Headaches, Discharge and More: 10 NuvaRing Side Effects You Should Know About

NuvaRing (etonogestrel / ethinyl estradiol) is one of several birth control options. For many, this vaginal ring is more convenient than daily birth control pills. And it works well to prevent pregnancy.

If you’re new to NuvaRing, you might be wondering what to expect when you start using it. Side effects are often top of mind. Common side effects — such as headaches and period changes — often lessen over time. Although rare, serious problems such as blood clots can also occur while using NuvaRing.

So what NuvaRing side effects should you know about?

NuvaRing side effects at a glance

Most NuvaRing side effects are mild and tend to improve over time. Serious complications are rare, but it’s important to know what signs to look for so you can get medical help if needed.

Common or mild NuvaRing side effects include:

• Changes to vaginal discharge

• Vaginitis (vaginal irritation, itching, or discomfort)

• Headaches, including migraines

• Changes to menstruation (your period)

• Breakthrough bleeding or spotting

• Nausea or vomiting

• Tender breasts

• Mood swings

• Acne

• Weight gain

• Menstrual cramps

• Stomach pain

• Lower libido (sex drive)

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Rare but serious NuvaRing side effects and risks include:

• Toxic shock syndrome (TSS)

• Liver problems

• Depression

• Raised blood pressure

• Gallbladder problems

• A higher risk of breast or cervical cancer

• Allergic reactions

This medication also has a boxed warning (the FDA’s strictest medication warning) for serious cardiovascular problems. These include blood clots, which may cause a heart attack or stroke.

Below are 10 notable NuvaRing side effects, along with some helpful tips for managing them.

1. Vaginal discharge

Changes to vaginal discharge is a common NuvaRing side effect. In fact, it’s possible with all hormonal birth control methods. You may notice changes to your discharge color, amount, or consistency.

Typically, this NuvaRing side effect is harmless. Wearing a panty liner may help you feel more comfortable. If your discharge has a foul odor or a cottage cheese-like consistency, talk to a healthcare professional. These could be symptoms of a vaginal infection, such as a yeast infection.

EXPERT PICKS: WHAT TO READ NEXT

• More about the ring: Pharmacists discuss what you need to know about vaginal ring birth control, including how well they work and what brands are available.

• NuvaRing vs. Annovera: Read about how these two vaginal rings compare for birth control.

• Can you get birth control without seeing a doctor? Yes, but it depends on where you live. Find out which states allow pharmacists to prescribe birth control.

2. Vaginal irritation

Vaginitis is another common NuvaRing side effect. You may experience itching, irritation, or discomfort in or around the vagina. This side effect is typically mild and improves with continued use of NuvaRing.

Typically, vaginitis on its own isn’t a cause for concern. But it can be uncomfortable. There are things you can do at home to help boost vaginal health and ease vaginal irritation, such as:

• Use only warm water to clean your vagina.

• If you need to use soap in the genital area, opt for a mild one. Avoid soaps that include perfumes or dyes.

• Avoid douching.

• Wear 100% cotton underwear.

• Avoid feminine sprays or deodorants.

• Wear loose-fitting pants. Avoid wearing tight clothing.

Sometimes vaginitis can be a symptom of an infection. Yeast infections, bacterial vaginosis, and trichomoniasis can all cause vaginal itching or irritation. See a healthcare professional if you experience any of these symptoms along with vaginitis:

• Vaginal burning

• A strong, fish-like odor

• Abnormal vaginal discharge

• Burning during urination

3. Headache

All hormonal birth control, including NuvaRing, can cause headaches or migraines as a side effect. And if you have an existing migraine condition, NuvaRing could worsen it. Sometimes, changes to hormone levels can trigger migraines.

Most times, headaches from NuvaRing are mild and improve as your body adjusts to the medication. But there are ways you can manage headaches at home, such as:

• Drink plenty of water or other hydrating fluids.

• Take steps to optimize your sleep hygiene so you get enough rest at night.

• Exercise regularly, or find ways to add movement to your routine.

• Avoid or limit caffeine and alcohol.

• Rest in a dark, quiet room until the headache eases up or passes.

• Apply an ice pack to your head.

• Ask a healthcare professional if you can take over-the-counter (OTC) pain relievers, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).

If these tips don’t help, contact your prescriber. You should also tell your healthcare team if you have a history of migraines before starting NuvaRing. Depending on your age and the types of migraines you experience, NuvaRing may not be a safe option for you.

4. Changes to your period

It’s common for NuvaRing to cause changes to your period. It’s also typical to experience breakthrough bleeding or spotting. These side effects are most common during the first 3 months of using NuvaRing. They should improve or resolve after your body adjusts to the hormones in the ring.

Period changes and spotting are generally harmless. But they can be disruptive to your day. You may want to wear darker-colored underwear until this NuvaRing side effect eases up. It’s also a good idea to carry period products with you on the go, in case you need them.

