NuvaRing vs. Mirena for Birth Control: Important Differences and Potential Risks.

NuvaRing

(etonogestrel / ethinyl estradiol)

Mirena IUD

(levonorgestrel)

Summary for NuvaRing

Prescription only

NuvaRing (etonogestrel / ethinyl estradiol) can be used as birth control to help prevent pregnancy. It contains two hormones: a progestin and an estrogen. It's a latex-free, flexible plastic ring that’s inserted into the vagina. You keep it in your vagina for 3 weeks before you remove it for 1 week, and then you start again with a new ring. NuvaRing (etonogestrel / ethinyl estradiol) can cause side effects like headache and irritation in the vagina. Some people might also gain weight while using the medication. There are detailed instructions to help you use it properly. This birth control ring is available as brand-name and generic versions.

Indications for NuvaRing

Prevention of pregnancy

Pros and Cons for NuvaRing

Pros

A flexible plastic ring that you place into the vagina for 3 weeks at a time (not taken once a day)
Can insert and take out the birth control ring on your own
Very effective at preventing pregnancy when used as directed

Cons

Need to remember when to take out the ring and when to insert a new one
Can accidentally come out during sex, bowel movements, or if it breaks
Not recommended for people over 35 who smoke because of higher risk of blood clots and stroke

Common Side Effects for NuvaRing

Inflammation or irritation of the vagina (14%)
Headache, including migraine (11%)
Mood changes (e.g., depression, mood swings; 6%)
Device-related events (e.g., ring accidentally coming out, feeling discomfort in the vagina; 6%)
Nausea or vomiting (6%)
Vaginal discharge (6%)
Weight gain (5%)

Warnings for NuvaRing

Cigarette smoking and the risk of serious health problems
Risk of blood clots and related complications (e.g., heart attack, stroke)
Toxic shock syndrome (TSS)
Liver problems
High blood pressure
Vaginal irritation
Gallbladder problems
High blood sugar, high cholesterol, and high triglyceride levels
Possible risk of breast cancer or cervical cancer

Summary for Mirena

Prescription only

Mirena (levonorgestrel) is a progestin intrauterine device (IUD). It's approved for females of reproductive age to prevent pregnancy for up to 8 years. It can also help relieve heavy menstrual periods for up to 5 years. Mirena IUD (levonorgestrel) is inserted into the uterus by a provider in their office. Some of the more common side effects of Mirena IUD (levonorgestrel) include changes to menstrual bleeding and pelvic pain. Rarely, it can also cause some weight gain.

Indications for Mirena

Prevent pregnancy for up to 8 years
Relieve heavy menstrual periods for up to 5 years

Pros and Cons for Mirena

Pros

Work better than (works better) oral birth control pills to prevent pregnancy
Can be used while breastfeeding
Can be inserted in your provider's office within a few minutes and without any kind of sedation (medication to put you asleep)
Helps relieve heavy menstrual periods for up to 5 years

Cons

Can raise your risk of an ectopic pregnancy
Breakthrough bleeding and irregular cycles are common side effects
Not safe to use if you have liver problems or have ever had breast, uterine, or cervical cancer
Can't be used if you have uterine fibroids, are prone to pelvic infections, or have pelvic inflammatory disease (PID)