Contraceptive hormonal ring Nuvaring - instructions for use

Nuvaring is a hormonal contraceptive, the intravaginal administration of which leads to inhibition of the synthesis of hormones - FSH and LH, inhibition of ovulation, obstruction of follicle maturation, thereby blocking ovulation and the occurrence of an unexpected pregnancy.

Taking into account the Pearl index, the possible pregnancy after using this contraceptive does not exceed 0.96%. The drug will not affect the decrease in bone density, but can reduce the frequency of acyclic menstrual bleeding and the development of iron deficiency anemia.

Effect of the drug

Blocking ovulation occurs thanks to 2 active components in the composition of Nuvaring - estrogen and progesterone, as binders with natural receptors in the female body, having a complex effect on the target organ:

1. etonogestrel enters the vagina, it begins to be immediately released from the Nuvaring ring and combines with globulin and albumin in the form of serum (as sex hormones). Bioavailability is 97%. Excretion from the body occurs in the form of metabolites (as inactive breakdown products) after 5-6 days together with bile and urine.
2. Ethinyl estradiol in Nuvaring has a bioavailability of 58%. Excretion occurs in the urine in the form of inactive metabolites.

If you use Nuvaring constantly, you will experience:

• regulation of menstrual cycles;
• reduction of spasms, pain syndromes, bleeding;
• obstacle to the development of permissible ectopic pregnancy, cysts, ovarian, breast, and endometrial cancer.

With Nuvaring, the components are evenly distributed throughout the tissues of the vaginal mucosa and almost completely absorbed into the systemic bloodstream.

Special case

As stated above, the risk of encountering negative phenomena when using Nuvaring is higher if a woman belongs to certain groups of patients. For example, a number of dangers are associated with insufficient functioning of the renal and hepatic systems. There is no official information about how the circulation of active compounds of a contraceptive drug in the body may change under such conditions. It is assumed that when liver functionality is impaired, the metabolism of sex hormones slows down and worsens.

Indications for use

The drug is an excellent and safe contraceptive and is considered the best contraceptive for women of reproductive age.

It has a low-dose combined hormonal effect, promotes:

• preventing the release of an egg from the ovary;
• protection against unwanted pregnancy;
• normalization of menstruation;
• reduction of painlessness, acyclic manifestations.

Nuvaring can be used for uterine fibroids if, of course, according to ultrasound, the tumor has stopped growing.

Although you should first consult your doctor about the advisability of using contraception. Also, the course of the disease improves with endometriosis as the hormonal ring is used.

With the arrival of menstruation, patients begin to lose significantly less blood, pain decreases and the endometrial uterine layer is restored.

The action of Nuvaring is gentle and gentle, therefore it does not lead to the failure of systems and organs, and the active components, when they come into contact with the mucous layer of the uterus, begin to have a local therapeutic effect.

How it works?

Having considered the possible side effects of Nuvaring (no menstruation, headache, bowel problems), it makes sense to understand how and why this contraceptive works. In the description, the manufacturer indicates that the contraceptive is a combination contraceptive and contains two types of hormones that correct the functioning of the female reproductive system - ethinyl estradiol and etonogestrel. The first is estrogen, now widely used as a contraceptive. The second name is progestogen, characterized by increased affinity for progesterone receptors.

The contraceptive “Novaring” is effective due to its combined effect on the female body. Active compounds can suppress the ovulation process, but to increase reliability, components have been introduced that affect other features of the female body, including the quality of mucus. As specialized tests have shown, the rate of conception per hundred women who used the medication for one year is 0.96. The studies were conducted with women aged 18-40 years. The results obtained are comparable to combined hormonal contraceptives intended for oral administration.

Safe days calendar

1st day of last menstruation

Average cycle length

Duration of menstruation

Contraindications

In some cases, the use of rings is unacceptable and is contraindicated for medical reasons.

This:

• excessive hypersensitivity to active components;
• pulmonary embolism;
• myocarditis infarction, pre-stroke syndrome;
• diabetic angiopathy;
• hormone-dependent tumor of the reproductive system;
• bleeding from the vagina of unknown etiology;
• the onset of accidental pregnancy followed by a period of lactation;
• vein thrombosis due to genetic predisposition;
• migraine with signs of neuralgia;
• liver cancer;
• angina pectoris;
• heart valve damage;
• obesity with body weight indexed over 30 kg per 1 meter2;
• mechanical trauma to the vagina after surgery;
• smoking after 35 years;
• malignant or benign liver tumor;
• diabetes mellitus due to vascular damage.

Studies have not been conducted on the use of Nuvaring for girls under 18 years of age, so its safety and effectiveness have not been established. It is not recommended to use the device in early adolescence. If, out of ignorance, it was still used, then if unpleasant symptoms appear, you should urgently stop the drug and consult a doctor.

A contraceptive should be used with caution, after first assessing the possible risks and benefits:

• heart valve pathology;
• genetic predisposition;
• myocarditis;
• obesity;
• focal migraine occurring after surgery;
• atherosclerosis;
• rectal hernia;
• chronic constipation, when it can be difficult to install a vaginal ring;
• systemic lupus;
• sickle cell anemia;
• otosclerosis due to hearing loss;
• ulcerative colitis;
• the appearance of itching on the skin, jaundice.

If these diseases worsen and the condition worsens sharply, then you need to stop the drug and consult a specialist.

Side effects

Side effects after using Nuvaring are rare, but cases have been reported:

• hypoesthesia;
• severe migraine with side effects from the central nervous system;
• hot flashes, high blood pressure with side effects from the heart, blood vessels;
• increase in extra pounds and appetite with impaired metabolism;
• decreased libido in mental disorders;
• development of cystitis, cervicitis;
• diarrhea, vomiting, abdominal pain;
• the appearance of itching, rash, eczema, acne on the skin;
• spasms in the back and muscles;
• pollakiuria, dysuria;
• pain, bleeding in the pelvis, usually after sexual intercourse;
• vaginal discharge with odor, dryness, burning;
• irritability, malaise;
• swelling on the face.

Side effects often occur when Nuvaring is taken with other hormonal drugs in combination, when allergies, acne, decreased libido, and vomiting may occur.

What is possible?

It is known that the side effects of Nuvaring can bother those who use the drug uncontrollably, without the consent of the treating doctor, and without following the instructions. In addition, there is a risk of individual intolerance and allergic reaction. Persons for whom Nuvaring is prohibited according to the instructions or is allowed only with great caution may encounter a negative response from the body. To minimize the dangers to yourself and reduce the chance of unpleasant experiences, before starting to use the product you should consult a professional gynecologist, and possibly undergo tests to determine the characteristics of your hormonal levels. In this case, you are guaranteed to find the best option.

Due to side effects, Nuvaring, as indicated in the accompanying documentation, can cause a decrease in sexual desire, as well as cause increased sensitivity. The manufacturer draws attention to the possibility of activating appetite and weight gain. In rare cases, the use of Nuvaring causes depression, sudden changes in mood, sometimes unpredictable. There is a possibility of headaches similar to migraines. In addition, Nuvaring can provoke a deterioration in the functioning of the visual system.

Instructions for use Nuvaring rings

You can insert the ring into the vagina with your own hands and in the comfort of your home.

It's easy to do, just:

• Find a better position: stand (raising one leg up) or squat;
• Unpack the device;
• Gently insert into the vagina, squeezing lightly in your hands.
• To remove the device, you should also pinch it in the middle with your index and middle fingers and carefully remove it from the vagina.

If you violate the rules and mode of application, the effectiveness of the impact will be greatly underestimated.

On a note! If the ring is accidentally broken, the concentration of released hormones should not change. Usually a damaged ring falls out immediately. In this case, it is advisable to immediately replace it with a new one.

