Nuvaring hotline. Brown discharge and Nuvaring

Vaginal ring NuvaRing is modern method contraception, which has very high reliability and relative ease of use. The NuvaRing hormonal ring is gaining more and more popularity and is gaining good feedback gynecologists.

The contraceptive ring is inserted into the vagina and remains there for 3 weeks. Once in the vagina, the NuvaRing releases small doses hormones that suppress the ovaries, prevent ovulation and make pregnancy impossible.

According to the manufacturer, the effectiveness vaginal ring NuvaRing in preventing pregnancy is about 99%, however, according to independent studies, it is within 92%. The NuvaRing contraceptive ring is more reliable than birth control pills, and about the same efficiency as .

Composition and release form

The NuvaRing hormonal ring is available in the form of flexible transparent rings in packages of 1 and 3 pieces.

Each NuvaRing ring contains the hormones etonogestrel (11.7 mg) and ethinyl estradiol (2.7 mg).

Advantages of the NuvaRing vaginal ring

What are the advantages of NuvaRing? The contraceptive ring has the following advantages:

• Unlike birth control pills, which need to be taken every day, the NuvaRing hormonal ring needs to be inserted into the vagina only once a month (to be more precise, once every 4 weeks).
• With the constant use of NuvaRing, periods become less painful and less abundant.
• Data from some studies suggest that the use of NuvaRing reduces the risk of ovarian cancer.
• The NuvaRing ring adapts to individual characteristics the female body, therefore it is not felt in any way either by the woman herself or her sexual partner.
• Unlike a hormonal contraceptive injection, the NuvaRing ring does not lead to the appearance of symptoms and to.

Disadvantages of the NuvaRing contraceptive ring

The main disadvantages of the NuvaRing ring are its price (higher compared to birth control pills) and the risk of the ring falling out if it is inserted incorrectly. The skill of inserting a ring correctly comes with experience.

In addition, the NuvaRing ring does not protect against sexually transmitted diseases (, etc.), therefore it is recommended only for women who have a permanent partner in whom she is confident.

Important information

Do not forget that the NuvaRing ring is a hormonal method of contraception, which means its use is associated with some risks. Do not start using NuvaRing on your own or based on recommendations from friends. Before using the drug, consult a gynecologist and make sure that you have no contraindications to this method contraception.

Contraindications to the use of the NuvaRing ring

Avoid using the NuvaRing hormonal contraceptive ring if:

• You are or may be pregnant.
• You are breastfeeding.
• You are over 35 years old and smoke.
• You have had vein thrombosis or are prone to forming blood clots.
• You have high blood pressure.
• You often have headaches.
• You have diabetes.
• You have had breast cancer or other malignant diseases.
• You often have bleeding from the vagina, and the cause is unclear to you.

In some situations, the use of NuvaRing is permissible after consultation with your doctor:

• At varicose veins veins
• At elevated level cholesterol in the blood.
• With a body weight of more than 90 kg.
• For epilepsy.
• For gallbladder diseases (cholecystitis, gallstones).
• For problems with the thyroid gland.

This is far from full list. If you are unsure whether NuvaRing is appropriate for your disease or condition, consult your doctor.

Rules for using the NuvaRing ring

The NuvaRing hormonal ring should be inserted into the vagina for 3 weeks and removed on the same day of the week. The new ring must be inserted exactly after 7 days. During the week's break, you may begin to menstruate.

For example, if you inserted a ring on Monday at 8 pm, then you need to remove it exactly 3 weeks later on Monday at 8 pm and insert a new ring the following Monday at approximately 8 pm.

Wash your hands thoroughly before inserting the ring. Take a comfortable position: standing with one foot on the toilet, squatting or lying down. Remove the ring from the package, squeeze it between your index and thumb and insert deep into the vagina. The ring will automatically take the desired position around the cervix. If the ring is inserted correctly, you will not feel it.

To remove the NuvaRing, wash your hands thoroughly, take a comfortable position, and pick up the ring with one or two fingers. The used ring can be thrown into the trash (but not into the toilet).

Is the contraceptive effect maintained during the break?

During a week's break contraceptive effect The NuvaRing remains intact and you do not need to use other methods of contraception. This is only true if you insert a new ring after the break ends.

If you did not use hormonal contraceptives in the previous cycle

Enter contraceptive ring NuvaRing on the first day of your period. In this case, the contraceptive effect will occur immediately. If for some reason you inserted the ring on days 2-5 of your period, you should use it within the next 7 days.

How to switch to NuvaRing from birth control pills?

If the package of your birth control pills contained 21 tablets, then insert the NuvaRing ring on the 7th day of the week break (that is, on the day when you started taking the next package of pills).

If your OC contained 28 tablets per package, administer the NuvaRing ring the day after taking the last 28 tablets.

How to use NuvaRing after childbirth?

The NuvaRing hormonal ring should be inserted into the vagina no earlier than a month after childbirth. If the ring is inserted in the first 4 weeks after birth, there is a very high risk of it falling out.

If you have already had unprotected sex before inserting the ring, you should first make sure that you are not pregnant, or wait until your first menstruation begins.

If you are not menstruating yet, you can start using the ring any day (after making sure that you are not pregnant). After inserting the ring, use additional funds contraception (condoms) for another 7 days.

Can NuvaRing be used while breastfeeding?

How to use the NuvaRing ring after an abortion?

If the pregnancy was terminated at less than 12 weeks, the NuvaRing ring can be inserted on the day of the abortion. In this case, the contraceptive effect occurs immediately, and you do not need to use additional contraception. If you did not have time to insert the ring on the day of the abortion, then wait next menstruation and insert the ring on the first day of your period. Use condoms before your period starts.

If the pregnancy termination occurred more than 12 weeks, then use the instructions in the section “How to use NuvaRing after childbirth.”

What should I do if I forgot to remove the NuvaRing after 3 weeks?

