NuvaRing Side Effects

As of June 30, 2024, pulmonary embolism and deep vein thrombosis (DVT) were the most common NuvaRing side effects reported to the Food and Drug Administration. Reports also frequently listed breakthrough bleeding and incorrect use of the product.

The FDA considered 47.5% of the reports it received to be serious adverse events.

Disclaimer: Reports sent to the FDA don’t necessarily mean the drug caused an adverse event. Consult a health care professional before stopping or changing medication.
When used correctly, NuvaRing appears to have a strong safety profile. However, you should always discuss the possible side effects and risks with your health care provider.

FAERS data indicate that adverse effects from a failure to follow the prescribed regimen were widespread among NuvaRing users. Improper use can cause vaginal irritation, injury and infections. It can also lower NuvaRing’s effectiveness.

According to NuvaRing’s prescribing information, the most common reactions leading to study withdrawal were device-related events, including expulsion or discomfort, mood changes, headache and vaginal symptoms. It further states that 13% of women enrolled in clinical trials withdrew because of side effects.

Some NuvaRing users reported broken devices that can cause vaginal injury. Additionally, sexual partners may develop penile disorders, such as rash, from contact with a vaginal ring.

Many common NuvaRing side effects, such as expulsion and discomfort, relate to how the patient inserted it. Other side effects, such as headache, weight gain and breast tenderness, are similar to the side effects of other types of hormonal birth control.

Mild side effects tend to be most pronounced when first starting NuvaRing. They usually lessen and may go away completely after a few months of use.

Talk to your doctor if side effects worsen, interfere with your ability to use NuvaRing or last for more than a few months.

NuvaRing users reported severe adverse effects including blood clots, heart attack and stroke. Cardiovascular side effects can lead to serious health consequences, including death.

One 2017 study published in the Journal of Stroke and Cerebrovascular Diseases concluded that vaginal contraceptive rings led to a 2.5 times increased stroke risk.

Seek emergency medical care if you experience any of the following severe side effects.

Post-marketing experience shows that hypersensitivities, including allergic reactions leading to anaphylaxis, are possible with NuvaRing. Anaphylaxis is a life-threatening condition.

Notify your doctor immediately if you develop hives, difficulty breathing or swelling of the face, throat or nose, as these could be symptoms of anaphylaxis.

A 2022 report in the American Journal of Case Reports showed an approximately three-fold increase in thromboembolism among NuvaRing users compared to individuals who do not use hormonal birth control methods. This is a blood clot that breaks loose from where it formed and becomes lodged in another body part. The rates of thromboembolism in NuvaRing users averaged .08%, whereas the rate was .03% in the control group.

Blood clots can cause serious injury, including death. There are various symptoms of blood clots which depend on where the clot is. With NuvaRing, the clots are typically deep vein thrombosis clots. This type typically forms in the leg and causes swelling and pain.

Blood clot symptoms include any new and unexplained limb pain – especially in the calf -, severe headaches, breathlessness, yellowing of the skin or vision problems.

NuvaRing Lawsuits

In February 2014, NuvaRing manufacturer Merck agreed to a $100 million deal to settle multiple NuvaRing lawsuits. Plaintiffs claimed Merck knew of the risk of blood clots related to product use but failed to provide patients with a clear warning about the risk.

In total, over 3,500 plaintiffs took advantage of the settlement. Some cases continue to play out individually, but most have been resolved.

NuvaRing has a boxed warning for the risk of cardiovascular side effects among individuals who smoke. This is the strictest type of FDA warning, indicating a drug may cause serious health consequences or death.

The warning also indicates that women over 35 and those who smoke should not use combined hormonal contraceptives (CHCs). This includes treatments such as NuvaRing and hormone-based patches and pills.

Other FDA Warnings

The manufacturer updated NuvaRing packaging information in 2024 to warn of an increased risk of developing elevated liver enzymes in patients using NuvaRing who are also on certain hepatitis medicines.

This comes after the addition of two warnings in 2018. One warned of how there have been reports of vaginal injury with ring breakage. According to the warning, ring breakage is more likely to happen if the patient inserts the device incorrectly. The other warning was for the risk of hypersensitivity reactions.

The prescribing information also contains a warning highlighting the risk of pregnancy associated with using NuvaRing in a way contrary to the provided information. It details instructions for replacing an expelled device depending on the timing of your menstrual cycle and how long the ring was out.

Some patients using NuvaRing reported allergic reactions of anaphylaxis and swelling. Prescribing information recommends discontinuing the use of the device and seeking medical treatment for these conditions.

Anyone with a known hypersensitivity to a component or ingredient in NuvaRing should not use it.

Some lifestyle choices, medications and health conditions increase the risks of NuvaRing side effects. According to its prescribing information, people who smoke, are over the age of 35, have unexplained vaginal bleeding or take certain hepatitis C drug combinations should not use NuvaRing.

Sharing a complete overview of your medical history and lifestyle with your health care provider before using NuvaRing can help reduce the risk of side effects. This allows you to work together to make an informed decision about safe and effective contraception.

NuvaRing can be an effective contraceptive method for many people, but it does pose some health risks. If you are concerned about possible side effects, you might want to consider alternative forms of contraception.

However, many NuvaRing alternatives also contain hormones that can cause similar side effects.

As with any medication, you must weigh the benefits and risks of using a specific contraceptive. For example, IUDs can be hormonal or non-hormonal, which influences the side effects.

Ease of use may also play a factor in your decision. You only need to insert NuvaRing once per month, and IUDs last several years, as opposed to taking a daily pill or using barrier contraceptives for sexual interactions.

However, IUDs and implants require a doctor for insertion and removal, whereas patients insert vaginal rings or apply patches at home.

You can discuss any concerns with your health care provider to find a solution you are comfortable with.

Editor Lindsay Donaldson contributed to this article.