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Ethinyl estradiol / etonogestrel Side Effects

For the Consumer

Applies to ethinyl estradiol / etonogestrel: vaginal insert extended release

In addition to its needed effects, some unwanted effects may be caused by ethinyl estradiol / etonogestrel. In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking ethinyl estradiol / etonogestrel:

Incidence not known:
  • Abdominal or stomach fullness
  • abdominal or stomach pain or tenderness usually after eating a meal
  • blurred vision
  • changes in skin color
  • chest pain or discomfort
  • confusion
  • constipation
  • diarrhea
  • dizziness
  • gaseous abdominal or stomach pain
  • headache
  • inability to speak
  • nausea
  • nervousness
  • numbness of the hands
  • pain or discomfort in the arms, jaw, back, or neck
  • pain
  • pains in the chest, groin, or legs, especially calves of the legs
  • pounding in the ears
  • prominent superficial veins over the affected area with tenderness and warmth
  • recurrent fever
  • seizures
  • severe headaches of sudden onset
  • slow or fast heartbeat
  • sudden loss of coordination
  • sudden onset of slurred speech
  • sudden vision changes
  • sudden and severe weakness in the arm or leg on one side
  • sweating
  • swelling of the foot or leg on one side of the body
  • temporary blindness
  • vomiting or vomiting of blood
  • yellow eyes or skin

If any of the following symptoms of overdose occur while taking ethinyl estradiol / etonogestrel, get emergency help immediately:

Symptoms of overdose:
  • Menstrual changes
  • nausea
  • vaginal bleeding
  • vomiting

Minor Side Effects

Some of the side effects that can occur with ethinyl estradiol / etonogestrel may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:
  • Cough
  • fever
  • headache
  • itching of the vagina or genital area
  • pain during sexual intercourse
  • pain or tenderness around the eyes and cheekbones
  • sore throat
  • stuffy or runny nose
  • thick, white vaginal discharge with no odor or with a mild odor
  • tightness of the chest
  • weight gain
Less common:
  • Crying
  • depersonalization
  • false or unusual sense of well-being
  • hoarseness
  • mental depression
  • paranoia
  • quick to react or overreact emotionally
  • rapidly changing moods, mild feeling of sadness or discouragement that come and go
Incidence not known:
  • Absent, missed, or irregular menstrual periods
  • bloody vaginal discharge
  • brown, blotchy spots on exposed skin
  • chills
  • clay-colored stools
  • contact lenses intolerance
  • dark urine
  • decreased amount or quality of milk
  • dry mouth
  • dry skin
  • fruit-like or unpleasant breath odor
  • increased hunger
  • increased thirst
  • increased urination
  • loss of appetite
  • medium to heavy, irregular vaginal bleeding between regular monthly periods, which may require the use of a pad or a tampon
  • rash
  • soreness, swelling, or discharge from the breast or breasts
  • trouble getting pregnant
  • unexplained weight loss
  • unusual tiredness or weakness

For Healthcare Professionals

Applies to ethinyl estradiol / etonogestrel: vaginal ring


Genitourinary side effects reported by 5% to 14% of women include vaginitis and leukorrhea. The most common events leading to discontinuation in 1% to 2.5% of women include foreign body sensation, coital problems, and device expulsion. Vaginal/cervical erosion or ulceration in women using ethinyl estradiol and etonogestrel vaginal ring has been rarely reported. In some cases, the ring adhered to vaginal tissue, necessitating removal by a healthcare provider. There have been rare reports of inadvertent insertions of ethinyl estradiol and etonogestrel vaginal ring into the urinary bladder, which required cystoscopic removal. Healthcare providers should assess for ring insertion into the urinary bladder in ethinyl estradiol and etonogestrel vaginal ring users who present with persistent urinary symptoms and are unable to locate the ring.[Ref]


Respiratory side effects reported by 5% to 14% of women include upper respiratory tract infection and sinusitis.[Ref]


Gastrointestinal side effects reported by 5% to 14% of women include nausea. Combination contraceptives have been associated with reports of abdominal cramping, bloating, and vomiting.[Ref]


General side effects reported by 5% to 14% of women include weight gain and headache. The most common adverse effect leading to discontinuation in 1% to 2.5% of women was emotional lability and weight gain.[Ref]


Hematologic side effects associated with the use of combination hormonal contraceptives include thromboembolic disorders.[Ref]


Cardiovascular side effects reported with the use of combination hormonal contraceptives include hypertension and myocardial infarction.[Ref]


Hepatic side effects reported with the use of combination hormonal contraceptives include hepatic adenomas and benign liver tumors.[Ref]


Ocular side effects reported with the use of combination hormonal contraceptives include retinal thrombosis, changes in corneal curvature (steepening), and intolerance to contact lenses.[Ref]


1. "Product Information. NuvaRing (ethinyl estradiol-etonogestrel)." Organon, West Orange, NJ.

Not all side effects for ethinyl estradiol / etonogestrel may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.