The Nuvaring is an estrogen/progesterone containing vaginal ring that the patient places in the vagina and leaves in for three weeks, during which time the contraceptive is absorbed through the vagina into the bloodstream, and the patient removes and discards the ring after 3 weeks. In the fourth week, no ring is present, and menses occur. A week later a new ring is inserted, beginning the next cycle.
Hormone release is slow and steady, and patients do very well and are usually quite satisfied with this method. Users can swim with the ring in place and can have sex with the ring in (or take it out if they wish for up to 3 hours and still be protected).
The Nuvaring is more than 99% effective in preventing pregnancy and has less breakthrough bleeding than OCPs or the patch. Patients only have to remember it twice a month (once to insert it and once to remove it).
Side effects are similar to those in pill users, plus some users complain of vaginal discharge, and rarely they can be expelled. Risks and contraindications are similar to OCPs, with the addition of thinking twice about using it in patients with severe constipation or uterine prolapse (more expulsion), and in patients with recurrent vaginal infections (it increases vaginal discharge, but not infection).
