NuvaRing Side Effects

Generic name: ethinyl estradiol / etonogestrel

Medically reviewed by Drugs.com. Last updated on Aug 21, 2024.

Note: This document provides detailed information about NuvaRing Side Effects associated with ethinyl estradiol / etonogestrel. Some dosage forms listed on this page may not apply specifically to the brand name NuvaRing.

Applies to ethinyl estradiol / etonogestrel: vaginal insert extended release.

Precautions

It is very important that your doctor check your progress at regular annual visits to make sure this medicine is working properly and does not cause unwanted effects. Your doctor may also want to check your blood pressure while using this medicine.

Although you are using this medicine to prevent pregnancy, you should know that using this medicine while you are pregnant could harm your unborn baby. If you think you have become pregnant while using this medicine, tell your doctor right away. You may start using this medicine 4 weeks after giving birth and if you are not breastfeeding.

Vaginal bleeding of various amounts may occur between your regular menstrual periods during the first 3 months of use. This is sometimes called spotting when lighter, or breakthrough bleeding when heavier.

• If this should occur, continue using NuvaRing®.
• The bleeding usually stops within 1 week. Check with your doctor if the bleeding continues for more than 1 week.
• If the bleeding continues after you have been taking hormonal contraceptives on schedule and for more than 3 months, check with your doctor.

You may be pregnant if:

• You missed a period and NuvaRing® was out of the vagina for more than 3 hours during the 3 weeks of ring use.
• You missed a period and waited longer than 1 week to insert a new ring.
• You missed two periods in a row.
• You have left NuvaRing® in place for longer than 4 weeks.

If you suspect that you may be pregnant, stop using this medicine and check with your doctor right away.

Do not use this medicine together with medicine to treat hepatitis C virus infection, including ombitasvir/paritaprevir/ritonavir, with or without dasabuvir (Technivie®, Viekira Pak®).

Do not use this medicine if you smoke cigarettes or if you are over 35 years of age. If you smoke while using NuvaRing®, you increase your risk of having a blood clot, heart attack, or stroke. Your risk is even higher if you are over age 35, if you have diabetes, high blood pressure, high cholesterol, or if you are overweight. Talk with your doctor about ways to stop smoking. Keep your diabetes under control. Ask your doctor about diet and exercise to control your weight and blood cholesterol level.

Using this medicine may increase your risk of having blood clotting problems. Check with your doctor right away if you have pain in the chest, groin, or legs, especially the calves, difficulty with breathing, a sudden, severe headache, slurred speech, a sudden, unexplained shortness of breath, a sudden loss of coordination, or vision changes while using this medicine.

Check with your doctor immediately if blurred vision, difficulty in reading, or any other change in vision occurs during or after treatment. Your doctor may want an eye doctor (ophthalmologist) to check your eyes.

Toxic shock syndrome (TSS) may occur while using this medicine. Call your doctor right away if you have any of the following symptoms: sudden high fever, diarrhea, dizziness, fainting, vomiting, muscle aches, or a sunburn-like rash.

Check with your doctor right away if you have pain or tenderness in the upper stomach, dark urine, pale stools, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Your blood pressure might get too high while you are using this medicine. This may cause headaches, dizziness, or blurred vision. You might need to measure your blood pressure at home. If you think your blood pressure is too high, call your doctor right away.

This medicine may increase your risk of having gallbladder disease. Check with your doctor if you start to have stomach pains, nausea, and vomiting.

Using this medicine may increase your risk of breast cancer or cervical cancer. Talk with your doctor about this risk. Check with your doctor immediately if you experience abnormal vaginal bleeding.

This medicine may cause skin discoloration. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.

Check with your doctor before refilling an old prescription, especially after a pregnancy. You will need another physical examination and your doctor may change your prescription.

Make sure any doctor or dentist who treats you knows that you are using this medicine. The results of some medical tests may be affected by this medicine. You may also need to stop using this medicine at least 4 weeks before and 2 weeks after having major surgery.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

Common side effects of NuvaRing

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:

Serious side effects of NuvaRing

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:

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

Symptoms of overdose

• menstrual changes
• nausea
• vaginal bleeding

For healthcare professionals

Applies to ethinyl estradiol / etonogestrel: vaginal ring.

General adverse events

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]

Genitourinary

• 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, vaginal injury (including associated pain, discomfort, and bleeding) associated with ring breakage^[Ref]

Cardiovascular

• 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]

In studies that were required or sponsored by regulatory agencies, this combined hormonal combination vaginal ring showed a VTE risk similar to combined oral contraceptive use (8.3 per 10,000 women-years versus 9.2 per 10,000 women-years).^[Ref]

Hypersensitivity

• Frequency not reported: Anaphylaxis, angioedema

Local

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

Gastrointestinal

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

Oncologic

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

Respiratory

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

Dermatologic

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

Hepatic

• Frequency not reported: Cholelithiasis, liver disease^[Ref]

Ocular

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

Immunologic

• Common (1% to 10%): Allergic reaction
• Frequency not reported: Hypersensitivity
• Postmarketing reports: Anaphylaxis^[Ref]

Musculoskeletal

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

Metabolic

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

Psychiatric

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

Other

• 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]

Renal

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

See also:

Frequently asked questions

• What are my birth control options and how effective are they?
• Vaginal bleeding while Nuvaring is still inserted?
• Would it be a problem if the Nuvaring was stored at room temperature?
• What is the name of the generic NuvaRing?
• How long do antibiotics affect birth control?

Further information

NuvaRing side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer