Contraceptive hormonal ring Nuvaring - instructions for use. Nuvaring: instructions for use of the hormonal ring Nuvaring for the first month of use

Description:

A modern combined hormonal contraceptive (ring) for intravaginal administration.

Manufacturer:

ORGANON (Netherlands)

Composition and release form

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

Active ingredients: ethinyl estradiol 2.7 mg, etonogestrel 11.7 mg. Excipients: ethylene vinyl acetate copolymer (28% vinyl acetate), ethylene vinyl acetate copolymer (9% vinyl acetate), magnesium stearate.

pharmachologic effect

Combined hormonal contraceptive drug for intravaginal use. Contains etonogestrel, which is a progestogen, a derivative of 19-nortestosterone, and ethinyl estradiol, which is an estrogen. The main mechanism of contraceptive action of the drug NuvaRing is inhibition of ovulation. The progestin component (etonogestrel) inhibits the synthesis of LH and FSH by the pituitary gland and, thus, prevents follicle maturation (blocks ovulation).

The Pearl index, an indicator reflecting the frequency of pregnancy in 100 women during a year of contraception, when using the drug NuvaRing is 0.96. The use of the drug reduces the pain and intensity of menstrual-like bleeding, reduces the frequency of acyclic bleeding and the likelihood of developing iron deficiency conditions. In addition, there is evidence of a reduced risk of endometrial and ovarian cancer with the use of the drug. NuvaRing does not reduce bone mineral density.

Indications for use

Intravaginal contraception (prevention of unwanted pregnancy) in women.

Mode of application

NuvaRing is inserted into the vagina once every 4 weeks. The ring is 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. For example: if the NuvaRing ring was installed on Wednesday at approximately 10:00 pm, then it should be removed on Wednesday 3 weeks later at approximately 10:00 pm; on the following Wednesday 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 a new ring is installed.

Start using Nuvaring

Hormonal contraceptives were not used in the previous menstrual cycle
NuvaRing should be administered on the first day of the cycle (i.e., the first day of menstruation). It is possible to install a ring on days 2-5 of the cycle, however, in the first cycle in the first 7 days of using the drug NuvaRing, additional use of barrier methods of contraception is recommended.

Switching from taking combined oral contraceptives

NuvaRing should be administered on the last day of the free interval in taking combined hormonal contraceptives (pills or patch). If a woman has been taking the combined hormonal contraceptive correctly and regularly and is confident that she is not pregnant, she can switch to using a vaginal ring on any day of her cycle. The duration of the interval in taking hormonal contraceptives should not exceed the recommended period.

Switching from progestin-only contraception (mini-pill, implant, or injectable contraception) or progestogen-releasing intrauterine device (IUD)

A woman taking the mini-pill can switch to using NuvaRing on any day (the ring is inserted on the day the implant or IUD is removed or on the day of the next injection). In all these cases, the woman should use a barrier method of contraception for the first 7 days after insertion of the ring.

After an abortion performed in the first trimester of pregnancy

You can start using NuvaRing immediately after an 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, the ring should be used in the same way as if hormonal contraceptives were not used in the previous cycle. In the interval, the woman is recommended an alternative method of contraception.

After childbirth or abortion performed in the second trimester of pregnancy

The use of NuvaRing should begin within the 4th week after childbirth (if the woman is not breastfeeding) or abortion in the second trimester. If the use of NuvaRing is started at a later date, 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 the drug NuvaRing.

The contraceptive effect and cycle control may be impaired if the patient does not comply with the recommended regimen. To avoid loss of contraceptive effect in case of deviation from the regimen, you must follow the following recommendations.

Extending the break from using the ring

If you had sexual intercourse during a break from using the ring, pregnancy should be ruled out. The longer the break, the higher the likelihood of pregnancy. If pregnancy is ruled out, a new ring should be inserted into the vagina as quickly as possible. Over the next 7 days, an additional barrier method of contraception, such as a condom, can be used.

If the ring has been temporarily removed from the vagina

If the ring remains 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 was left outside the vagina for more than 3 hours during the first or second week of use, the contraceptive effect may be reduced. You should place the ring in your vagina as soon as possible. Over the next 7 days, you must use a barrier method of contraception, such as a condom. The longer the ring was outside the vagina and the closer this period is to the 7-day break in using the ring, the higher the likelihood of pregnancy.

If the ring was left outside the vagina for more than 3 hours during the third week of use, the contraceptive effect may be reduced. The woman should throw away this ring and choose one of two methods:
Immediately install a new ring. Please note that the new ring can be used for the next 3 weeks. In this case, there may be no bleeding associated with the cessation of the drug's effect. However, spotting or bleeding in the middle of the cycle is possible.

Wait for bleeding associated with the cessation of the drug, and insert a new ring no later than 7 days after removing the previous ring. This option should only be chosen if the ring use regimen has not previously been violated during the first 2 weeks.

Extended use of the ring

If the drug NuvaRing was used for no more than a maximum period of 4 weeks, then the contraceptive effect remains sufficient. You can take a week's break from using the ring and then insert a new ring. If NuvaRing remains in the vagina for more than 4 weeks, the contraceptive effect may deteriorate, so pregnancy must be ruled out before inserting a new ring.

To change the time of onset of menstrual bleeding

To delay (prevent) menstrual-like withdrawal bleeding, you can insert a new ring without a week's break. The next ring must be used within 3 weeks. This may cause bleeding or spotting. Then, after the usual one-week break, you should return to regular use of NuvaRing.

To postpone the onset of bleeding to another day of the week, it may be recommended to take a shorter break from using the ring (for as many days as necessary). The shorter the interval between ring use, the higher the likelihood that there will be no bleeding after ring removal, and no bleeding or spotting will occur when the next ring is used.

Ring damage

In rare cases, ring rupture has occurred when using NuvaRing. The core of the NuvaRing ring is solid, so its contents remain intact, and the release of hormones does not change significantly. If the ring ruptures, it usually falls out of the vagina. If the ring ruptures, a new ring must be inserted.

Ring falling out

NuvaRing has sometimes been reported to fall out of the vagina, for example, when it was inserted incorrectly, when a tampon was removed, during sexual intercourse, or due to severe or chronic constipation. In this regard, it is advisable for a woman to regularly check the presence of the NuvaRing ring in the vagina.

Incorrect insertion of the ring

In very rare cases, women have inadvertently inserted NuvaRing into the urethra. When symptoms of cystitis appear, it is necessary to consider the possibility of incorrect insertion of the 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 the ring is in a comfortable position. The exact position of NuvaRing in the vagina is not decisive for the contraceptive effect.

After insertion, the ring must remain in the vagina continuously for 3 weeks. If the ring was accidentally removed, it should be washed with warm (not hot) water and immediately inserted into the vagina.

To remove the ring, you can pick it up with your index finger or squeeze it between your index and middle fingers and pull it out of the vagina.

Side effect

The following side effects may occur when using Nuvaring:

Contraindications for use

Venous thrombosis (including a history), including deep vein thrombosis, pulmonary embolism;
- arterial thrombosis (including a history), including stroke, transient cerebrovascular accidents, myocardial infarction and/or precursors of thrombosis, including angina pectoris, transient ischemic attack;
- heart defects with thrombogenic complications;
- changes in blood parameters indicating a predisposition to the development of venous or arterial thrombosis, including resistance to activated protein C, antithrombin III deficiency, protein C deficiency, protein S deficiency, hyperhomocysteinemia and antiphospholipid antibodies (anticardiolipin antibodies, lupus anticoagulant);
- migraine with focal neurological symptoms;
- arterial hypertension (systolic blood pressure? 160 mm Hg. or diastolic blood pressure? 100 mm Hg.);
- diabetes mellitus with vascular damage;
- pancreatitis incl. history, in combination with severe hypertriglyceridemia;
- severe liver diseases, until normalization of liver function indicators;
- liver tumors (including in history);
- hormone-dependent malignant tumors (for example, breast cancer), established, suspected or in history;
- bleeding from the vagina of unknown etiology;
- pregnancy (including suspected);
- lactation period;
- surgical interventions followed by long-term immobilization;
- smoking (15 or more cigarettes per day) in women 35 years of age and older;
- hypersensitivity to the components of the drug.

The drug should be prescribed with caution if any of the following disease conditions or risk factors are present; in such cases, the doctor must carefully weigh the benefit-risk ratio of using the drug NuvaRing:

Venous or arterial thrombosis (in siblings and/or parents);
- obesity (body mass index more than 30 kg/m2);
- dislipoproteinemia;
- varicose veins (in combination with thrombophlebitis of the superficial veins);
- atrial fibrillation;
- diabetes;
- systemic lupus erythematosus;
- hemolytic-uremic syndrome;
- epilepsy;
- chronic inflammatory bowel diseases (Crohn's disease and ulcerative colitis);
- sickle cell anemia;
- congenital hyperbilirubinemia (Gilbert, Dubin-Johnson, Rotor syndromes);
- chloasma;
- uterine fibroids;
- fibrocystic mastopathy;
- conditions that make it difficult to use a vaginal ring: cervical prolapse, bladder hernia, rectal hernia, severe chronic constipation;
- adhesions in the vagina;
- smoking (less than 15 cigarettes per day) in women 35 years of age and older.

If the disease worsens, the condition worsens, or other risk factors appear, the woman should also consult a doctor and possibly discontinue the drug.

Although a cause-and-effect relationship has not been convincingly proven, caution should be exercised when prescribing NovaRing if the following conditions/diseases have previously developed or worsened during the use of any other hormonal contraceptives or previous pregnancy: jaundice and/or itching associated with cholestasis, formation of gallstones, porphyria, Sydenham's chorea, herpes of pregnancy, otosclerosis with hearing loss, (hereditary) angioedema.

Recurrence of cholestatic jaundice and/or cholestasis with itching, which was observed during pregnancy or previous use of sex hormones, is grounds for discontinuing the use of NuvaRing.

Use of NuvaRing during pregnancy and breastfeeding

The use of NuvaRing is contraindicated during pregnancy, suspected pregnancy and lactation. NuvaRing is contraindicated during breastfeeding. NuvaRing can affect lactation, reduce the amount and change the composition of breast milk. Small amounts of contraceptive steroids and/or their metabolites may be excreted in milk.

Use for liver dysfunction

NuvaRing is contraindicated in severe liver diseases (until normalization of function indicators).

special instructions

Before prescribing or resuming the use of the drug NuvaRing, you should conduct a medical examination: analyze your medical history (including family history) and exclude pregnancy; measure blood pressure; conduct an examination of the mammary glands, pelvic organs, including cytological examination of smears from the cervix; conduct some laboratory tests to exclude contraindications and reduce the risk of possible side effects of the drug NuvaRing. The frequency and nature of medical examinations are carried out by a specialist, taking into account the individual characteristics of each woman, but at least once every 6 months.

The patient should read the instructions for use of the drug NuvaRing and follow all recommendations.

It should be kept in mind that NuvaRing does not protect against HIV infection (AIDS) and other sexually transmitted diseases.

Women aged 40 years and older, women with cervical intraepithelial neoplasia, as well as women who smoke at any age require additional consultation with a gynecologist before prescribing NuvaRing.

The effectiveness of the drug NuvaRing may decrease if the regimen is not followed.

While using NuvaRing, acyclic bleeding (spotting or sudden bleeding) may occur. If such bleeding is observed after regular cycles while using NuvaRing in accordance with the instructions, you should contact your gynecologist to conduct the necessary diagnostic tests, incl. to exclude a malignant tumor and pregnancy. A diagnostic curettage may be required.

Some women do not bleed after the ring is removed. If NuvaRing is used as directed, it is unlikely that the woman is pregnant. If the recommendations of the instructions are not followed and there is no bleeding after removing the ring, as well as if there is no bleeding in two cycles in a row, pregnancy must be excluded.

The most important risk factor for developing cervical cancer is infection with the human papillomavirus (HPV). Epidemiological studies have shown that long-term use of combined hormonal contraceptives further increases this risk, but the extent to which this is due to other factors remains unclear. The positive role of regular examinations of women by a gynecologist and the use of barrier methods of contraception are obvious. There is no information about an increased risk of developing cervical cancer in HPV-infected women using NuvaRing.

Studies have found a small increase in the relative risk (1.24) of developing breast cancer in women taking combined hormonal oral contraceptives, but this risk gradually decreases over 10 years after discontinuation of the drugs. Breast cancer is rare in women under 40 years of age, so the additional incidence of breast cancer in women who have received or continue to use combined oral contraceptives is small compared to the overall risk of developing breast cancer. There is evidence that women who have taken oral combined contraceptives have less breast cancer than women who have never used such medications. The possibility of the effect of the drug NuvaRing on the incidence of breast cancer is being studied.

In rare cases, benign liver tumors were observed in women taking combined oral contraceptives, and even more rarely, malignant ones. In some cases, these tumors led to the development of life-threatening bleeding into the abdominal cavity. If severe pain appears in the upper abdomen, liver enlargement, or signs of intra-abdominal bleeding in a woman using NuvaRing, a liver tumor should be excluded.

Although many women taking hormonal contraceptives experience a slight increase in blood pressure, clinically significant hypertension is rare. A direct connection between the use of hormonal contraceptives and the development of arterial hypertension has not been established. However, if, when using the drug NuvaRing, there is a constant increase in blood pressure, the patient should contact her gynecologist; in such cases, the ring should be removed, antihypertensive therapy should be prescribed and the issue of choosing the most acceptable method of contraception, incl. possible resumption of use of the drug NuvaRing.

Although estrogens and progestogens can influence peripheral insulin resistance and tissue tolerance to glucose, there is no evidence to support the need to change hypoglycemic therapy during the use of hormonal contraceptives. However, women with diabetes should be under constant medical supervision when using NuvaRing, especially in the first months of contraception.

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

Serious surgery (including on the lower extremities) is a contraindication to the use of the drug. In case of planned surgery, it is recommended to stop using the drug at least 4 weeks in advance, and resume no earlier than 2 weeks after complete restoration of motor activity.

Women predisposed to the development of chloasma should avoid exposure to sunlight and ultraviolet radiation while using NuvaRing.

The extent of exposure and possible pharmacological effects of ethinyl estradiol and etonogestrel on the glans mucosa and skin of the penis have not been studied.

Impact on the ability to drive vehicles and operate machinery

Considering the pharmacodynamic properties of the drug NuvaRing, its effect on the ability to drive a car and use complex equipment is not expected.

Overdose

Serious consequences of an overdose of hormonal contraceptives have not been described. Suspected symptoms: nausea, vomiting, slight vaginal bleeding in young girls.

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

Drug interactions

Interactions between hormonal contraceptives and other drugs may lead to the development of acyclic bleeding and/or contraceptive failure. There may be an interaction with drugs that induce microsomal enzymes, which can lead to increased clearance of sex hormones.

The effectiveness of NovaRing may be reduced with simultaneous use of antiepileptic drugs (phenytoin, phenobarbital, primidone, carbamazepine, oxcarbazepine, topiramate, felbamate), anti-tuberculosis drugs (rifampicin), antimicrobial drugs (ampicillin, tetracycline, griseofulvin), possibly antiviral drugs (ritonavir) and medicines containing St. John's wort.

When treating any of the listed drugs, a woman should temporarily use a barrier method of contraception in combination with the drug NuvaRing or choose another method of contraception. When treating with drugs that induce liver enzymes, a barrier method (condom) should be used during treatment and for 28 days after discontinuation of such drugs.

If concomitant therapy is to be continued after 3 weeks of ring use, the next ring should be administered immediately without the usual interval.

During treatment with antibiotics (excluding amoxicillin and doxycycline), it is necessary to use a barrier method of contraception (condom) during treatment and for 7 days after their discontinuation. If concomitant therapy is to be continued after 3 weeks of ring use, the next ring should be administered immediately without the usual interval.

As a result of pharmacokinetic studies, no effect on the contraceptive effectiveness and safety of the drug NuvaRing when used simultaneously with antifungals and spermicides was identified. When combined with suppositories and antifungal agents, the risk of ring rupture increases slightly.

Hormonal contraceptives can cause disruption of the metabolism of other drugs. Accordingly, their concentrations in plasma and tissues may increase (for example, cyclosporine) or decrease (for example, lamotrigine).

To exclude possible interactions, it is necessary to study the instructions for use of other drugs.

The use of tampons does not affect the effectiveness of NuvaRing. In rare cases, the ring may be accidentally removed when removing the tampon.

Storage conditions and periods

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

As follows from the instructions, the Nuvaring hormonal ring provides women with an exceptionally high level of protection against unwanted pregnancy. Reviews confirm the reliability of the product and ease of use. Hormonal contraception has become widespread in recent years due to its many advantages. Which of them can Nuvaring boast?

Essence of the question

The two most popular modern approaches to contraception are hormonal methods and barrier methods. Both have pros and cons. Hormonal contraceptives (not the least of which is the Nuvaring contraceptive ring) are easy to use according to the instructions, and the effectiveness of these methods exceeds 95%. Reliable in their effectiveness, these pregnancy prevention options are easy to use. There are tablets that are meant to be taken at the same time, patches that need to be applied once a week, injections, implants, rings. All hormonal contraceptives are divided into those containing one or two active compounds.

Among the most convenient, with good reviews from doctors, is Nuvaring. The instructions for use included in the packaging by the manufacturer provide a detailed understanding of the rules for directly installing the drug and the features of its operation. The manufacturer does not hide the mechanism by which the product works, what its strengths and weaknesses are, and possible side effects. It would be fair to immediately mention that negative reactions to the ring occur, but quite rarely, they are mostly weak and disappear some time after the start of regular use.

What is it about?

As follows from the instructions, “Novaring” is a contraceptive ring that belongs to the category of combined hormonal drugs. The product contains estrogen and progestogen in microscopic doses. Visually, this is a flexible ring with a diameter of 5.5 cm and a thickness of 8.5 mm. The product is made from hypoallergenic raw materials and is intended for placement in the vagina. Once inserted, the ring releases microscopic doses of hormonal compounds into the environment every day. The correct dosage is determined by the membrane system that forms the basis of the high-tech development for women.

The instructions for use of the Nuvaring contraceptive ring indicate that the drug can suppress the ovulation process. Hormonal effects correct the quality of uterine mucus, increasing viscosity. The advancement of sperm under such conditions is noticeably difficult, which is an additional mechanism of protection against unplanned pregnancy.

Reliable and safe

As can be seen from the reviews and instructions, the Nuvaring ring rarely becomes a source of side effects, since it is intended for direct injection into the area of ​​action, which significantly distinguishes it from contraceptives used orally. The feature is a really important plus. The product does not come into contact with the tissues of the stomach or intestines, does not have a negative effect on the liver, and at the same time guarantees a regular supply of microscopic doses of the necessary hormones to the body. Consequently, the chance of side effects is minimal, especially compared to more traditional pregnancy prevention hormone formats. Reviews also confirm that negative reactions are rare (but do occur).

The Nuvaring instructions indicate reliability indicators obtained during numerous specific experiments. Scientists have confirmed that the product is effective, safe, and effective. In relation to the ring, it was calculated based on statistical data: it was revealed how many women out of a hundred who used the medication year-round became pregnant. A detailed study yielded a result of 96% effectiveness. But for medications used orally, this parameter varies between 10-90%.

Multi-faceted action

From the instructions for Nuvaring it follows that the drug not only prevents unwanted pregnancy, but also has additional positive qualities. The most pronounced positive effect on the menstrual cycle. Under the influence of active compounds, it becomes more regular, each monthly bleeding is less painful, not as heavy as without using the ring.

At the same time, the manufacturer in the instructions for “Novaring” (photos are presented in the article) draws attention to the fact that the drug was developed strictly as a method of preventing unwanted conception. The ring does not reduce the risk of contracting pathologies transmitted through intimate contact. “Novaring” is optimal if a woman has one permanent healthy partner, that is, the risk of infection is minimal.

Sometimes you can't

Instructions for use of Nuvaring (photos of the ring are presented in the article) draw attention to cases when the product cannot be used. There are quite a lot of contraindications - this is typical for any hormonal contraceptives (and other compositions with hormones). First of all, it is necessary to note the increased sensitivity to the active compounds used by the manufacturer. You cannot use the ring if you have high blood pressure, thrombosis, heart attack, stroke, or diabetes. The product is not intended for persons suffering from severe impairment of the functionality of the pancreas and liver, as well as for the detection of neoplasms and tumor processes in the liver. It is unacceptable to resort to Nuvaring if a malignant neoplasm that is dependent on hormonal levels is diagnosed.

For certain cases, the instructions for the Nuvaring ring contain a mention in the application category, especially carefully and carefully. These are heart defects, excess weight. Before installing a contraceptive for the first time, you need to read the instructions in detail in order to assess to what extent it is suitable for a particular woman, which you need to pay special attention to when using it. As new significant information is revealed about the effects of the medication on the female body, the manufacturer will supplement the accompanying documentation.

I want a baby!

The instructions for the Nuvaring ring contain unambiguous instructions on the rules of behavior if it has been decided to abandon contraception in order to become pregnant. In such a situation, stop using the medication and wait for some time until the natural cycle of menstruation returns to normal. In most cases, pregnancy can be expected no more than a couple of months, usually within a month after stopping birth control.

The manufacturer recommends avoiding Nuvaring while breastfeeding. Reviews from doctors and the instructions for Nuvaring agree on this: professionals also advise against using the ring. The components contained in it can negatively affect the volume of milk produced by the mammary glands. There is a risk of changes in the composition of the natural product. If conception is detected while using the ring, the contraceptive should be removed immediately. Its use during pregnancy is strictly contraindicated.

How to use it correctly?

Regarding how to install the product for the first time, the instructions for use of Nuvaring contain clear and consistent instructions. However, the most reasonable option is to seek help from a doctor. An experienced gynecologist will help you understand the drug, tell you the basic rules for its use, and warn about common mistakes that can reduce the effectiveness of the drug. It is believed that the medication is convenient to use, since it does not require monitoring every day. The ring is installed for three weeks at a time, after which it is removed. On what day of the week the contraceptive was placed, on the same day it should be removed.

According to the instructions for using the Nuvaring ring, after removing the item, you must wait seven days and insert a new copy. During this period, withdrawal bleeding is observed. The logic, as you can see, is similar to the use of oral contraceptives, and the only difference is the absence of daily control over the dose of the drug - hormones are injected automatically, it is only important to monitor the passage of three-week, seven-day time intervals.

Accuracy doesn't hurt

In the instructions for use of the Nuvaring ring, the manufacturer points out that special attention is required when starting to use the drug. During the first seven days, to reduce the likelihood of unwanted pregnancy, it is reasonable to use barrier contraceptive measures. Before installing the product for the first time, you should consult a doctor. The doctor will examine the client, formulate a conclusion regarding the possibility of using the ring, and also give individual recommendations on its use. In some specific cases the rules may differ from generally accepted practice.

How to place it correctly?

All features of the procedure are described in the instructions for use of the Nuvaring ring. Reviews confirm that there is nothing complicated in this procedure. You should start by choosing a comfortable position for administering the product: you can stand, sit, lie down. The object is squeezed and inserted into the vagina. Once in the zone of constant presence, it automatically takes the correct shape, adapting to the characteristics of the female body with all its individual specific features.

The removal process, as the instructions for using Nuvaring say, is no more complicated. The ring is squeezed with two fingers and pulled out. As a rule, withdrawal bleeding begins a couple of days after this point. In some cases, by the day when a new ring needs to be inserted, the discharge has not yet stopped. This is not a reason to postpone the use of the specimen - a new ring is introduced, soon after which the spotting will completely stop until a new cycle.

Negative effects: what to prepare for?

The instructions for use of Nuvaring draw attention to the possibility of side effects. The likelihood of their occurrence is minimized due to the local release of active components, but it is impossible to completely exclude the absence of a negative response from the body. One of the relatively common unpleasant phenomena is headache. Some women complained of dizziness, changes in emotions, sometimes even causing depression. It is known that in rare cases, Nuvaring can cause weight gain or problems with the digestive system and stool disorders.

The instructions for use of Nuvaring contain references to the possibility of vaginal discharge when using the ring. There is a risk of infection of the genitourinary organs. In rare cases, the mammary glands become more sensitive and cause painful sensations. Reactions can be local - discomfort during intimate contact, anxiety associated with the sensation of a foreign body inside the body.

Appearances and passwords

If, after reading the instructions for using Nuvaring, a woman decides in favor of this particular method of contraception, it makes sense to visit a convenient pharmacy to purchase a copy. Currently, there are two forms of release on sale: one and three copies per package. The smaller option costs about 1,300 rubles; for a package with three products they will ask for about 3,500 rubles.

The manufacturer and doctors strongly recommend that before making a decision in favor of the drug, you visit a qualified doctor for a full examination of the body. During the consultation, the specialist will tell you what the main pros and cons of different methods are, and will recommend the optimal approach taking into account the individual characteristics, lifestyle of the patient, as well as the physiological needs of the woman. Don’t forget about personal preferences, because a contraceptive should be easy to use.

Don't mix concepts!

Some people believe that hormonal and barrier are two different words that mean the same remedy. Some people decide in favor of Nuvaring, fearing to use regular tablets or mini-pills, as they affect hormonal levels. Make no mistake: Nuvaring is also a drug that affects the concentration of hormones in a woman’s blood. The contraceptive ring is not a mechanical contraceptive.

To provide barrier contraception, it makes sense to pay attention to caps, diaphragms, and spirals. But the ring is exclusively a hormonal drug that helps prevent conception. In order not to get confused in concepts, when choosing the optimal method for yourself, it would be reasonable to first study how different methods and means work, and only then make a decision in favor of a specific name.

This is interesting

Currently, on the shelves of pharmacies in our country, the contraceptive ring is represented by a single name - this is the described drug “Novaring”. It was invented by Dutch scientists, first went on sale in 2001, and is now widespread in European countries and America.

Features of application

To achieve maximum effectiveness and safety, Nuvaring is installed simultaneously with the beginning of a new menstrual cycle. If you administer the drug later, but within the first five days from the start of menstruation, throughout this cycle you will need to use additional barrier methods to prevent unwanted pregnancy. Nuvaring is safe and is used after a spontaneous, medical abortion. It is advisable to place the ring the very next day after the event.

If a woman is planning intimate intercourse with a partner who is at risk of contracting sexually transmitted diseases, in addition to the ring, it is necessary to use additional barrier methods of contraception, since the drug only corrects hormonal levels, but cannot protect against infection. In general, this method is considered optimal if a woman has one permanent partner, and both are regularly tested for the absence of STDs.

No savings!

The removed Nuvaring contraceptive ring is not intended for reuse. The copy must be thrown away, and after a seven-day break, install a new one or begin using other means of preventing unwanted conception. A medical item should not remain in a woman’s body for more than three weeks.

Correct use of the contraceptive ring helps prevent the formation of myomatous nodes. It is known that among women using Nuvaring, fewer women suffer from endometriosis. Studies have shown that in cases of acne and excessive oiliness of the skin, Nuvaring normalizes the activity of the sebaceous glands, which leads to an improvement in appearance.

Special case

In the instructions supplied with the drug, the manufacturer indicates that Nuvaring is not recommended for use by women who smoke. The remedy should not be chosen if autoimmune pathologies, heart problems, or gallstones are detected. You should not use hormonal birth control before adulthood, especially without consulting your doctor. If there is prolapse of the vaginal walls, prolapse of the uterus, the ring is also ineffective. You should not use this method of contraception before surgery, in the presence of wounds, or inflammation of the genital organs. If an operation is planned, the best option is to completely abandon any hormonal drugs to prevent pregnancy a month before the event.

Where to stop?

In comparison with other options for preventing conception presented on pharmacy shelves, “Novaring” has both positive aspects and disadvantages. When compared with oral contraceptives, you should pay attention to the dosage of hormonal compounds. Mostly, the drugs supply the body with 30 mcg of active substance daily, while the ring is a source of a third less volume. Due to this, the effectiveness is not reduced, but the risk of side effects is reduced.

Another important positive point is independence from a woman’s lifestyle and character traits. It is known that many people forget to take pills on time, intended for use every day at the same time, which leads to low effectiveness of the contraceptive program. When using the ring, you don’t have to think about it at all; you just need to remember twice a month about the need to install and remove the drug. Every day, the device automatically injects the required amount of hormones into the female body, so you don’t have to think about it at all. At the same time, the condition of the hair and skin improves, and the pain syndrome that accompanies menstrual bleeding is relieved. If the need arises, you can shorten the monthly cycle or lengthen it a little, which is especially convenient if you are planning a trip or vacation. True, before shifting your cycle you need to consult a gynecologist.

Along with the pros there are always cons

Along with the positive qualities, Nuvaring also has some weaknesses. In particular, only then does the ring show reliability and effectiveness when it is used in strict accordance with the instructions, when maintaining the regime specified by the manufacturer. Weaknesses include the abundance of contraindications. It is known that when the genital organs become infected, the ring can cause an exacerbation of the process, since the amount of discharge in the volume increases slightly. There is a possibility of spontaneous loss, so it is important to regularly check that the contraceptive is in place.

Among the negative aspects, it is worth mentioning the fairly high cost of the ring, especially in comparison with some hormonal contraceptives. The manufacturer draws attention to the fact that the drug is sold only in certified pharmacies. It is strictly not recommended to purchase it at other points, as there is a risk of encountering a counterfeit.

Contraception and sexual desire

It is known that some hormonal drugs have a negative effect on a woman's libido. It is believed that in general Nuvaring does not have such effects due to the reasonable dosage of estrogen. If you have previously used tablets, switch to Nuvaring on the eighth day after using the last one. If you have previously used mini-pills, you can start using the ring on any convenient day, but in the first week additionally use barrier methods to prevent conception.

NuvaRing, instructions for use of which are given below, is a contraceptive. The new millennium has arrived, and women in Russia are still poorly informed about means of preventing unwanted pregnancy. Most of them use interrupted coitus or a condom for this. Gynecologists continue to sound the alarm about the growing number of abortions, while a new generation of contraceptives appear on the pharmaceutical market every year.

There are a number of reasons why our women prefer to take the risk of unwanted pregnancy and refuse new generation contraceptives:

1. The financial side of the issue. The more effective and safe the product, the higher its price. You can't argue with that. However, the modern arsenal of contraceptives includes dozens of items, from which a woman with any income level can choose the option that suits her. It is better after consultation with a gynecologist.
2. Laziness. Many women do not want to pay attention to contraception issues, finding a lot of excuses. It’s easier for them to hope that “maybe it will blow over,” have an abortion or give birth to an unwanted child, ruining their lives and his. Information about new means of contraception is available nowadays; you can read about it on the Internet at any time of the day, but so far the situation has not changed.
3. Horror stories about contraception. There are rumors in society that are filled with details and real-life incidents, such as: “one of my friends…”. It is believed that hormonal contraceptives can cause sudden weight gain, and intrauterine devices cause cancer. It is easier for women to believe rumors than to come for a consultation with a gynecologist and find out the opinion of a specialist.
4. Lack of contraceptive culture. Previously, it was not customary to talk about contraception in the USSR out loud, and the arsenal of means was limited to 1-2 items. More than 20 years have passed, and there is still no culture of contraception in our society. This is not talked about in schools, universities and work collectives. The situation requires change.

The modern business woman values ​​her health. She turns to a specialist who will help her choose a safe method of contraception, taking into account her individual characteristics and needs.

• Show all

  What methods of protection are there?

  The accumulated experience in this area allows us to talk about several basic methods of preventing unwanted pregnancy:

  Physiological methods of contraception. Despite the large share of errors, these methods continue to be practiced by our women. Among them there are 2 main ones:

  1. 1. Temperature method. A woman’s physiology is such that she can become pregnant only during the period of ovulation, when the egg is released from the ovarian follicle. During ovulation, your body temperature rises slightly. If you use the temperature method correctly, clearly keep a calendar of the menstrual cycle and measure the temperature in the rectum daily - morning and evening, then it works almost without errors. The advantage of the method is that it is natural and free. This is the only way to protect yourself from unwanted pregnancy, approved by the church. Disadvantage: takes time and requires concentration.
  2. 2. Calendar method. By counting, a woman makes a schedule of “safe” days and suitable days for conception. On “dangerous” days, she does not practice unprotected sex. Advantage of the method: ease of use. Disadvantage: suitable only for women with a stable menstrual cycle, as it gives a lot of errors. Gynecologists strongly advise against using the calendar method to prevent pregnancy.

  COCs - combined oral contraceptives. Pills are reliable means of contraception, their effectiveness is within 98%. Any oral contraceptive contains synthetic sex hormones, which:

  • inhibit the ovulation process;
  • change the structure of the endometrium of the uterus, as a result of which the fertilized egg cannot attach to its wall.

  Thus, multi-stage protection is carried out. All stories about the dangers of oral contraceptives are greatly exaggerated. After stopping the pills, all functions of the female body are quickly restored. Experts believe that pregnancy occurs faster as a result of the withdrawal effect and use this to stimulate conception. A small amount of hormones that are part of the tablets improves the condition of the skin, hair and nails, stabilizes the menstrual cycle, relieves the symptoms of premenstrual syndrome, and protects the body from iron deficiency anemia. In addition, according to WHO, women taking oral contraceptives have a reduced risk of developing cancer and osteoporosis.

  Like any pill, COCs have contraindications. They should only be prescribed by a doctor, based on examination data and diagnostic studies. It may be necessary to change 2-3 drugs when selecting a suitable remedy.

  Barrier means of protection against unwanted pregnancy. These include barrier agents that prevent the penetration of sperm into the vagina - condoms and chemical barrier preparations.

  If sexual intercourse happened suddenly and the sexual partner turned out to be accidental, then a condom is the best method of contraception. Currently, they are made from high quality latex rubber and are equipped with spermicidal and antibacterial lubricants for additional protection.

  

  For women who have regular sex life with one partner, chemical barrier protection products - gels, pastes, ointments, suppositories, vaginal rings and patches - are more suitable. All of them belong to the group of topical drugs.

  Chemical barrier contraceptives include special substances - spermicides, which:

  • destroy sperm that enter the vagina;
  • create a thin protective film on the walls of the vagina;
  • thicken the discharge from the cervical canal of the cervix, creating an additional barrier.

  Among the advantages of these contraceptives are effectiveness, antiseptic, antifungal, antiviral and antibacterial effects, and ease of use. The substances included in their composition inhibit pathogenic flora - chlamydia, herpes, gonococci, genital herpes virus. Barrier contraceptives are indicated for women during breastfeeding, as they are completely safe for the baby. The absence of contraindications makes them attractive to women over 40 years of age. The most popular drugs are:

  • gramicidin ointment;
  • Patentex Oval candles;
  • cream, vaginal balls and tampons "Pharmatex".

  Their method of application is approximately the same - insertion into the vagina 10-15 minutes before sexual intercourse.

  Barrier chemicals have a number of contraindications; they are not effective against sexually transmitted infections. Before use, you should consult your doctor.

  Intrauterine device. An IUD is a special flexible device that is inserted into the uterine cavity for a long time and prevents pregnancy. Spirals are divided according to the methods of influence: medicinal and non-medicinal. Spirals made of copper, gold, silver, with the addition of progesterone have a medicinal effect.

  Functions of the IUD:

  • causes thickening of the mucus of the cervical canal, creating a barrier in the cervix;
  • slows down the movement of the egg into the uterine cavity;
  • reduces the motor activity of sperm;
  • causes changes in the structure of the endometrium, as a result of which the fertilized egg cannot implant into the wall of the uterus.

  To date, the effectiveness of the IUD is 99%. The advantages of the product are reliable and durable protection against pregnancy, the optimal option for protection after childbirth, and the possibility of installation on any day of the menstrual cycle. Disadvantages - not suitable for nulliparous women; after the expiration of the IUD, it is necessary to remove it and take a break for 3 months before the next installation. The IUD does not protect against sexually transmitted diseases.

  Preventive measures for men. Gone are the days when contraception was considered the prerogative of women. A man who respects himself and his woman will protect her from unwanted pregnancy and plan the birth of children. Among the well-known means of male contraception are:

  1. 1. Interrupted sexual intercourse. The method is not entirely effective, since a little lubricant containing sperm is secreted on the head of the penis. Also, a man must clearly control the onset of ejaculation, and this is not always possible.
  2. 2. Condom. A simple and convenient way for emergency situations when sex happens suddenly. It has no contraindications and, when used correctly, provides 98% protection.
  3. 3. Vasectomy. A simple and safe sterilization operation that lasts 10 minutes and makes a man unable to conceive. Currently, it is completely reversible; if desired, a man can always regain his fertile function.

  Male contraceptive methods have no contraindications.

  Emergency contraception methods. There are situations in life when unprotected sex occurs, or a woman has been subjected to violence and emergency measures are required to protect against unwanted pregnancy.

  The pharmaceutical industry offers a number of tablets containing a loading dose of hormones that prevent conception and cause rapid rejection of the endometrium from the walls of the uterus. These drugs include Escapelle and Postinor, which are sold in pharmacies without a prescription.

  It is important to remember that these are emergency medications and cannot be used continuously, as this can cause serious disruptions to the menstrual cycle. In the case of adolescents, the question of using the drug is decided by the doctor.

  

  The essence of the method

  Hormonal rings are a relatively new means of barrier contraception. Their popularity among the female population of the planet is growing. The main advantage of rings in comparison with tablets is a single injection every few weeks, while tablets must be taken daily, without forgetting about it.

  

  The contraceptive ring is made of plastic polymers. Its thickness is 8.4 mm and its circumference is 55 mm. The ring is given the anatomical shape of the vagina, so that the woman does not experience discomfort while wearing it. One ring is used during one menstrual cycle - it is installed on the 5th day of menstruation and removed after 21 days, before the onset of menstruation.

