Skip to Content

Ethinyl estradiol / etonogestrel Side Effects

For the Consumer

Applies to ethinyl estradiol / etonogestrel: vaginal insert extended release

Along with its needed effects, ethinyl estradiol/etonogestrel may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking ethinyl estradiol / etonogestrel:

Incidence not known
  • Blurred vision
  • changes in skin color
  • chest pain or discomfort
  • confusion
  • constipation
  • diarrhea
  • dizziness
  • gaseous stomach pain
  • headache
  • inability to speak
  • nausea
  • nervousness
  • numbness of the hands
  • pain in the chest, groin, or legs, especially calves of the legs
  • pain or discomfort in the arms, jaw, back, or neck
  • pounding in the ears
  • prominent superficial veins over the affected area with tenderness and warmth
  • recurrent fever
  • seizures
  • severe headache of sudden onset
  • slow or fast heartbeat
  • stomach fullness
  • stomach pain or tenderness usually after eating a meal
  • 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 with or without blood
  • yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur while taking ethinyl estradiol / etonogestrel:

Symptoms of overdose

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

More common
  • Cough
  • fever
  • 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 or without 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 lens 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


Adverse reactions leading to study discontinuation occurred in 13% of the women during clinical trials. The most common adverse reactions leading to discontinuation were device-related events (2.7%), mood changes (1.7%), headache/migraine (1.5%), and vaginal symptoms (1.2%).[Ref]


Very common (10% or more): Vaginitis (13.8%)
Common (1% to 10%): Vaginal discharge, vaginal discomfort, breast pain/discomfort/tenderness, dysmenorrhea, genital pruritus, vaginal discomfort, pelvic pain, leucorrhoea, vaginal infection
Uncommon (0.1% to 1%): Dysuria, micturition urgency, pollakiuria, urinary tract infection, amenorrhea, breast enlargement, breast mass, cervical polyp, cervicitis, coital bleeding, coital discomfort, dyspareunia, ectropion of cervix, fibrocystic breast disease, menorrhagia, metrorrhagia, pelvic discomfort, premenstrual syndrome, uterine spasm, vaginal burning sensation, vaginal odor, vaginal pain, vulvovaginal discomfort, vulvovaginal dryness
Frequency not reported: Penile disorder, galactorrhea, uterine bleeding irregular
Postmarketing reports: Local reaction to penis[Ref]


Uncommon (0.1% to 1%): Blood pressure increased, hot flush
Rare (less than 0.1%): Venous thromboembolism, arterial thromboembolism
Frequency not reported: Deep vein thrombosis
Postmarketing reports: Arterial event, myocardial infarction, varicose vein aggravated[Ref]


Common (1% to 10%): Medical device discomfort, discomfort/foreign body sensation[Ref]


Common (1% to 10%): Nausea/vomiting, abdominal pain, diarrhea, toothache
Uncommon (0.1% to 1%): Abdominal distention, constipation, abdomen enlarged[Ref]


Uncommon (0.1% to 1%): Breast fibroadenosis
Frequency not reported: Hormone dependent tumors, liver tumor[Ref]


Common (1% to 10%): Bronchitis, coughing, pharyngitis, rhinitis, sinusitis, upper respiratory tract infection[Ref]


Common (1% to 10%): Acne
Uncommon (0.1% to 1%): Pruritus, rash, alopecia, eczema
Frequency not reported: Urticaria, chloasma[Ref]


Frequency not reported: Cholelithiasis, liver disease[Ref]


Uncommon (0.1% to 1%): Visual disturbance[Ref]


Common (1% to 10%): Allergic reaction
Frequency not reported: Hypersensitivity[Ref]


Common (1% to 10%): Back pain
Uncommon (0.1% to 1%): Muscle spasm, pain in extremity[Ref]


Uncommon (0.1% to 1%): Appetite increased[Ref]


Common (1% to 10%): Mood changed/altered, depression, mood swings, affect lability, libido decreased
Uncommon (0.1% to 1%): Anxiety, irritability[Ref]


Common (1% to 10%): Expulsion of contraceptive device, device-related event, weight increased, fatigue, fever, influenza-like symptoms
Uncommon (0.1% to 1%): Device breakage, device complication, cervicitis, herpes simplex, malaise, edema[Ref]

Nervous system

Very common (10% or more): Headache/migraine (11.2%)
Uncommon (0.1% to 1%): Dizziness, hypoesthesia
Postmarketing reports: Stroke/cerebrovascular accident[Ref]


Uncommon (0.1% to 1%): Cystitis[Ref]


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

2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

3. Cerner Multum, Inc. "Australian Product Information." O 0

Some side effects of ethinyl estradiol / etonogestrel may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

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.