If you forgot to remove the NuvaRing ring in time, then try to remember how long ago you installed it:

• If the ring was inserted 4 weeks ago or less, remove the ring as soon as possible and take a 7-day break. Insert a new ring on the 7th day after removing the previous one. You don't need to use additional methods contraception, since in this case the contraceptive effect of the NuvaRing ring is preserved.
• If the ring was inserted more than 4 weeks ago, the contraceptive effect may be reduced. In this case, you need to remember whether you had unprotected sex. If you have had unprotected sex, stop using rings until you are sure that you are not pregnant (make or donate). If you have not had unprotected sexual intercourse and you are sure that you are not pregnant, then insert a new ring immediately after removing the previous one and use additional methods of contraception for another 7 days.

What should I do if I forgot to put in a new NuvaRing after a week's break?

Try to remember if you had unprotected sex after the previous ring was removed. If so, do not insert a new ring until pregnancy has been ruled out.

If after removing the previous ring you did not have unprotected sex, then insert a new ring as quickly as possible and use additional methods of contraception (condoms) for another 7 days.

What to do if the NuvaRing falls out?

If the NuvaRing is not installed correctly, it may fall out of the vagina. In this case, the contraceptive effect may be reduced and there is a risk of pregnancy.

If the ring fell out less than 3 hours ago, wash it cool water and insert it back into the vagina. In this case, the contraceptive effect is not impaired and the risk of pregnancy does not increase.

If the ring fell out more than 3 hours ago, the contraceptive effect is reduced.

• If this is the first or second week after inserting the ring, then after rinsing the ring with cool water, insert it back into the vagina and use additional methods of contraception (condoms) for another 7 days.
• If this is the third week after inserting the ring, then throw it away and insert a new ring immediately. In this case, you may not bleed, or you may experience spotting. This is fine. If for some reason you did not insert a new ring immediately, then wait for the start of bleeding (menstruation) and insert a new ring in the first 7 days after removing the previous one.

How to postpone unwanted menstruation using the NuvaRing ring?

When using the NuvaRing contraceptive ring, you have the opportunity to postpone your next period if for some reason you do not want it (vacation, etc.)

To do this, install a new NuvaRing on the same day as the previous one was removed, without taking a 7-day break. Remove this ring after 3 weeks and then take a 7-day break, returning to your normal ring usage.

In this case, you may experience spotting and spotting. This is fine.

Bloody (brown) discharge when using the NuvaRing ring

While using the contraceptive NuvaRing, spotting may occur. bloody discharge in the middle of the cycle. This is a normal phenomenon that does not require discontinuation of the drug. Contact your doctor if you experience spotting almost every day or every day for an entire month.

The appearance of spotting in the middle of the cycle may also indicate that the ring has fallen out and the contraceptive effect is reduced. In this regard, when spotting appears, you need to make sure that the ring is in place. To do this, wash your hands thoroughly and, taking a comfortable position, insert one finger into the vagina, trying to feel the ring.

Can I use tampons and the NuvaRing at the same time?

Yes, there are no contraindications for this. In this case, of course, you should comply.

IN in rare cases The ring may fall out when you remove the tampon, so when using tampons you should regularly check that the ring is in place.

In what cases can the contraceptive effect of the NuvaRing ring be reduced?

Taking certain medications may reduce the contraceptive effect of NuvaRing. For example, when taking antibiotics, a woman is recommended to use additional contraception (condoms) throughout the entire course of treatment and for another 7 days after finishing antibiotic treatment.

Before taking any medicine, check with your doctor to see if it may reduce the contraceptive effect of the NuvaRing.

What to do if your period does not come within a week's break?

In some women, due to constant use of the NuvaRing ring, menstruation may stop altogether.

If your period does not come during a week-long break, then try to remember whether the ring fell out for more than 3 hours last month. If it fell out, then the contraceptive effect of the ring could be reduced, which means you need to do it.

If you used the ring according to the instructions, then the likelihood of pregnancy is quite low. In this case, you can insert a new ring on the 7th day after removing the previous one. If menstruation does not begin in the second cycle, consult a doctor.

What to do if pregnancy occurs while using the NuvaRing ring?

Despite high efficiency contraceptive ring NuvaRing, in rare cases, pregnancy occurs during its use. If you think you may be pregnant, remove the ring from your vagina immediately and contact your doctor.

If the pregnancy is confirmed and you want to keep it, then there are no obstacles to this. The use of the ring does not increase the risk of developmental abnormalities in the fetus, which means you still have a high chance of giving birth to a healthy baby.

How to get pregnant after using the NuvaRing ring?

If you are planning a pregnancy, then after the third week of using the ring, remove it and do not install a new one. Pregnancy can occur in the next cycle after you stop using NuvaRing.

NuvaRing (vaginal rings. sachet N1) Netherlands N.V.Organon

Trade name: NuvaRing

International name: Etonogestrel + Ethinyl estradiol

Manufacturer: N.V.Organon

Country: Netherlands

Packaging: vaginal rings 1 pc., sachets (1) - cardboard packs

Registration number P N015411/01

Registration date 12/25/2003

Description (Vidal 2008):

NuvaRingR

Representation:

ORGANON ATX code: G02BB01

Registration Certificate Holder:

ethinylestradiol + etonogestrel

Release form, composition and packaging

The vaginal ring is smooth, transparent, colorless or almost colorless, without large visible damage, with a transparent or almost transparent area at the junction.

ethinylestradiol 2.7 mg

Excipients: ethylene vinyl acetate copolymer (28% vinyl acetate), ethylene vinyl acetate copolymer (9% vinyl acetate), magnesium stearate, purified water.

1 PC. - aluminum foil bag (1) - cardboard boxes.

Clinical and pharmacological group: Hormonal contraceptive for intravaginal administration

Registration No.:

# vaginal ring 11.7 mg+2.7 mg: 1 pc. - P No. 015411/01, 12/25/03 PPR

The description of the drug is based on the officially approved instructions for use and approved by the manufacturer for the 2006 edition.

Pharmacological action | Pharmacokinetics | Indications | Dosage regimen | Side effect| Contraindications | special instructions| Overdose | Drug interactions| Storage conditions and expiration dates

pharmachologic effect

Hormonal contraceptive for intravaginal use containing estrogen - ethinyl estradiol and gestagen - etonogestrel. Etonogestrel, a 19-nortestosterone derivative, binds to progesterone receptors in target organs.

The contraceptive effect of the drug NuvaRing is based on various mechanisms, the most significant of which is inhibition of ovulation. The Pearl index of the drug NuvaRing is 0.765.

In addition to the contraceptive effect, the drug has positive influence for the menstrual cycle. With its use, the cycle becomes more regular, menstruation is less painful, with less bleeding, which in turn can help reduce the frequency iron deficiency conditions. In addition, there is evidence of a reduced risk of endometrial and ovarian cancer.

Pharmacokinetics

Suction

Etonogestrel released from NuvaRing is rapidly absorbed by the vaginal mucosa. The etonogestrel Cmax of approximately 1700 pg/ml is achieved approximately one week after ring insertion. Serum concentrations are subject to slight fluctuations and slowly reach a level of 1400 pg/ml after 3 weeks. Absolute bioavailability is about 100%.

Distribution

Metabolism

Removal

The decrease in serum etonogestrel concentration is biphasic. T1/2?-phase is about 29 hours. Etonogestrel and its metabolites are excreted in urine and bile in a ratio of 1.7:1. T1/2 of metabolites is about 6 days.

Ethinyl estradiol

Suction

Ethinyl estradiol released from NuvaRing is rapidly absorbed by the vaginal mucosa. Cmax is about 35 pg/ml, achieved by 3 days after insertion of the ring and decreases to 18 pg/ml after 3 weeks. Absolute bioavailability is about 56%, which is comparable to oral bioavailability.

Metabolism

Ethinyl estradiol is initially metabolized by aromatic hydroxylation to form a variety of hydroxylated and methylated metabolites, which are present both in the free state and as glucuronide and sulfate conjugates. Serum clearance is about 3.5 l/h.

Removal

The decrease in serum ethinyl estradiol concentration is biphasic. T1/2?-phase is characterized by large individual differences, and, on average, is about 34 hours. Ethinyl estradiol is not excreted unchanged; its metabolites are excreted in urine and bile in a ratio of 1.3:1. T1/2 of metabolites is about 1.5 days.

Indications

Contraception.

Dosage regimen

NuvaRing is inserted into the vagina once every 4 weeks. The ring is placed in the vagina for 3 weeks and then removed on the same day of the week on which it was placed in the vagina. After a week's break, a new ring is inserted. Bleeding associated with discontinuation of the drug usually begins 2-3 days after removal of the NuvaRing and may not completely stop until the next ring needs to be used.

If hormonal contraceptives have not been used in the previous menstrual cycle, NuvaRing should be administered between days 1 and 5 menstrual cycle, but no later than the 5th day of the cycle, even if the woman has not completed menstrual bleeding. During the first 7 days of the first cycle of NuvaRing use, additional use of barrier methods of contraception is recommended.

When switching from taking combined oral contraceptives, NuvaRing should not be administered. later in the day, following the interval in taking the drug. If the combined oral contraceptive also contains inactive tablets (placebo), then NuvaRing should be administered no later than the day following the taking of the last placebo tablet.

When switching from progestogen contraception (mini-pill, implant or injectable contraception) or progestogen-releasing intrauterine devices (IUD), NuvaRing should be administered on any day (if the patient took the mini-pill), the day after removal of the implant or IUD, and for injection contraception - on the day when the next injection is needed. In all these cases, an additional barrier method of contraception should be used during the first 7 days of using NuvaRing.

After an abortion performed in the first trimester of pregnancy, you can start using NuvaRing immediately after the abortion. In this case, there is no need for additional use of other contraceptives. If the use of NuvaRing immediately after an abortion is undesirable, then the ring should be used in the same way as if hormonal contraceptives were not used in the previous cycle.

After childbirth or an abortion performed in the second trimester of pregnancy, you should begin using NuvaRing within the 4th week after childbirth or abortion. If the use of NuvaRing is started more than late dates, then additional use of barrier methods of contraception is necessary in the first 7 days of using NuvaRing. However, if sexual intercourse has already taken place during this period, you must first exclude pregnancy or wait until your first menstruation before starting to use NuvaRing.

The contraceptive effect and cycle control may be impaired if the patient violates the recommended regimen. To avoid loss of contraceptive effect in case of deviation from the regimen, you must follow the following recommendations:

If you are not using the ring for an extended period, you should place a new ring in your vagina as soon as possible. Additionally, over the next 7 days it is necessary to use a barrier method of contraception. If you had sexual intercourse during the break from using the ring, you should consider the possibility of pregnancy. How longer break, the higher the risk of pregnancy.

If the ring was accidentally removed and remained outside the vagina for less than 3 hours, the contraceptive effect will not decrease. The ring should be reinserted into the vagina as soon as possible. If the ring is left outside the vagina for more than 3 hours, the contraceptive effect may be reduced. The ring should be placed in the vagina as soon as possible, after which it should be in the vagina continuously at least for 7 days, and it is necessary to additionally use a barrier method of contraception during these 7 days. If the ring was outside the vagina for more than 3 hours during the third week of its use, then its use should be extended beyond the prescribed three weeks (until the end of 7 days after reinsertion of the ring). After this, the ring should be removed and a new one placed after a week's break. If removal of the ring from the vagina for a period of more than 3 hours occurs during the first week of using the ring, the possibility of pregnancy should be considered.

In case of prolonged use of the ring, but not longer than 4 weeks, the contraceptive effect is maintained. You can take a week's break and then place a new ring. If NuvaRing has been in the vagina for more than 4 weeks, the contraceptive effect may decrease, and pregnancy must be excluded before using a new NuvaRing ring.

If the patient does not adhere to the recommended regimen and then does not experience bleeding caused by ring removal during a week-long break from using the ring, pregnancy must be ruled out before using a new vaginal ring.

To delay the onset of menstruation, you can start using a new ring without a week's break. The next ring should also be used for 3 weeks. This may cause bleeding or spotting. Then, after the required one-week break, you should return to regular use of NuvaRing.

To shift the onset of menstruation to another day of the week from the day that falls according to the current scheme of using the ring, you can shorten the upcoming break in using the ring for as many days as necessary. The shorter the break in using the ring, the higher the likelihood of no bleeding occurring after ring removal, and the occurrence of untimely bleeding or spotting during the use of the next ring.

Rules for using NuvaRing

The patient can independently insert NuvaRing into the vagina. To insert the ring, a woman should choose the position that is most comfortable for her, for example, standing, raising one leg, squatting, or lying down. NuvaRing must be squeezed and inserted into the vagina until comfortable position rings. The exact position of NuvaRing in the vagina is not decisive for the contraceptive effect of the ring. After insertion, the ring must remain in the vagina continuously for 3 weeks. If it is accidentally removed (for example, when removing a tampon), the ring must be rinsed warm water and immediately place it in the vagina. To remove the ring, you can pick it up index finger or squeeze it between your index and middle fingers and pull it out of the vagina.

Side effect

From the side of the central nervous system: headache, migraine, depression, emotional lability, dizziness, anxiety, feeling tired.

From the outside digestive system: nausea, abdominal pain, diarrhea, vomiting.

From the outside endocrine system: decreased libido, soreness, tension and enlargement of the mammary glands, dysmenorrhea, increase or decrease in body weight.

From the reproductive system: vaginal discharge(“leucorrhoea”), vaginitis, cervicitis.

From the urinary system: infections urinary tract(including cystitis).

Local reactions: loss of the ring, feeling of discomfort during sexual intercourse in women and men, sensation foreign body in the vagina.

Contraindications

Venous or arterial thrombosis/thromboembolism (including a history);

Risk factors for thrombosis (including history);

Migraine with focal neurological symptoms;

Diabetic angiopathy;

Pancreatitis (including a history) in combination with high degree hypertriglyceridemia (LDL concentration more than 500 mg/dL);

Severe liver diseases (until normalization of function indicators);

Liver tumors (benign or malignant, including history);

Hormone dependent malignant tumors(established or suspected, for example, tumors of the genital organs or mammary glands);

Vaginal bleeding of unknown etiology;

Pregnancy or suspicion of it;

Lactation period;

Hypersensitivity to the components of the drug.

The drug should be prescribed with caution when diabetes mellitus, obesity (body mass index over 30 kg/m2), arterial hypertension, atrial fibrillation, heart defects, dyslipoproteinemia, liver or gallbladder disease, Crohn's disease or ulcerative colitis, sickle cell anemia, systemic lupus erythematosus, hemolytic uremic syndrome, epilepsy, smoking in combination with age over 35 years, with prolonged immobilization, major surgical interventions, fibrocystic mastopathy, uterine fibroids, congenital hyperbilirubinemias (Gilbert, Dubin-Johnson and Rotor syndrome), chloasma (avoid exposure to ultraviolet rays), as well as conditions that make it difficult to use a vaginal ring (cervical prolapse, hernia Bladder, rectal hernia, severe chronic constipation).

Use for liver dysfunction

Contraindicated in serious illnesses liver (until normalization of function indicators).

special instructions

Before prescribing NuvaRing, you should collect a detailed medical history of the patient, as well as conduct a medical examination, taking into account contraindications and precautions. During the period of use of NuvaRing, the examination should be repeated at least once a year. The frequency and list of studies should be selected individually for each patient, but in any case Special attention should be given to blood pressure control, examination of the mammary glands, organs abdominal cavity and pelvis, including cytological examination cervix and related laboratory tests.

The effectiveness of NuvaRing may be reduced if the regimen is not followed or if other drugs are used concomitantly.

If necessary, use while using NuvaRing medicines which may affect the contraceptive effect of the ring, you should use a barrier method of contraception in addition to using NuvaRing or choose another method of contraception. When taking inducers of microsomal liver enzymes while using NuvaRing, you should use a barrier method of contraception during the course of taking concomitant medications and for 28 days after stopping them. At simultaneous administration antibiotics (excluding rifampicin and griseofulvin) the barrier method should be used for at least 7 days after stopping the course antibacterial therapy. If the course of therapy with concomitant medications continues beyond 3 weeks of ring use, the next ring is placed immediately, without a week's break.

The use of contraceptive steroids may affect the results of certain laboratory research, including biochemical indicators of liver function, thyroid gland, adrenal glands and kidneys, plasma levels of transport proteins (for example, corticosteroid binding globulin and sex hormone binding globulin), lipid/lipoprotein fractions, indicators carbohydrate metabolism and indicators of coagulation and fibrinolysis. Indicators, as a rule, vary within normal values.

During pregnancy or taking oral hormonal contraceptives, conditions such as gestational herpes, hearing loss, minor chorea, and porphyria may occur.

The patient should be informed that NuvaRing does not protect against HIV infection (AIDS) and other sexually transmitted diseases.

While using NuvaRing, irregular bleeding may occur ( slight discharge or sudden bleeding).

Some women do not experience any bleeding caused by ring removal while they are not using the ring. If NuvaRing is used as directed, it is unlikely that the woman will be pregnant. If you deviate from the recommended regimen and there is no bleeding from drug withdrawal, or if there is no bleeding 2 times in a row, pregnancy should be excluded.

Degree of impact and possible pharmacological effects ethinyl estradiol and etonogestrel on sexual partners through absorption through the skin of the penis have not been studied.

Overdose

Cases of overdose are unknown.

Suspected symptoms of overdose: nausea, vomiting, vaginal bleeding.

Treatment: carried out symptomatic therapy. There are no antidotes.

Drug interactions

Interactions between hormonal contraceptives and other medicines may result in breakthrough bleeding and/or loss of contraceptive effect.

