Online Prescription

Nuvaring Contraceptive Ring

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Webdoctor.ie Customer Review

Very happy with service, it was user friendly for a person on the go that is not overly technically savvy. I was so pleased with the prompt and thorough response. I absolutely will be using this again!

—Elaine, 9th May 2022

What is the Nuvaring and what is it used for?

Nuvaring is a small flexible contraceptive ring that you insert into your vagina. It is a combined hormonal contraceptive and provides a slow, steady release of oestrogen and progestogen into the bloodstream through the vaginal wall. Each ring contains etonogestrel and ethinylestradiol. Nuvaring remains in place for 3 weeks at a time and then it is removed for a hormone-free break.

It is used to prevent pregnancy and can be useful in the management of heavy/ painful periods and polycystic ovarian syndrome. Nuvaring provides effective reversible contraception if used correctly, and good cycle control.

Nuvaring prevents pregnancy by:

  1. Preventing ovulation (the release of an egg).
  2. Causing the mucus at the cervix (neck of the womb) to thicken, preventing sperm from entering the womb.
  3. Thinning the lining of the womb, making it more difficult for a fertilised egg to implant.

Nuvaring patches do not protect against sexually transmitted infections (STIs). You should always use a barrier method such as a condom to reduce your risk of STIs.
Here is some important information on the contraceptive vaginal ring.

Important Medical Information

Who is this service suitable for?

This service can provide Nuvaring prescriptions for female (birth sex) patients who require contraceptive treatment to:

  • Prevent pregnancy.
  • Regulate troublesome periods.

You can apply for this treatment if you are aged between 17 and 49 years. A risk assessment will be carried out to determine if Nuvaring is suitable for you.

To use this service safely, we require up-to-date height & weight measurements and a recent blood pressure reading. If you have had a recent blood pressure check by your GP/ nurse, you can use this. If not, a reading from your local gym, pharmacy or home monitor can be used.

How do you use Nuvaring?

If this is your first time using Nuvaring or you are restarting:

  • Insert Nuvaring on days 1-5 of your next period and you will have full contraceptive cover immediately.
  • If you have not been sexually active since your last period, you can start using Nuvaring at any time of your cycle. You will need to use additional contraception if you have sex within the first 7 days after insertion.

Traditionally, the ring remains in place for 3 weeks and then it is removed for a 7-day hormone-free break. After this break, insert the new ring at the same time of day exactly one week after you removed the previous ring.

If you are changing from another form of contraception, please send us a message with your Nuvaring request and we can give you individual advice on how to do this.

Tailored Use of Nuvaring
There is no medical reason to leave Nuvaring out for a full 7 days before inserting a new one.

It is now recommended that contraceptive rings can be used in cycles as follows if preferred, to provide more reliable contraceptive cover and better bleeding control:

  1. Insert a new ring and leave it in place for 3 weeks, then remove it and have a ring-free interval of 4 days only, before inserting the next new ring.
  2. Insert a new ring every 3 weeks for 9 weeks (i.e. 3 times in a row without a break) and then have a ring-free interval of 4 days before inserting a new ring.
  3. Continuous use of the ring (inserting a new ring every 3 weeks) until there is spotting for 2 days, then take a 4-day break and insert a new ring. Continue this pattern of use until spotting occurs again.

If you follow a set pattern of use and have a planned break, you will usually bleed during this time. Make sure you insert the next ring after the recommended ring-free break (see above) regardless of your bleeding pattern.

These options are not licensed (you will not see them detailed in the leaflet that comes with your medicine) but are recommended by The Faculty of Sexual and Reproductive Health (UK).

We can offer you further advice on this, just send us a message via your account when you have completed the request questionnaire.

How do you insert Nuvaring?

The Nuvaring is very flexible and you will be able to squeeze it easily when inserting it.

  • Wash and dry your hands.
  • Choose a comfortable position (e.g. standing with one leg up, squatting, or lying down.
  • Compress the ring using your thumb and index finger and gently insert the Nuvaring into the vagina until it feels comfortable.

If you can feel the ring or it is uncomfortable, you can use your finger to gently push it in further. Don’t worry, you will not push it in too far! The exact position of the ring does not affect how it works.

Each Nuvaring ring remains in place for 3 weeks, during which time you should regularly check it is in place.

Very rarely, a ring may break while in the vagina. In this case, you should remove the broken ring, insert a new one and use additional contraception for 7 days.

Further details on this (including images) are available on the information leaflet that comes with Nuvaring.

How do I remove Nuvaring?

To remove Nuvaring:

  • Wash and dry your hands.
  • Hook your index finger under the rim and pull it out gently.
  • Dispose of it in the bag provided.

If you are having difficulty getting it out or you have any bleeding or pain, please contact your local doctor, nurse or family planning clinic.

What are the potential side effects of Nuvaring?

Nuvaring is generally very well- tolerated and most women do not experience side effects. In those that do, localised side effects are most common.

  • You may be aware of the ring in your vagina and find this unpleasant.
  • Your partner may feel the ring during sex.
  • Sore/ irritated vagina.
  • Increased vaginal discharge.

Other side effects include nausea, headaches and breast tenderness – these are the most common and usually settle quickly. Spotting between periods is also common and should settle within the first 3 cycles.

Occasionally skin changes, such as acne, decreased libido (sex drive), altered mood and fatigue are reported.

If you develop any of these symptoms and they are persisting, or you are concerned, please speak with your doctor. There are many alternative contraceptive options to consider.

The oestrogen in combined contraceptives can cause increases in blood pressure. It is not medically safe to use this type of contraception if you have high blood pressure. A blood pressure check should be performed every 6-12 months to monitor for this as you are unlikely to have any symptoms.

For full details of the potential side effects of these medications, please ensure that you read the patient information leaflet that comes with your medication before you start to use it.

Does using the Evra patch increase my risk of getting a blood clot?

Yes, using combined contraception such as Nuvaring can increase your risk of developing a potentially harmful blood clot, compared to non-users.

However, the overall risk of developing a blood clot is very small and is significantly lower than during pregnancy or the postpartum period. But, blood clots are potentially very serious and in very rare cases can be fatal.

You should see a doctor immediately if you develop any of the following symptoms when using Nuvaring:

  • Pain or swelling in the legs.
  • Severe chest pain.
  • Breathlessness or coughing up blood.
  • Bad fainting attack or collapse.
  • Unusual headaches or difficulty with speech or sight.
  • Numbness or weakness of a limb.

The potential risk of developing a blood clot when using combined contraception varies between different contraceptive products. Current evidence suggests that Nuvaring may have up to twice the risk compared to some other combined contraceptive products.

The risk of developing a blood clot is greatest in the months immediately after starting combined contraception (Evra patch, Nuvaring or any of the combined pills), or when restarting after a break of at least one month. This risk reduces over the first year of use and then remains stable. It is for this reason that frequent starting and stopping of combined contraceptive methods should be avoided.

  • If a blood clot develops in the leg, it can cause deep vein thrombosis (DVT).
  • If it travels to the lung, it can cause a pulmonary embolism (PE).
  • If it travels to the heart, it can cause a heart attack.
  • If it travels to the brain, it can cause a stroke.

Other things that can increase your risk of developing a blood clot when using Evra include:

  • Being overweight.
  • Smoking.
  • Increasing age (from 35 years and older).
  • Having a family member with a blood clot ages <45 years.
  • Postpartum (6-12 weeks post-delivery).
  • Reduced mobility (even temporarily).

The more of these risk factors that apply to you, the greater your risk.

Seek additional advice if you are:

  • Having a procedure or surgery (of any type).
  • Planning a long-haul flight.
  • Planning a holiday to an area of high altitude.
  • Immobilised for a prolonged period of time.