If the changes to your period or breakthrough bleeding are bothersome, tell your prescriber. Your body may respond differently to another birth control method.

5. Nausea

Nausea is another mild NuvaRing side effect. Although, the vaginal ring is less likely to cause this side effect than oral birth control pills. Nausea usually improves as your body adjusts to the medication.

If you feel nauseated, try the following:

• Stay hydrated, especially if you’ve been vomiting.

• Avoid spicy, fried, or greasy foods.

• Eat smaller, more frequent meals instead of large meals a few times a day.

• Drink peppermint or ginger tea.

• Ask your healthcare team if you can take an OTC nausea medication, such as bismuth subsalicylate (Pepto-Bismol).

If your nausea is excessive or you’re vomiting nonstop, tell your prescriber. This isn’t typical with NuvaRing, and there may be another cause for your symptoms.

6. Breast tenderness

NuvaRing can also cause breast tenderness. This is due to the changes in your hormone levels, and it can happen with all hormonal birth control. The tenderness should be mild and go away after you’ve been using NuvaRing for a few months.

 You can do things at home to help manage breast tenderness, such as:

• Apply a warm or cool compress to the area that’s sore.

• Wear a supportive, comfortable bra.

• Avoid tight-fitting clothing.

• Limit the amount of caffeine you consume.

• Ask your prescriber or pharmacist whether you can take an OTC pain reliever.

If you have severe breast pain, notice a lump, or see a change in your breast’s appearance, tell your prescriber. These are not typical NuvaRing side effects. And they can be potential symptoms of a more serious condition, such as breast cancer.

7. Mood changes

Mood changes are a less common NuvaRing side effect. In most cases, mood swings are mild and don’t last long. But in rare cases, NuvaRing may cause or worsen depression or anxiety.

Be sure to tell your prescriber if you have a history of mental health conditions before starting NuvaRing. And let them know if you notice changes to your mood or behavior after you begin using it. They may suggest you try a different birth control method.

For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text “HOME” to 741-741 to reach the Crisis Text Line.

8. Acne

Acne can be a side effect of NuvaRing, but it’s fairly uncommon. Acne is most likely caused by the ring’s progestin component, etonogestrel. In most cases, this side effect can be managed at home with OTC treatments.

Popular OTC acne treatments come in several forms, such as washes, gels, and creams. Examples include:

• Adapalene (Differin)

• Benzoyl peroxide

• Salicylic acid

Your prescriber or pharmacist can help you choose the best acne treatment for you. Keep in mind that it may take about 12 weeks (or 3 months) of consistent use to see results. And it’s common for your acne to appear worse before it gets better.

If OTC treatments don’t work well enough or your acne seems severe, tell your prescriber. They may suggest prescription acne treatments. Or they may recommend an alternative to NuvaRing. Some birth controls help manage acne better than others.

9. Toxic shock syndrome (TSS)

TSS is a bacterial infection that can start in the vagina. It’s a rare but serious NuvaRing side effect. The following may be signs and symptoms of TSS:

• Flu-like symptoms

• Sudden skin redness, similar to a sunburn

• Nausea, vomiting, or diarrhea

• Dizziness

• Redness of the eyes, lips, or throat

• Severely low blood pressure

• Blood clotting issues

• Septic shock (when the infection causes organ damage)

TSS is a medical emergency and requires treatment in a hospital.

Changing your NuvaRing on time helps to lower the risk of developing TSS. And be sure to wash your hands with soap and water before removing the old ring and inserting a new one. If you develop symptoms of TSS, seek medical help right away.

10. Blood clots

NuvaRing carries a boxed warning for blood clots. In severe cases, blood clots can lead to a heart attack or stroke. This side effect is rare but potentially life-threatening. And it can occur with any birth control that contains both estrogen and progestin.

Most people have a very low risk for this NuvaRing side effect. In fact, the risk of blood clots is much higher during pregnancy and shortly after giving birth than it is while using birth control. So for many, the benefits of NuvaRing outweigh the risk of blood clots.

However, some people have a higher risk of this serious NuvaRing side effect. This includes individuals who:

• Are age 35 or older and smoke

• Have a history of blood clots

• Have heart disease

• Have a history of heart rhythm problems

• Have a blood clotting condition

• Have high blood pressure that isn’t well managed

• Have diabetes and problems with their blood vessels

• Have a history of migraine with aura

• Are age 35 or older and have a history of any type of migraine

The manufacturer recommends avoiding NuvaRing if you have any of the risk factors listed above. Talk with your prescriber about safer alternatives.

If you experience any of the following symptoms of blood clots, call 911 or go to the nearest ER:

• Pain, redness, or warmth in the arm or leg

• Chest pain, shortness of breath, or a bloody cough (possible symptoms of a blood clot in the lung)

• Chest pain that feels like pressure, worsens with activity, or travels to the arms, neck, or jaw (possible symptoms of a heart attack)

• Weakness on one side of the body, facial drooping, or slurred speech (possible symptoms of a stroke)

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Written by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

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