With simultaneous use of NuvaRing with drugs that induce microsomal liver enzymes (phenytoin, phenobarbital, primidone, carbamazepine, rifampicin, oxcarbazepine, topiramate, felbamate, ritonavir, griseofulvin, St. John's wort), the metabolism of sex hormones is increased and the contraceptive effect of NuvaRing is reduced.

The effectiveness of NuvaRing may also be reduced when taking certain antibiotics, such as penicillins and tetracyclines, at the same time. These drugs reduce the enterohepatic circulation of estrogens, resulting in decreased concentrations of ethinyl estradiol.

Effect on the contraceptive effect and safety of NuvaRing antifungal drugs There are no known spermicides prescribed intravaginally. No direct interactions were observed between etonogestrel and co-administered ztinyl estradiol.

Storage conditions and periods

NuvaRing should be stored out of the reach of children at a temperature of 2° to 8°C.

Conditions for dispensing from pharmacies

NuvaRing is available with a prescription.

Self-sufficiency and success modern woman allows her to plan her lifestyle the way she wishes.

Gone are the days when women were little aware of methods of contraception. One of the innovations in contraception can be successfully called the Nuvaring contraceptive ring - a hormonal method that prevents unwanted pregnancy.

The cost of one ring ranges from 975 - 1730 rubles. The three-ring pack costs more.

Instructions for using the Nuvaring ring

The protective properties of the vaginal ring are based on the activity of etonogestrel, a progestogen derivative, and ethinyl estradiol. The latter is an estrogen widely used in contraceptives. The main effect of the ring is based on inhibition of ovulation.

How to use the Nuvaring birth control ring?

• The ring is inserted into the vagina at comfortable for this pose.
• From the moment of insertion, the ring must remain inside the vagina three weeks.
• After three weeks, the ring must be removed and menstruation will begin.
• After a week's break, it is introduced new Nuvaring ring.

Nuvaring is administered between the first and fifth day of the menstrual cycle.

If menstruation does not end on the fifth day, the ring still needs to be inserted into the vagina on 5th day of the cycle.

For the first seven days the ring is in place, you must use a condom.

After childbirth or abortion, the ring can be used as a contraceptive for fourth week.

Contraindications to the use of a vaginal ring

Contraindications to the use of the ring are the following diseases of a woman:

• vein thrombosis
• predisposition to blood clots
• diabetes
• vaginal bleeding of unknown cause
• malignant tumors
• pancreatitis
• allergic reaction to the components of the drug
• pregnancy
• lactation
• ulcerative colitis
• smoking in older age 35 years
• chronic constipation

If the ring falls out, the contraceptive properties of the ring remain for several hours, and an unwanted pregnancy cannot occur.

It is necessary to insert the ring into the vagina as quickly as possible.

Reviews of women who used the Nuvaring ring

All more women choose a vaginal ring as a method of contraception.

The Nuvaring ring used, which has varying reviews, causes some controversy among women. They mainly concern the high price of contraception. As reviews show, the ring has its advantages:

• menstruation becomes regular and predictable
• pain decreases during menstruation
• reduces the intensity of bleeding during menstruation
• reduces the risk of developing anemia

Anastasia, 25 years old: for a long time I used a spiral.

Yulia, 30 years old: I thought about this method of contraception for a long time. There was no doubt about the reliability of the method. I decided to use the ring a year ago and have never regretted it. The ring never falls out and is very effective.

Anna, 32 years old: Unlike other hormonal methods, the ring is modern means from unwanted pregnancy. Once a month you insert the ring and there are no problems. You immediately forget about the ring, it doesn’t cause any inconvenience. Despite the fact that the vaginal ring is large, it is not felt inside.

Side effects

Popular contraceptive ring Nuvaring as hormonal drug may cause some side effects using. Possible manifestation:

• vaginal infections (cystitis, genital tract infection, cervicitis)
• headaches
• abdominal pain
• nausea
• acne
• decreased libido
• depression
• muscle cramps
• hypertension

When using a vaginal ring, it is possible violations blood circulation, venous thrombosis, symptoms of which include acute, uncharacteristic pain in the limbs and swelling.

Today, the vaginal ring is one of the most effective and efficient methods of contraception. Nuvaring contraceptive ring – hormonal method, which acts throughout the entire menstrual cycle. It is enough just to purchase a hormonal contraceptive and start using it on the fifth day of menstruation. Convenient way will make you feel free and in control of your life long time. You should not waste time taking pills. It is better to purchase a safe Nuvaring ring.

There is a great abundance of contraceptives in pharmacies. Every woman, man or married couple can choose the most comfortable one for themselves. All are guaranteed to be effective, but some can be dangerous, others need to be consumed regularly on a daily basis. These rules do not apply to the Nuvaring birth control ring.

How to use it? What is the mechanism of action? To whom is it shown and for whom is it shown? forbidden fruit? - you will learn from this article.

pharmachologic effect

Placement of the Nuvaring ring in the vagina

The contraceptive Nuvaring is a hormonal contraceptive.

The effect is provided by etonogestrel and ethinyl estradiol.

Thanks to the use of the Nuvaring vaginal ring, the menstrual cycle is adjusted. Pain during menstruation becomes less noticeable, and the amount of discharge decreases.

The possibility of iron deficiency anemia also decreases.

The main advantage of the Novaring hormone-based contraceptive ring is that its use prevents:

• Ovarian cancer.
• Endometrial oncology.
• Ovarian cysts.
• Ectopic pregnancy.
• Inflammatory diseases of the genital organs.
• Benign neoplasms in the mammary glands.

Composition and release form

The contraceptive Nuvaring is made in the form of a vaginal ring.

The concentration of ethinyl estradiol in it is 2.7 mg, and etonogestrel is 11.7 mg.

The composition includes additional substances as:

1. Ethylene copolymer.
2. Vinyl acetate copolymer.
3. Magnesium stearate.

Indications for use

The birth control contraceptive Nuvaring is mainly intended to protect against pregnancy.

Contraceptive effect hormonal ring

The Nuvaring vaginal ring is often prescribed by doctors for endometriosis. They also treat uterine fibroids when they are small in size and can be dispensed with. surgical intervention.