Further information about blood clot risk and Nuvaring is available here. Please read this information before you use this medication so you can make an informed choice.

Can I delay my period using Nuvaring?

If you are using Nuvaring, you can delay or prevent your period by skipping your ring-free break. This is a form of tailored ring use – as discussed above, in the second FAQ – “How do you use Nuvaring?”

Some women will experience breakthrough bleeding when using more than 2 vaginal rings in a row without a break.

What happens if the Nuvaring slips out?

If your ring comes out and it has been out for less than 3 hours, rinse it in warm (not hot) water and put it back in. You will still be in full contraceptive cover.

If it has been out for more than 3 hours, what to do depends on what stage of your cycle you are in.

Week One
The contraceptive cover may be reduced.

  1. Rinse the ring and reinsert it as soon as you can.
  2. Use additional contraceptive cover for 7 days.
  3. If you have had unprotected intercourse in the previous week, speak with your doctor as you may need emergency contraception.

Week Two or Three
Dispose of the ring that slipped out and either:

Insert a new ring and begin a new 3-week cycle (from this time).

OR

Have your ring-free break and insert a new ring 7 days after the ring came out. Only choose this option if a ring has been in place continuously for the previous 7 days.

Regardless of which option you select, use additional protection for 7 full days.

What if I forget to remove the ring?
If you are less than 7 days late removing the ring, remove it when you remember and insert a new one as usual (i.e. shorten your ring-free break).

If you are more than 7 days late removing the ring, change it immediately and use additional contraception for 7 days. If you have had unprotected sex during this time, speak with your doctor for advice as emergency contraception may be required.

What if I forget to insert a new ring?

If you are less than 24 hours late, insert the new ring when you remember. No additional contraception is required.

If you are more than 24 hours late, insert a new ring as soon as you remember and use additional contraception for 7 days. If you have had unprotected sex during this time, speak with your doctor for advice as emergency contraception may be required.

Can I take other medications with Nuvaring?

Some medications (prescribed and over the counter), herbal remedies and supplements can interact with Nuvaring. This can cause contraceptive failure and increase the possibility of potential side effects.

Please seek advice from a healthcare professional (e.g. doctor, pharmacist or nurse):

  • Before starting any new medications, herbal remedies or supplements if you are using Nuvaring.
  • If you are taking regular medication and are planning to start using Nuvaring (or any contraceptive).

Examples of some medications that can interact with Nuvaring include EllaOne (emergency contraceptive pill), St John’s wort, antiviral medications used to treat HIV/ AIDs, certain epilepsy medications, griseofulvin antifungal, rifampicin antibiotic (please note, other antibiotics do not affect the Nuvaring patch).

Contraceptive Pill, Patch & Ring Options That We Prescribe

Too busy to see your GP? Order your repeat prescription for the contraceptive pill, patch or ring online with Webdoctor.ie! Once your request has been approved, we can send your prescription directly to your chosen Irish pharmacy via secure Healthmail. If you do not see your pill listed, please email us for advice.

Most Common Brands

We issue prescriptions for generic name medicines to ensure maximum availability of treatments. Please check your dispensed prescription before leaving the Pharmacy as no changes can be made after that point.

How It Works

Requesting a prescription for Nuvaring couldn’t be easier with Webdoctor.ie. Simply fill in a short online questionnaire and our GPs will issue a prescription if this treatment is medically suitable and safe for you.

Step 1

Online Questionnaire

Access and complete a brief questionnaire on your phone, tablet or laptop – it only takes a few minutes!

Step 2

Medical Review

One of our Irish-registered doctors will review your questionnaire to make sure this treatment is medically safe and suitable for you. If our doctor requires further clinical information to help safely assess your request, they will send you a message via your secure patient account.

Step 3

Decision Made
We will send your prescription to an Irish pharmacy of your choice once it has been approved.

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