Terms of use

1. Administration of the drug is a course, i.e. performed once a month vaginally. So you need to carefully insert it, place it on the vaginal mucosa, leave it for 3 weeks, then remove it and interrupt the course for 1 week.
2. It is not advisable to interrupt courses , because the effectiveness can be significantly reduced.
3. Starting from the second course, the ring must be inserted on the same day on which it was initially inserted. So, when installed on Wednesday, it must also be removed on Wednesday, but after 21 days. After a 7-8 day break, the ring can be inserted again .
4. If the contraceptive was taken orally in the last cycle with a course of treatment of 21 days, then you can replace it on any day during the first 7, from which time the countdown will begin. If for some reason the ring was removed or fell out, then it is advisable to replace it no later than the first 3 hours in order to avoid a decrease in the effect.
5. Also, the effect will be slowed down if the drug is kept in the vagina for more than 4 weeks in a row. It will be difficult to exclude the possible occurrence of an unwanted pregnancy. If menstruation is suspected or delayed, it is recommended to first purchase a test and get checked.

If the ring falls out

IMPORTANT! It happens that the drug suddenly falls out due to improper use or as a result of combined removal with a tampon. In this case, you can rinse with warm water and put it back on. If necessary, you can change the arrival time of menstruation, for example, shorten the break by using the device for the required number of days.

Use of oral contraceptives

If you have previously used oral contraceptives, then switching to the ring should be done on the last, 7th day of the intermediate interval between courses.

In this case, women are advised to first make sure that there is no pregnancy and only then start taking Nuvaring correctly, regularly, starting on any day of the cycle.

After childbirth and abortion

If, for medical reasons, using the device during an abortion is undesirable, then you can choose a different method of contraception in the interval between menstrual cycles.

During the postpartum period or after surgery (abortion), the use of Nuvaring should be started from the 4th week. If you had sexual intercourse during the first 7 days, then it is advisable to check first to see if there is any pregnancy, then, if it is ruled out, wait for the arrival of menstruation and start using the drug again.

If patients do not comply with the recommended regimen for taking Nuvaring, it is quite possible that the menstrual cycle will be disrupted and the protective barrier effect will decrease.

Additional recommendations

In addition, while using contraception, women should not neglect the following rules and recommendations:

• do not extend the break when using the ring , because the likelihood of pregnancy will be higher;
• if at the time of the break during use there was unprotected sex , then first you should exclude the onset of pregnancy, which is quite possible;
• it is allowed to use other methods of barrier contraception (condoms) for the period of temporary removal of the ring from the vagina;
• the time interval between courses should not exceed 3 hours , otherwise the effectiveness of the drug will be noticeably reduced;
• if the ring is torn , then you need to throw it away and install a new one immediately, or wait for bleeding, i.e., install it in the next three weeks;
• if bleeding occurs after the device stops working , then a complete one should be administered no later than the seventh day after removal of the previous one;
• It is better to set it on the 1st day of the menstrual cycle , although no later than the 5th day of the cycle;
• when used in the initial cycle during the first 7 days, it is better to use other contraceptives in addition;
• it is recommended to regularly check whether Nuvaring is located in the vaginal cavity , because it is poorly felt and can accidentally fall out during sexual intercourse;
• rare, but there are cases of incorrect insertion of the ring by women, i.e. in the urethra . Burning, itching, and signs of cystitis may appear. This will indicate that the device needs to be rearranged urgently.

When using a hormonal contraceptive, it is not recommended to violate the frequency and exceed the time period of 3 weeks. If mini-pills have been used previously, the contraceptive ring should be inserted immediately the next day or wait a 7-day break using additional barrier methods.

Important aspect

At the moment, there is no official information about the possible negative consequences of using Nuvaring by underage girls. No special studies were organized to determine this fact.

Analyzes were conducted to determine the effects of the active compounds on bone mineral density. The duration of the program is two years. Nuvaring and intrauterine device were compared. Based on the results, a reasonable conclusion was made that there was no effect on bone density when choosing Nuvaring as a method of contraception.

Some doubt what Fr. should be like. The manufacturer points out that no special measures are required. Consent with the treating doctor is only necessary if the ring was used against the background of fibroids. Otherwise, the woman simply stops using the contraceptive at any time of her own free will.

Dosage

It is recommended to use the ring once a month by inserting it on the 1st day of menstrual bleeding. If there was no use of hormonal contraception in the previous menstrual cycle, then Nuvaring can be started on days 2-5 of the cycle.

The ring stays in the vagina for 3 weeks.

Falling out or deliberate removal should not be prolonged. It is not necessary to change the drug to a new one. If it is in intact condition, then it is enough to rinse with warm water and re-introduce it within the next three hours.

Manufacturers of intrauterine rings

On the domestic pharmaceutical market you can find the NuvaRing ring, produced by Merck.
On average, for a package of products (3 pieces), you need to pay from 2,800 to 3,600 rubles. Contraceptive rings that protect against unplanned pregnancy can be easily purchased at pharmacies or on websites that sell certified contraception. Before using the ring, a woman must visit her gynecologist and undergo an appropriate examination to assess the general condition of the body and the condition of the reproductive system in particular. The use of this protective device is permitted only if there are no contraindications.

The maximum storage period for this device when sealed is 3 years . The recommended storage temperature should vary from +2 to +8 degrees, and it is important to ensure that the contraceptive is out of sight of children.

Interaction with other drugs

The effect of the drug may be reduced if you take certain medications at the same time:

• anti-tuberculosis (Rifampicin);
• antiviral (Ritonavir);
• natural medicines containing St. John's wort;
• antimicrobial (Tetracycline, Ampicillin);
• antiallergic (Phenobarbital, Primidon, Phenytoin, Felbamate, Carbamazepine, Topiramate,).

Recommendations for combination with other medications:

1. If it is necessary to carry out concomitant therapy, then when taking Nuvaring you should first consult a doctor, so as not to get adverse reactions later.
2. A number of drugs may well lead to acyclic bleeding. Should not be taken together. Ring rupture is also possible when taken simultaneously with the antifungal “Spermicide”.
3. If used in conjunction with suppositories, in order to avoid unpleasant consequences from interaction, it is important to study the instructions before using other vaginal contraceptives.

Tampons and pads will not have a negative impact and will not affect the effect when Nuvaring is administered, although it happens that the ring is removed accidentally, together with the removal of the tampon.

Is the devil really that scary?

As the manufacturer mentions in the instructions, although the Nuvaring ring can cause side effects, in practice this is really rare. Mostly unpleasant impressions accompany the very beginning of using a contraceptive and gradually disappear over time. No specific treatment is required. If the symptoms are severe and difficult to tolerate, you should seek help from a qualified doctor as quickly as possible. The doctor will help you choose the best replacement option if Nuvaring is not suitable as a contraceptive.

Some people note in their reviews the side effects of Nuvaring: dizziness, headache. It is known that in rare cases, the use of contraceptives has even caused anxiety. When using this method of protection, vomiting is possible, although this is observed quite rarely, since the drug is used topically and not orally, and does not irritate the intestines or stomach at the stage of primary processing of the medication. The possibility of weight gain was mentioned above, but in rare cases the effect on a woman using Nuvaring was exactly the opposite - when using a contraceptive there is a risk of sudden, causeless weight loss.

Use during pregnancy and breastfeeding

Nuvaring is designed to protect the female body from unwanted pregnancy.
If you want to get pregnant, women are advised to first wait until the natural menstrual cycle is restored, then start calculating the possible date of conception and birth.

The drug should not be used once pregnancy occurs, as soon as it is known.

In this condition, it is important to stop contraception in a timely manner, despite the absence of cases of detecting defects in newborns.

Nuvaring is administered topically, into the vagina, and is considered a safe drug, but it is not advisable to use it while breastfeeding. The active ingredients will negatively affect lactation and reduce the production of breast milk.

It is known that metabolites and steroids are excreted in breast milk, although a negative impact on the health of children has not been proven.