  The vaginal hormonal ring combines the advantages of barrier and hormonal contraceptives. The active ingredients of the drug are absorbed into the blood under the influence of body temperature and suppress the ovulation process.

  Benefits of the ring:

  • use once a month;
  • easy administration without the help of a doctor;
  • does not reduce libido and does not change sensations during sexual intercourse;
  • facilitates the occurrence of premenstrual syndrome and menstruation;
  • reduces the risk of cancer in the reproductive system and colon;
  • minimizes the development of ovarian cysts, uterine fibroids and mammary gland mastopathy.

  

  Among the shortcomings, experts highlight:

  • lactation disturbance;
  • side effects;
  • soreness of the mammary glands;
  • lack of protection against sexually transmitted diseases.

  Since the vaginal ring contains hormonal drugs, you should consult a gynecologist before use.

  

  What is the product?

  The NuvaRing vaginal hormonal ring is made of modern polymer materials. It is smooth and colorless. The product contains 2 synthetic hormones:

  • estradiol derivative;
  • northotestosterone derivative.

  Polymers are used as auxiliary substances. Thus, NuvaRing is a combination product that consists of derivatives of female and male hormones. This combination suppresses ovulation and protects against possible pregnancy.

  

  NuvaRing is an effective modern contraceptive. Laboratory studies have shown that it protects in 96-97% of cases of use. In terms of effectiveness, the drug is not inferior to oral combined contraceptives, since it has almost the same composition and mechanism of action.

  It has been proven that NuvaRing has the ability to reduce the pain and profuseness of menstrual bleeding, protecting a woman from a decrease in hemoglobin levels in the blood. Regular use of contraception reduces the risk of developing malignant neoplasms of the reproductive organs.

  Compared to hormonal pills, the use of the ring does not cause increased menstrual bleeding or spotting. This effect is observed only during periods of abrupt withdrawal of the drug.

  

  Numerous studies have not documented an increase in body weight with long-term use of the NuvaRing contraceptive.

  The effects of ring hormones have not been studied in adolescent girls (under 18 years of age).

  

  Mechanism of action of the product

  The hormone, a derivative of nortestosterone, is released from the ring under the influence of body temperature and is quickly absorbed into the vaginal walls. Its highest concentration in the blood is achieved 1 week after insertion of the ring. It is important that the bioavailability of the drug exceeds that of hormonal pills.

  Once in the bloodstream, the substance binds to blood plasma proteins and has an effect on the ovaries and all target organs that produce sex hormones. The main property of the hormone is to slow down the onset of ovulation.

  

  The second component of the vaginal ring, an estradiol derivative, reaches its maximum concentration on the 3rd day after installation. It affects the condition of the endometrium, making it impossible for a possible fertilized egg to implant on the uterine wall.

  The components of the vaginal ring are easily metabolized by the kidneys and excreted from the body.

  The cycle of use of the vaginal ring is as follows:

  1. 1. The ring is installed on the 5-6th day of bleeding caused by removal of the previous one.
  2. 2. Removed after 3 weeks, on the same day of the week when it was installed and preferably at the same hour (for example, Wednesday 21:00).
  3. 3. A break of 7-10 days is taken, then a new ring can be installed.

  Removing the vaginal ring can provoke menstrual bleeding, which usually ends with the installation of a new contraceptive.

  

  When installing a barrier ring for the first time, in the first days of use it is recommended to use other means of contraception, preferably barrier ones - pastes, gels, creams.

  How to switch from different types of contraceptives?

  Switching from oral contraceptives. If a woman decides to switch from using pills to using a vaginal ring, then she can do this on any day of the cycle, with full confidence that pregnancy has not occurred. Experts recommend doing this in the interval between cycles of taking pills.

  

  Switching from prostagene-based drugs. These include progestogen pills, mini-pills, implants, intrauterine devices with hormones, and contraceptive injections. The barrier ring can be inserted any day after you have finished taking progestogen medications. Immediately after removal of the IUD or on the day when the drug injection is prescribed. In the first week after installation, it is recommended to use other types of barrier contraceptives.

  After an artificial termination of pregnancy, NuvaRing can be installed on the same day. Then there is no need to use other contraceptives. If this cannot be done, then the procedure for using the vaginal ring is the same as in the previous case - use additional contraceptives in the first week.

  After the birth of the child and the feeding period, such a ring can be inserted after the first menstruation.

  

  Violation of the terms of use

  While using the vaginal ring, it sometimes becomes necessary to remove it. In such cases, the following rules apply:

  1. 1. If the ring is removed for a period of no more than 3 hours, then a sufficient concentration of hormones that prevent pregnancy will remain in the blood.
  2. 2. In the case when the ring was removed and there was sexual intercourse, it is necessary to make sure that pregnancy did not occur. It is better to insert a vaginal ring after the onset of menstruation.
  3. 3. If the ring was removed for more than 3 hours in the first 2 weeks after installation, this may reduce its contraceptive effect. The ring should be installed as soon as possible and other contraceptives should be used in addition to the first week.
  4. 4. If the ring was removed during the 3rd week of use, then you must either insert a new contraceptive, or wait for bleeding and insert it after a few days.
  5. 5. If the ring is used for more than 4 weeks, its effect is reduced. The contraceptive should be removed from the vagina and replaced with a new one.

  

  A woman can avoid bleeding associated with contraceptive discontinuation. To do this, you need to insert a new ring without interruption. In this case, spotting bleeding is considered normal.

  In this way, the woman herself can regulate the onset of bleeding and its duration. The shorter the period between changing barrier rings, the shorter the period of bleeding, even absence.

  When the NuvaRing ring is installed correctly, cases of spontaneous loss are quite rare. The ring may fall out if:

  • when the tampon is removed;
  • after sexual contact;
  • after a difficult act of defecation (constipation).

  

  In such cases, you must either insert a new ring or follow the installation rules after a break.

  How should the ring be inserted?

  A woman can insert a barrier ring herself, without resorting to the help of a gynecologist. To do this, she should take a comfortable position - standing, squatting, standing on one leg and raising the other, lying on her back. The instructions for installing the ring are as follows:

  1. 1. Squeeze the ring between your fingers.
  2. 2. Insert your fingers deep into the vagina.
  3. 3. Release the ring.

  If NuvaRing is installed correctly, the woman will not feel its presence when walking, sitting or lying down. The ring can get in the way when it is not inserted deeply. In this case, it should be removed, washed well with warm water and reinstalled.

  

  To remove the ring, you need to grab its rim between your fingers and carefully, so as not to damage the mucous membrane with your nails, remove it from the vagina.

  Existing contraindications

  The barrier ring contains hormonal drugs, so you should consult a doctor before using it as a contraceptive. Only he can assess the degree of risk in the presence of concomitant diseases.

  

  Contraindications to the use of NuvaRing:

  • diseases associated with the formation of blood clots in arteries and veins - blockage, disturbances of venous outflow, hereditary and genetic diseases associated with circulatory disorders;
  • diseases of the heart and blood vessels: malnutrition of the heart muscle, acute cerebrovascular accidents, attacks of angina and ischemia, installation of artificial heart valves, hypertension;
  • frequent migraines with neurological syndrome;
  • diabetes mellitus types 1 and 2, when vascular damage occurs;
  • a history of severe injuries with a long period of rehabilitation;
  • obesity 3-4 degrees;
  • chronic pancreatitis;
  • conditions of liver failure or liver dysfunction;
  • existing or previously experienced hormone-dependent oncological diseases;
  • period of pregnancy and breastfeeding;
  • increased sensitivity to the hormonal components of the contraceptive;
  • long-term smoking.