Contraindications

The Nuvaring vaginal ring should not be used if you have:

• Thrombosis/thromboembolism.
• Heart defects.
• Migraine.
• Diabetes mellitus affecting the vascular system.
• Severe liver diseases.
• Neoplasms in the liver are benign/malignant.
• Neoplasms with location in reproductive system which depend on hormones.
• The period of gestation.
• Intolerance to contraceptives.

Photo gallery of contraindications:

Thrombosis Migraine
Malignant neoplasms in the liver

Rarely and with great caution, the Nuvaring vaginal ring is recommended if:

• Thrombosis in relatives.
• Serious operations in general and on the legs as well.
• Obesity.
• Thrombophlebitis.
• Arterial hypertension.
• Smoking after 40 years.
• Violations by fat metabolism in organism.
• Gallstone disease.
• Hemolytic-uremic syndrome.
• Choreas.
• Otosclerosis with impaired auditory perception.
• Systemic lupus erythematosus.
• Angioedema.
• Crohn's syndrome.
• Ulcerative colitis.
• Sickle cell anemia.
• Porphyria.
• Chronic constipation.
• Hernia of the urethra.
• Rectal hernia.
• Uterine prolapse.

Side effects

Even the recommendations of gynecologists will not help avoid adverse reactions from the use of the Nuvaring contraceptive ring if the woman’s body does not accept it.

No.	Organ system	Adverse reactions from the Nuvaring hormonal ring
1	Reproductive and urinary systems	Thrush and other vaginal infections Cervicitis Cystitis Other ureteral infections Genital itching Breast engorgement and tenderness Dysmenorrhea Amenorrhea Heavy menstruation Uterine bleeding PMS Burning sensation in the vagina Pain and discomfort at the injection site
2	Immunity	Allergy
3	Metabolism	Increased appetite Weight gain
4	Mental disorders	Change in sex drive Mood variability Depressive state
5	Nervous system	Headache Migraine Dizziness
6	Visual organs	Visual impairment
7	SSS	Increased blood pressure Tides
8	Digestive system	Nausea Flatulence Pain in the abdomen Diarrhea Constipation Vomit
9	Skin layer	Acne Itching Rashes
10	Muscles and bone tissue	Pain in the legs and back Spasmodic pain
11	Other	Fast fatiguability Swelling

Patients also note discharge while using the Nuvaring vaginal ring. During intimacy they may be bloody.

Sometimes the body can react to the contraceptive Nuvaring with a temperature of 37, which is an individual reaction of the female body.

Useful video:

Drug interactions

It is worth using additional methods of contraception together with the Nuvaring vaginal ring during the period of use of the following drugs and 30 days after treatment with them:

• Barbiturates.
• Oxcarbazepine.
• Felbamate.
• St. John's wort.

Photos of medicines:

If it is necessary to use intravaginal suppositories against candidiasis, it may occur damage or rupture Nuvaring vaginal ring.

Alcohol compatibility

alcohol should not be combined. This helps to reduce the contraceptive effect.

Dosage and overdose

The Nuvaring vaginal ring is not capable of causing severe symptoms overdose. Sometimes nausea or vomiting and bleeding may occur.

Instructions for use

The pros and cons of the Nuvaring contraceptive ring are clearly visible from the rules of use.

No.	Category	How to use the Nuvaring vaginal ring
1	How to insert?	Intravaginally, squeezing with fingers, in a squatting position, lying on your back or standing with your leg elevated. The diagram in the pictures will help you insert the ring correctly. This procedure is done once a month, preferably on the first day of menstruation. After 21 days, you need to remove the contraceptive for 7 days. On the 8th day, insert a new ring.
2	Switching from COC	Insert on the 7th day of the break after taking the tablets.
3	Switching from a mini-pill	According to the rules of the previous remedy / on any day.
4	Early abortion	Immediately after the procedure.
5	Late miscarriage/birth	3 weeks after the process.
6	Why does it fall out?	Most often this is due to damage to the contraceptive. In this case, you need to use a new ring.
7	Is it possible to place it in the middle of a cycle?	You can, but you must use condoms for the first week.
8	Is it possible to remove the ring ahead of time?	Not recommended, since such an action may provoke hormonal disbalance in organism.

Photo instructions:

1 2 3 4 5

Shelf life and storage of the drug

The Nuvaring vaginal ring should be stored under conditions 8 degree temperature during 3 year term.

special instructions

If a woman is prone to pigmentation of the epidermis, it is better for her to avoid exposure to direct sunlight

Is it possible to get pregnant with a ring? None of the existing contraceptives absolutely protects against pregnancy.

The same applies to the Nuvaring vaginal ring. In certain cases they talk about counterfeiting.

Treatment of endometriosis with the contraceptive Nuvaring should be prescribed by a doctor and the process should be monitored regularly.

When using the Nuvaring vaginal ring, taking a bath is not prohibited.

Price

The cost of one contraceptive Nuvaring is about 1,200 rubles.

Conditions for dispensing from pharmacies

The Nuvaring vaginal ring is available at some pharmacies by prescription only. Will this tell you so? hotline any pharmacy chain.

Analogues substitutes

You can replace the contraceptive Nuvaring with the following medications:

• consists of ethinyl estradiol and dienogest in tablet form. Manufacturer: Bayer Pharma (Germany).
• is made on the basis of drospirenone and ethinyl estradiol in tablet form. Manufacturer: Gedeon Richter (Hungary).
• Available in tablet form with drospirenone and ethinyl estradiol. Manufacturer: Bayer Weimar (Germany).
• is created in the form intrauterine device with levonorgestrel. Manufacturer: Bayer Schering Pharma (Germany/Finland).
• Femoston It is produced in tablet form with estradiol and dydrogesterone. Manufacturer: Abbott Laboratories S.A. (USA), Solvay Pharmaceuticals (Netherlands).
• Logest Available in the form of tablets with gestodene and ethinyl estradiol. Manufacturer: Bayer Pharma (Germany).

