using it as their method of birth control by 2012.
NuvaRing’s failure rate is 0.3 percent for perfect use and 9 percent for typical use, similar to birth control pills and patches.
The Centers for Disease Control and Prevention defines “perfect use” as when a birth control method is used “correctly and consistently as directed.” “Typical use” is defined as how effective a method is during actual use, including those times with it is used inconsistently or incorrectly.
The percentages are based on the number out of 100 women who became pregnant within the first year of using it as a birth control method. In other words, if 1,000 women all used NuvaRing perfectly for a full year, there would be only three unintended pregnancies. If 1,000 women used NuvaRing as they typically would use it, there would be 90 unintended pregnancies.
What Are the Advantages and Disadvantages of NuvaRing?
It is important to discuss your complete medical history with your doctor before using NuvaRing. Medical conditions or other medications you are taking may cause increased risks.
|Simple and convenient||Incompatible or dangerous for women with certain medical conditions|
|Fewer hormonal effects than pill or patch||Increased risk of potentially fatal heart attack, stroke, and blood clots|
|Can lead to regular, lighter and shorter periods||Potential for bleeding between periods|
|Exact positioning is not needed for it to be effective||Possible nausea and vomiting|
|No need to be fitted by a doctor||May cause vaginal discharge, irritation, or infection|
|Discreet, no one may know you are using it||May cause breast tenderness|
|Since it is inserted once a month, it may allow for greater spontaneity||Can reduce libido in users|
A 2012 study of 1.6 million women’s medical records covering a 10-year period found those who used NuvaRing faced a “6.5 times increased risk of confirmed venous thrombosis compared with non-users of hormonal contraception.”
Venous thrombosis is the formation of blood clots in the veins, most often in the large veins of the legs, called a deep vein thrombosis (DVT). DVTs can be extremely painful, and if a clot breaks free, it can be fatal. The clot can travel to the lungs, block an artery, and cause a pulmonary embolism (PE). The combination of DVT and PE is referred to as venous thromboembolism (VTE). VTE is the third most frequently diagnosed vascular condition in American, behind heart attack and stroke.
In October 2011, the FDA released a study of more than 800,000 women that found an increased risk of venous thromboembolism (VTE) among women using NuvaRing compared to oral CHCs.
While NuvaRing contains hormones comparable to birth control pills, as much as half of the hormones from pills are destroyed in the digestive tract, while the hormones from NuvaRing are absorbed directly into the body. NuvaRing uses a lower dose of hormones than pills, but the third-generation progestin (etonogestrel) in its formula has been linked to a higher clotting risk.
Terry Turner is an Emmy-winning former television journalist turned senior writer at Drugwatch. In more than 25 years of reporting, he has seen countless examples of how people armed with comprehensive, quality information have the power to make better decisions for their lives and holding those who harm them accountable.
- Rivera, R., et al. (1999, November). The Mechanism of Action of Hormonal Contraceptives and Intrauterine Contraceptive Devices. Retrieved from: http://www.ajog.org/article/S0002-9378(99)70120-1/fulltext
- Merck & Co., Inc. (n.d.). NuvaRing (etonogestrel/ethinyl estradiol vaginal ring). Retrieved from: https://www.nuvaring.com/what-is-nuvaring/
- FDA. (2001, October 3). Drug Approval Package; NuvaRing (Etonogestrel/Ethinyl Estradiol Vaginal Ring). Retrieved from: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-187_NuvaRing.cfm
- Schering-Plough. (2007, November 19). Schering-Plough Completes Acquisition of Organon BioSciences. Retrieved from: http://www.prnewswire.com/news-releases/schering-plough-completes-acquisition-of-organon-biosciences-59869472.html
- Reuters. (2009, November 3). Merck, Schering-Plough Set to Complete Merger. Retrieved from: http://www.reuters.com/article/us-merck-scheringplough-idUSTRE5A23YZ20091103
- Merck & Co. (2010, March 1). Annual Report on Form 10-K (pg. 6). Retrieved from: http://www.annualreports.com/HostedData/AnnualReportArchive/m/NYSE_MRK_2009.pdf
- Merck & Co. (2017, February 28). Annual Report on Form 10-K (pg.37). Retrieved from: http://s21.q4cdn.com/488056881/files/doc_financials/2017/Q4/merck-q4-10k.pdf
- Guttmacher Institute. (2016, September). Contraceptive Use in the United States. Retrieved from: https://www.guttmacher.org/fact-sheet/contraceptive-use-united-states
- Trussell, J. (2011, March 12). Contraceptive Failure in the United States. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3638209/
- CDC. (2017, February 9). Contraception; How Effective Are Birth Control Methods? Retrieved from: https://www.cdc.gov/reproductivehealth/contraception/
- Planned Parenthood. (n.d.) Birth Control Vaginal Ring (NuvaRing). Retrieved from: https://www.plannedparenthood.org/learn/birth-control/birth-control-vaginal-ring-nuvaring
- FDA. (2013, October). NuvaRing Label. Retrieved from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021187s022lbl.pdf
- NIH. (2016, May 15). Ethinyl Estradiol and Etonogestrel Vaginal Ring. Retrieved from: https://medlineplus.gov/druginfo/meds/a604032.html
- Lidegaard, Ø. et al. (2012, May 10). Venous Thrombosis in Users of Non-Oral Hormonal Contraception: Follow-Up Study, Denmark 2001-10. Retrieved from: http://www.bmj.com/content/344/bmj.e2990
- American Heart Association. (2017, March 9). What Is Venous Thromboembolism (VTE)? Retrieved from: http://www.heart.org/HEARTORG/Conditions/More/What-is-Venous-Thromboembolism-VTE_UCM_479052_Article.jsp#.WQdvytorKUk
- FDA. (2011, October 27). Combined Hormonal Contraceptives (CHCs) and the Risk of Cardiovascular Disease Endpoints. Retrieved from: https://www.fda.gov/downloads/Drugs/DrugSafety/UCM277384.pdf