  With caution, the NuvaRing vaginal contraceptive ring can be used for:

  • blockage of superficial veins;
  • heart defects;
  • controlled hypertension;
  • cholelithiasis;
  • jaundice caused by inflammation of the gallbladder;
  • mineralization in the gallbladder and kidneys;
  • manifestations of allergies;
  • gastrointestinal diseases;
  • iron deficiency anemia;
  • inflammatory processes in the cervix,
  • rectal hernia;
  • dyspeptic disorders.

  The specialist carefully weighs all the risks associated with using the NuvaRing ring and makes an appropriate conclusion.

  

  Side effects

  Side effects from using the hormonal ring:

  1. 1. Possible infection of the internal environment of the vagina and the development of inflammatory processes in the cervix, in the walls of the bladder and urinary tract.
  2. 2. Decreased immunity.
  3. 3. Metabolic disorders, increased appetite.
  4. 4. Changes in mental reactions: irritability, mood swings, depression, decreased sexual desire.
  5. 5. Manifestation of nervous disorders - headaches, fainting conditions.
  6. 6. Impaired visual acuity.
  7. 7. Vascular reactions - hot flashes, blood thickening.
  8. 8. Digestive disorders - constipation, diarrhea, nausea, flatulence.
  9. 9. Muscle reactions - pain in the lower back and back, spasms, numbness of the limbs.
  10. 10. Increased sensitivity of the urinary tract - frequent urge to urinate.
  11. 11. Symptomatic disorders of the reproductive organs - swelling and tenderness of the mammary glands, itching in the genital area, painful bleeding similar to menstrual bleeding, discharge, pain in the lower abdomen, vaginal dryness.
  12. 12. Unpleasant sensations associated with the installation of the ring - ailments, swelling, etc.

  Cases of side effects of the NuvaRing vaginal ring are quite rare, but those women who decide to use this contraceptive need to know about them.

  

  Excess of dosage and interaction with medicinal substances

  There have been no cases of overdose when using a contraceptive. In some cases, increased sensitivity to active substances was recorded - dyspeptic disorders, minor bleeding in girls under 18 years of age. In these cases, it is recommended to remove the ring and carry out symptomatic treatment. Then you should contact your gynecologist to select a different means of contraception.

  The hormonal components of the NovaRing contraceptive may interact with medications:

  1. 1. With enzyme preparations that improve liver function.
  2. 2. With preparations based on St. John's wort.
  3. 3. With antibiotics, which reduce the effectiveness of contraceptives.

Latin name: NovaRing
ATX code: G02BB01
Active substance: Ethinyl estradiol
and etonogestrel
Manufacturer: Organon, Netherlands
Conditions for dispensing from a pharmacy: On prescription

Nuvaring is a new highly effective contraceptive drug of the latest generation, intended for intravaginal use.

Indications for use

The Nuvaring contraceptive ring is prescribed for contraceptive purposes.

Compound

The active ingredients of the vaginal ring are ethinyl estradiol together with etonogestrel, the dosages of the active components are 2.7 mg and 11.7 mg, respectively.

Additional components include:

• Magnesium stearate
• Ethylene and vinyl acetate copolymer.

Medicinal properties

Price from 989 to 3897 rub.

Synthetic hormones released by the ring when used vaginally have a contraceptive effect by blocking the onset of ovulation. Each of the hormones entering the body affects the functioning of the ovaries, preventing the maturation of the follicles. Etonogestrel is the progestogen component of the ring, which binds to specific progesterone receptors in the so-called target organs.

Ethinyl estradiol is an estrogen component; the action of this drug is associated with the occurrence of various processes, which are mainly aimed at suppressing ovulation.

The hormonal drug exhibits not only contraceptive properties, normalizes the menstrual cycle, reduces pain during the first days of menstrual-like discharge, reducing blood loss. Due to this effect, the risk of iron deficiency and anemia is reduced.

When using Nuvaring, the likelihood of ectopic pregnancy, the development of ovarian and endometrial cancer of the uterus is significantly reduced. At the same time, cystic formations in the ovaries, inflammatory processes in the pelvic organs, and benign neoplasms in the mammary glands are less frequently diagnosed.

Etonogestrel penetrates the vaginal walls, its highest concentration is observed after 7 days, precisely when it begins to act as a contraceptive. Moreover, its bioavailability is 100%, which is significantly higher than that of oral contraceptives. Metabolic processes occur in liver cells, excretion is carried out by the intestines and the renal system. The half-life of metabolic products is about 6 days.

Ethinyl estradiol is characterized by fairly high absorption rates. The highest level of the hormone is observed after 3 days. from the moment of installation of the hormonal ring. The bioavailability rate is 56%, which is almost the same as the oral use of hormones. Metabolism occurs in the intestines and kidneys, metabolites are eliminated within 36 hours.

Release form

The surface of the hormonal ring is smooth, transparent and completely colorless. There is a small transparent area in the connection area. Inside the moisture-resistant bag there is 1 Nuvaring hormonal ring. A pack may contain 1 or 3 packets (with 3 rings - Nuvaring 3) along with instructions.

Nuvaring: instructions for use

The ring must be inserted into the vagina for 21 days. After this period, it must be removed on the day of the week on which it was installed. After a week break (7 days), a new contraceptive is introduced. It is worth noting that after 2-3 days. after removing the Nuvaring ring, menstrual-like bleeding usually begins, which ends after the next intravaginal installation of the contraceptive. If this contraceptive is used for the first time, then you should pay attention to some features of its use:

• A hormonal contraceptive has not been used before - the Nuvaring ring is inserted in the first days of the cycle (best on the 1st day). If the installation occurred later than 1 day. cycle, it is recommended to use additional methods of contraception for the next seven days.
• If you have previously used hormonal contraceptive drugs, the ring should be introduced in the interval between taking COCs (seven-day withdrawal period). If COCs are used correctly and it is confirmed that the woman is not pregnant, the Nuvaring ring can be inserted on any day of the MC. You can go from Yarina using the same scheme.
• After taking the mini-pill, single-component progestin contraceptive pills, using hormonal intrauterine systems, injectable contraceptives, and implants, the ring is inserted according to certain rules. After progestin pills (mini-pills), you can insert a contraceptive drug any day, regardless of when the last pill was taken, whether the cycle after childbirth has improved or not. After removing the IUD, you will need to insert a contraceptive ring on the same day (according to the instructions). If you have previously used an injectable contraceptive, you will need to install the ring on the day when the hormone injection procedure is to be carried out. During the seven-day use of the ring, it is necessary to use a barrier method of protection against unwanted pregnancy.

Instructions for use after abortion

If an abortion is performed before 4 months of pregnancy, you will need to insert the rings immediately after this procedure or wait until the first menstruation (in this case, the contraceptive is administered on the 1st day of the cycle).

After termination of pregnancy during the second trimester or after delivery, a vaginal ring can be installed no earlier than a month (4 weeks) after natural childbirth (breastfeeding is stopped) or abortion.
If the use of a hormonal drug deviates from the standard regimen, the following recommendations should be followed:

• The break in using the hormonal ring exceeds 7 days. in the presence of unprotected sexual contacts: first of all, pregnancy is excluded and a contraceptive is immediately introduced, the next 7 days. It is preferable to use barrier methods of protection against unwanted pregnancy.
• Temporary removal of the hormonal ring: its stay outside the vagina is less than three hours, but the level of protection against pregnancy is not reduced. If the period of absence of a hormonal drug in the vagina was more than 3 hours in the first weeks of using this contraceptive, the ring must be inserted as soon as possible. In this case, the contraceptive effect may be reduced, and there is a need to take additional measures to prevent pregnancy. If the ring was removed for more than 3 hours in the third week, you must stop using this drug and insert a new one. The break in use should not last more than 7 days. You can also wait for menstruation; on the first day when menstruation begins, you can insert an intravaginal contraceptive. Use condoms for the next 7 days. is mandatory.
• Use of vaginal contraception for more than 4 weeks. requires further exclusion of pregnancy due to the fact that the contraceptive effect of the drug has significantly decreased. After pregnancy has been ruled out, you can use the drug according to the standard regimen.