Photos of analogues:

Jess, Mirena, Yarina and Nuvaring

Jess and Yarina belong to combined oral contraceptives. Mirena is an intrauterine device.

All contraception They are used for the same purpose, but they are suitable for each woman differently and the comfort/discomfort from them is also different.

Have you used the contraceptive Nuvaring and was it effective?

The NuvaRing ring is a hormonal drug that has a high contraceptive effect and does not cause negative consequences for the body. The instructions for use characterize it as a reliable method of protection.

It is not fussy to use, since it does not require the daily participation of a woman, acting independently. How exactly is this level of protection against unwanted conception achieved, and in what situations should it be preferred?

Nuvaring ring, the instructions for use of which describe in detail the rules of use, is highly effective birth control contraceptive new generation. The artificial material from which the ring is made is also used for breast enlargement and in the manufacture of implants.

This is a translucent, almost colorless rim, 6 cm in diameter, which reliably protects the egg from fertilization by sperm and the onset of conception. The material from which the drug is made is hypoallergenic, so a negative reaction to it occurs extremely rarely.

Composition and principle of action

The instructions for the NuvaRing ring describe in detail active substance and mechanism of action. Inside the ring are ethinyl estradiol and etonogestrel, which are released from their membrane every day in strictly limited doses. Due to the fact that there are many vessels in the vagina, active substance quickly penetrates the blood and begins to act.

Birth control pills work in the same way, when taken the substance is absorbed through the stomach, and not through the walls of the vagina.

On female body NuvaRing has the following effects:

1. Suppresses the onset of ovulation.
2. Does not allow the hormonal system to function.
3. Promotes the formation of thick mucus in the cervix, preventing sperm from penetrating inside and fertilizing the egg.

These processes can be reversed if you stop removing the ring from the body and wait for the cycle to normalize.

Advantages of the method

In addition to the reliability of this type of contraception, the NuvaRing ring has other positive sides:

1. Low doses of hormones that a woman receives daily while using the ring. According to researchers, it releases almost a third less ethinyl estradiol than oral contraceptives.
2. A woman does not need to think about taking contraceptives every day, since the drug works independently of her, releasing the required amount of the active substance.
3. It makes it easy to adjust your monthly cycle, namely, delaying or prolonging the onset of menstrual bleeding.
4. Like any hormonal agent, NuvaRing has a beneficial effect on appearance– improves skin, hair and nails, helps reduce discomfort during menstruation and pain.

Disadvantages of the method

The main disadvantages of using a contraceptive ring are the presence of an impressive list of contraindications and side effects, as well as the need to strictly adhere to the regimen of using the drug.

But the disadvantages do not end there:

1. The NuvaRing cannot protect a woman from sexually transmitted diseases, such as AIDS and syphilis. The same can be said about all hormonal contraceptives.
2. Additionally, if a woman is susceptible to infection, the presence of a foreign object in the vagina can increase inflammation and increase the amount of discharge.
3. Due to the fact that the ring can move and even be removed from the vagina on its own, there is a need to periodically check its presence in order to prevent sperm from fertilizing the egg.
4. This method of contraception is psychologically unusual for women, and therefore often causes mistrust in its contraceptive properties.

Technique of use

You can use the NuvaRing ring only after fully reading the instructions and consulting with a gynecologist. You should not prescribe the use of this contraceptive yourself, as it is difficult to take into account all the nuances known only to a professional.

When the first period occurs, you can inject the drug into the vagina, and the procedure should be as follows:

1. To wash hands.
2. Take a comfortable position that allows access to the vagina and allows you to completely relax, for example, lie on the sofa.
3. Open the package and remove the ring from the aluminum wrapping.
4. Flatten it with two fingers and insert the ring deeply into the vagina, adhering to the back wall.

The whole process does not take much time and is very similar to inserting a tampon when menstruation occurs. None pain there should not be, therefore, if you feel discomfort, you must immediately remove the drug and consult a doctor. Elastic ring NuvaRing, in case of correct application, should stick to the walls of the vagina and be fixed on them.

After three weeks of use, the contraceptive should be removed. This needs to be done correctly, although there is nothing complicated in the process.

You need to again take a comfortable position and pick up the ring with your finger to carefully remove it from the body. This item can no longer be reused, so it can be disposed of. Next, the girl can expect bleeding, which should begin within the next 7 days. A new ring should be inserted 8 days after the previous one is removed.

Use if hormonal contraceptives were not used in the previous cycle

The NuvaRing ring can be administered already on the first day of the cycle when initial signs bleeding to protect yourself as much as possible from conception. If necessary, you can delay using the ring for 2-5 days if you contact alternative methods protection.

Switching from combined hormonal contraceptives

If desired, a woman can change the method of contraception and choose the NuvaRing ring instead of combined hormonal drugs. The instructions for use do not exclude this possibility if the woman followed the gynecologist’s instructions and did not miss taking pills.

Switching from drugs containing only progestogen

Mini-pills can also be easily replaced with NuvaRing. Moreover, the transition can be made on any day of the cycle by instantly replacing the implant or IUD with a ring. When using injections to prevent conception, you should not take breaks, but replace them after the final injection.

After this, it is better to use condoms for a week due to the possible decrease in the protective effect of the ring.

After an abortion in the first trimester

Using after abortion early stages NuvaRing ring, the instructions of which clearly describe this situation, does not require resorting to alternative methods of protection against conception. An exception may be medical indications, in which a woman is allowed to delay the insertion of the ring for up to 5 days.

After childbirth or after an abortion in the second trimester

More serious abortion performed surgical method By medical indications, or childbirth requires a more delicate approach in further protection. NuvaRing should be used only after a month if the woman is not breastfeeding her newborn.

If you delay contraception and use the ring at a later date, you should use condoms to protect yourself as much as possible from conception. In addition, you need to make sure that you are not pregnant. It is necessary to continue using barrier methods of protection for 7 days after inserting the ring.