There are different probabilities

In the instructions, the manufacturer indicates that Nuvaring can cause side effects, and then provides an exhaustive list of such phenomena. Mostly these are fairly minor threats, such as temporary bowel disorders or increased gas formation. All of them soon disappear on their own when the body adapts to the hormonal drug. But on the World Wide Web, some mention more severe consequences - even unsuccessful attempts to get pregnant due to prolonged use of contraception. For some, these stories are an important incentive to completely abandon the drug that corrects female hormonal levels. Let's first look at what the manufacturer pays attention to first, and to do this, let's look at what we're talking about in general.

As can be seen from the instructions, the Nuvaring ring is a colorless product made of smooth material. This is a transparent object that has no damage on the outer sides that is visible to the human eye. The junction is either completely transparent or close to it. This unique development of Dutch doctors has a reliable contraceptive effect, helps prevent unwanted pregnancy, and provides the highest level of reliability. The ring is easy to use; you don’t need to remember every day, as is the case with tablets, what time and how to take the drug. Its only weakness is the somewhat probable negative response of the body.

special instructions

• Nuvaring is not able to protect the vaginal mucosa from sexually transmitted infections.
• It’s not scary if vaginal bleeding appears as you use it , but if it intensifies or lasts too long, you should consult a specialist.
• The drug should be used only when a possible pregnancy has been ruled out , in particular after an examination of the mammary glands and cervix by taking a smear for cytology. It is imperative to exclude existing contraindications and side effects, and measure blood pressure before inserting a contraceptive.
• As women use hormonal Nuvaring, they periodically need to undergo medical examinations. examination at least 2 times a year. If unpleasant signs or exacerbation of chronic diseases appear, you should consult your doctor. The device, namely its frequent administration, can lead to circulatory disorders and deep vein thrombosis, when the risk of mortality due to complications is high.
• The connection between Nuvaring and other hormone-dependent contraceptives has not been identified, but it is possible: blurred vision;
• kidney dysfunction;
• venous arterial thrombosis;
• the appearance of sudden chest pain, coughing attacks, weakness, numbness of one (right, left) part of the body;
• double vision;
• dizziness;
• venous embolism;
• varicose veins

Forewarned is forearmed

As you know, the side effects of the Nuvaring ring include a negative effect on the functioning of the heart and vascular system. The likelihood of thromboembolism increases, and blood pressure may be impaired. Some women have experienced hot flashes while using this contraceptive method. In addition, the ring can have a negative effect on the stomach and intestines. This is expressed in stool disorders, increased gas formation, and other disorders. There is a risk of itching, skin rashes, minor inflammations, including the facial area.

Side effects mentioned in patient reviews about the Nuvaring ring include unpleasant, even painful sensations in muscle tissue, limbs, and various parts of the spinal column. Some complain of swelling and a general sluggish state of the body. There is a risk of cystitis, possible increased urge to urinate, dysuria. Negative responses can also be noticed from the reproductive system. Some women, when using Nuvaring as a method of contraception, experience engorgement of the breast glands, there is a possibility of disruption of the monthly cycle, and lack of bleeding in the prescribed time frame. It is known that under the influence of hormonal compounds contained in the ring, a genital node may appear, bleeding for no reason, and spotting during intimate contact are possible. Nuvaring can cause unpleasant local sensations - itching, burning, pain.

Analogs

There are no drugs known today that are similar in effect and composition to Navarng.

Taking into account the pharmacological group, the combination of estrogens and gestagens, the following can be considered analogues:

• Klimadinon;
• Divina;
• Janine;
• Desmoulins;
• Cliogest;
• Klimonorm;
• Midiana;
• Silest;
• Triquilar;
• Femoflor;
• Eviana;
• Yarina plus;
• Regulon;
• Povidone;
• Novinet;
• Non-ovlon.

Klimadinon

Janine

Yarina tablets

Divina

Klimonorm

Cliogest

Midiana

Non-Ovlon

Novinet

Regulon

Silest

Triquilar