How to delay menstruation

To postpone your period (the onset of bleeding) by a day or several days, you can administer a hormonal ring without the standard seven-day break. However, the possibility of bleeding should not be ruled out.

How to properly insert a ring into the vagina

Before inserting the ring, you need to squeeze it with your index finger and thumb and carefully place it inside the vagina.

If the ring accidentally falls out when using tampons, it is recommended to rinse the contraceptive under running warm water, then reinsert it. If necessary, you can check with your doctor: “What should I do if I pull out the tampon along with the ring?” It is worth noting that with a tampon a woman will not feel any discomfort. When using tampons, you need to be more careful to prevent the ring from falling out of the vagina.

To remove the ring, you should pick it up with your index finger, squeeze it slightly, and then pull it towards you. The used hormonal drug, which the woman removed from the vagina after 21 days, should be disposed of.

If a woman inserts the ring incorrectly, it is accidentally placed in the urethra, the likelihood of developing cystitis increases, and frequent urination may occur. In this case, the woman can become pregnant. Before you fight cystitis, it is worth finding out the true cause of its appearance. You will need to remove the ring as quickly as possible. As a result of subsequent correct administration, it must be securely fastened, frequent inflammatory processes of the genitourinary system, and in particular cystitis, after Nuvaring will no longer bother you, pain during urination will disappear.

Using a ring for fibroids

The presence of fibroids is not a contraindication to the use of this contraceptive; you can use the ring without harm to your own health. It is worth noting that fibroids do not grow during the use of the ring, as evidenced by ultrasound. Patients with fibroids are advised to consult with their doctor about the advisability of using the ring. If necessary, you can switch from Nuvaring to tablets. Whether it is possible to treat fibroids in this way and which contraceptives to give preference, check with your gynecologist. Cancellation of Nuvaring should be agreed with a specialist. Recovery of the cycle after hormone therapy will occur after six months.

Treatment of endometriosis

For endometriosis, the use of a hormonal ring may be indicated; when switching from other COCs (for example, if Yarina was previously prescribed), a significant improvement in the course of the disease is observed; during menstruation, a woman loses less blood. During the first month of use, the severity of pain decreases, which contributes to the gradual restoration of the endometrial layer of the uterus. After a woman switches to using the ring, her periods are painless. The drug acts gently, without disturbing the functioning of other organs and systems. Each of the active ingredients has a local therapeutic effect.

Use during pregnancy and pregnancy

Such contraceptives are not prescribed to this group of patients. The use of Nuvaring during lactation and pregnancy is contraindicated.

Contraindications

• Tendency to develop thrombosis and thromboembolism
• Conditions that indicate the development of thrombosis
• Current or previous severe migraine-like headaches with significant focal neurological symptoms
• Diabetes mellitus complicated by vascular lesions
• Pancreatitis with hypertriglyceridemia
• Serious liver disorders (including benign and malignant tumor processes)
• Presence of hormone-dependent neoplasms
• Bloody discharge from the internal genital organs of unknown origin
• Pregnancy, GW
• Excessive sensitivity to Nova Ring (main components).

Precautionary measures

If you have not previously used contraceptives of this type, you should undergo a medical examination to identify diseases that are a contraindication to the use of a hormonal ring. Control visits to the gynecologist should take place every 6 months.

It must be remembered that this contraceptive does not protect against AIDS and other infectious diseases that are sexually transmitted. When using a contraceptive, the risk of thrombosis increases significantly.

Possible symptoms include:

• Feeling of heat in the lower extremities, pain or severe swelling
• Hyperemia of certain areas of the skin
• Cough syndrome, developing shortness of breath with characteristic attacks
• Impaired vision clarity
• Intense and prolonged headaches
• Blurred speech
• Collapse
• Impaired motor activity
• Lethargy, decreased sensitivity of some part of the body
• Acute abdomen syndrome.

If possible blockage of blood vessels by blood clots cannot be ruled out, you must immediately stop taking the drug and seek medical help.

During contraceptive therapy (women used pills), the development of a tumor process in the liver tissue was diagnosed. The use of a vaginal ring does not exclude the development of such pathology, as with tablets.

During hormonal therapy, the risk of pancreatitis increases rapidly.

If you are prone to chloasma, you should avoid prolonged exposure to direct sunlight.

A worsening of the course of ulcerative colitis, as well as Crohn's disease, cannot be ruled out.

Persons with diabetes need to remain under strict medical supervision during the first months of hormonal therapy.

If your period stops and a woman becomes pregnant, you should stop using the contraceptive immediately.

Cross-drug interactions

It is necessary to read the instructions for drugs such as oxcarbazepine, carbamazepine, topiramate, phenytoin, felbamate, rifampicin, as well as barbiturates and drugs based on St. John's wort. This is due to the fact that with combined use the risk of acyclic bleeding increases. It is necessary to use additional means of protection during treatment with such drugs for a month.

The use of antibiotics (for example, tetracycline or ampicillin) reduces the contraceptive effect of the hormonal drug. It is recommended to use a condom during antibiotic treatment. It is better to ask your gynecologist which antibiotics to use and what the consequences of taking them are.

When using antifungal suppositories intravaginally, the risk of damage to the hormonal ring or its rupture increases.

During hormone therapy, changes in the metabolism of other drugs may be observed, these include cyclosporine and lamotrigine.

Side effects

With long-term use of hormonal drugs, it is worth studying the instructions for the drugs, as multiple side effects may develop, in particular with Nuvaring the following cannot be ruled out:

• Excessive sensitivity
• Increased appetite and weight gain
• Decreased libido
• Sudden mood swings, depressive mood
• Migraine-like pain
• Impaired visual acuity
• Deterioration of the cardiovascular system, which is characterized by thromboembolism, changes in blood pressure, and the occurrence of so-called hot flashes
• Gastrointestinal disorders
• Rashes, acne formations and severe itching
• Soreness in the muscles, spine and limbs
• Dysuria, tendency to frequent urination, cystitis
• Lethargy, swelling
• Reproductive system: breast engorgement, the appearance of a genital node, the development of dysmenorrhea, heavy periods or their absence, bleeding of unknown etiology, discharge mixed with blood during sexual intercourse, a local burning sensation, pain inside the vagina.

Overdose

No serious consequences of overdose were detected.

Bleeding and indigestion cannot be ruled out.

Please note that there is a dedicated hotline to help women with various vaginal ring concerns. If side symptoms develop due to an overdose, you should call the hotline (the number is listed on the official page of the drug Nuvaring in Russia). Hotline operators will advise and give recommendations on what to do in a given situation.

Storage conditions and shelf life

The hormonal ring must be stored under strict temperature conditions (2-8 C) for 3 years.

Analogs

Bayer, Germany

Price from 759 to 3295 rub.

Yarina belongs to combined hormonal drugs, the dose is designed for one month. The tablets act comprehensively, exhibiting a contraceptive effect and antiandrogenic effect. The package can contain 21 or 28 tablets.

Pros:

• Eliminate the appearance of acne
• Normalize MC
• Easy to switch from other COCs.

Minuses:

• Produced by a foreign manufacturer, which is reflected in the price
• Has a negative effect on liver function
• Adverse reactions may occur during hormone therapy.