The ring is placed into the vagina for a three-week period, then removal of the ring for one week, during which the user will experience a menstrual period. The break week is comparable to the placebo week for combined oral birth control pills ("the Pill"), and the birth control effect is maintained during this period. Extended use regimens (seven-week, quarterly, or annual) involving back-to-back use of (2, 4, or 17) rings have been studied in clinical trials, but are not currently approved. Insertion of the ring is comparable to insertion of other vaginal rings. The muscles of the vagina keep NuvaRing securely in place, even during exercise or sex. Women can check the birth control ring periodically with their finger. In rare instances, NuvaRing may fall out during sexual intercourse, while straining before or during a bowel movement, or while removing a tampon. In the case of accidental expulsion, the manufacturer recommends rinsing the ring with lukewarm water before reinserting. If not done correctly, the risk of pregnancy is increased. Birth control efficacy is reduced if the ring is removed, accidentally expelled, or left outside of the vagina for more than three hours. If left outside of the vagina for more than three hours, the device is to be rinsed and reinserted immediately. If this occurs, the manufacturer recommends that a backup method of birth control be used until the ring has been used continuously for a subsequent seven days. Benefits The benefits of the ring include: * once-a-month self-administered use offering convenience, ease of use and privacy (most users and most partners do not feel the ring, and of those who do, most do not object to it) * lower estrogen exposure than with combined oral contraceptive pills or the contraceptive patch Ortho Evra. * a low incidence of estrogenic side effects such as nausea and breast tenderness * a low incidence of irregular bleeding despite its lower estrogen dose
Ethinylestradiol/etonogestrel
Ethinylestradiol/levonorgestrel
Ethinylestradiol/desogestrel
Segesterone acetate/ethinylestradiol
Norelgestromin/ethinylestradiol
Ethinylestradiol/drospirenone
Ethinylestradiol/megestrol acetate
Ethinylestradiol/gestodene