Use during pregnancy and breastfeeding

Due to the fact that the NuvaRing ring is a hormonal drug intended to prevent pregnancy, its use during this period is strictly prohibited. Although studies of the drug have not been conducted among women expecting to give birth, there is no need to risk the health of the baby.

In addition, once pregnancy has already occurred, there is no need for contraception. The same cannot be said about the lactation period, which is also not recommended to be combined with the use of hormonal contraceptives. This is due to the fact that the active substance contained in the ring can change its composition breast milk, or reduce its volume.

Break in use

Violation of the contraceptive regimen prescribed by the gynecologist can lead to conception. Before using the NuvaRing ring after a break, the instructions provided by the manufacturer advise you to make sure there is no pregnancy.

If fertilization of the egg has not occurred, the drug should be installed in the most as soon as possible, while simultaneously using alternative ways contraception. But a break does not always happen due to the fault of a woman who simply got lost in the dates.

The NuvaRing ring tends to involuntarily move into the vagina and even be removed from it. Then it is urgent to return it to its place. If the contraceptive was absent from the vagina for no more than 3 hours, then there is no need to be afraid of conception. Otherwise, it is better to play it safe and resort to condoms or other barrier methods.

Extended use

If NuvaRing was used longer due date, but not longer than a month, then the contraceptive effect will remain sufficient to prevent conception. The woman needs to take the prescribed week break and use the following drug.

Scheme for using the NovaRing contraceptive ring.

After 4 weeks of use, the contraceptive effect of NuvaRing decreases, therefore, before inserting a new ring, you need to do a pregnancy test or consult a doctor to establish the fact that you are not pregnant.

Menstruation and bleeding during use

Bleeding during contraception with this hormonal drug is considered normal occurrence. Most often, menstruation begins immediately after the ring is removed and stops with the introduction of a new contraceptive. Less often, bleeding does not start at all, and this is also not a deviation, provided that all recommendations are followed.

Repeated absence of menstruation requires the intervention of a gynecologist, as this may mean pregnancy. However, when using the NuvaRing ring, the instructions require strict monitoring of the body’s condition, since heavy bleeding should be observed by the attending gynecologist.

Cancellation of NuvaRing

A woman can refuse contraception with NuvaRing at any time, since this process does not require special preparation. If necessary, the drug can be safely removed without waiting for 21 days of use.

Pregnancy after stopping the contraceptive ring

Refusal hormonal contraception leads to the cessation of effects on the woman’s body, and NuvaRing is no exception. Conception can occur as early as 4-5 weeks after the contraceptive ring is removed.

Drug interactions

Parallel use of the NuvaRing ring with others medications, may lead to a decrease in contraceptive effect, as the instructions warn about.

Medicines that should not be combined with hormonal contraception:

1. Drugs, in large quantities excreted by the liver, leading to hepatic metabolism. This refers to medications such as barbitures, carbamazepine, phenytoin, rifampicin, and some other medications containing St. John's wort. When undergoing therapy with these drugs, it is better to resort to alternative methods of contraception without removing the ring from the vagina.
2. Antibiotics also lead to a decrease in the contraceptive effect, as they have big influence on the active substance NuvaRing. When taking these drugs, with the exception of doxycycline and amoxicillin, you should use barrier contraceptives during treatment and for a week after the end of the course.

Protection using a hormonal ring can also affect the biochemical parameters of some organs and change the composition of the blood. If during contraception a woman needs to undergo a medical examination, the attending physician should be aware of the use of the NuvaRing ring.

Side effects

A negative reaction to the drug is extremely rare, but not completely excluded. Side effects associated with the use of NuvaRing rings usually do not require immediate attention. medical care because they pass on their own.

TO side effects relate:

1. Intoxication – nausea, diarrhea, and sometimes vomiting.
2. dizziness, constant anxiety, changeable mood, pain in the head area, as a result of the effect on the nervous system.
3. Weight gain, breast hardening, decreased libido.
4. Cystitis.
5. Minor discharge, vaginitis.

In addition, a woman may be bothered by the sensation of a foreign object in the vagina, as well as spontaneous removal of the ring.

Contraindications for use and use with caution

Not everyone is recommended to use the NuvaRing ring, since it has quite a lot of prohibitions and contraindications.

• Hormone-dependent malignant tumors.
• Vaginal bleeding that occurs for unknown reasons.
• Blood disorders such as thrombosis or bleeding disorders.
• Pregnancy and lactation.
• Severe liver pathologies, including tumors.
• Inflammatory processes in the vagina - vaginitis, colpitis.
• Allergies to contraceptive components.

Careful use of the product is possible for:

• varicose veins;
• heart disease;
• autoimmune diseases;
• when the walls of the female genital organ droop or fall out;
• cholelithiasis;
• smoking.

It is necessary to stop using NuvaRing before the proposed surgery.

Conditions and shelf life

To ensure that the drug does not lose its contraceptive properties, it must be kept at 2-8 ° C, then the NuvaRing ring will not lose its properties for 3 years from the date of release. The best place for this there will be a regular refrigerator compartment, where the required temperature is maintained.

In addition, the contraceptive ring should be protected from children's attention, since if it enters the body of a minor child, it can negatively affect the development of the baby. After the expiration date, it is strictly forbidden to use the drug for its intended purpose.

Where to buy and price

The NuvaRing ring is sold in free access, so you can find it at any pharmacy. Big choice The drug is offered by online portals for the sale of medicines. This makes it possible to resort to the use of NuvaRing in the most remote corners of the country, thanks to well-established logistics and courier delivery. On average, the price of one ring ranges from 600 to 1000 rubles.

Packages of the NuvaRing ring containing 3 contraceptives will cost from 1300 to 1800 rubles.

Every woman will find her own positive aspects of this method of contraception, because the convenience and effectiveness of the NuvaRing ring are obvious. Before deciding to use a hormonal drug, you should study the instructions and also consult a gynecologist.

Video about the NuvaRing ring, its effectiveness and rules of use

Instructions for use of the NuvaRing ring:

Expert opinion about the Nuvaring ring: