NuvaRing (etonogestrel / ethinyl estradiol) is a combination medication containing estrogen and progestin hormones that's used for birth control to help prevent pregnancy. It’s a latex-free, flexible ring that’s inserted into the vagina. The ring stays in place continuously for 3 weeks and then is removed for 1 week. Some pros and cons for using NuvaRing (etonogestrel / ethinyl estradiol) include high effectiveness when used as directed, but it can cause side effects like headache and irritation to the vagina. This medication is available as both brand and generic versions.
Prevention of pregnancy
NuvaRing (etonogestrel / ethinyl estradiol) contains a combination of two hormones: etonogestrel (a progestin) and ethinyl estradiol (an estrogen). These hormones work together to prevent pregnancy by:
Stopping your ovaries from releasing an egg (ovulation)
Making the mucus in your cervix thicker so it’s harder for sperm to move through and fertilize an egg
Making the lining of the uterus thinner so it’s harder for a fertilized egg to attach onto
Source: DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Incidence not known
Blurred vision
changes in skin color
chest pain or discomfort
confusion
dizziness
gaseous stomach pain
headache
inability to speak
nervousness
numbness of the hands
pain in the chest, groin, or legs, especially calves of the legs
pain or discomfort in the arms, jaw, back, or neck
pounding in the ears
prominent superficial veins over the affected area with tenderness and warmth
recurrent fever
seizures
severe headache of sudden onset
slow or fast heartbeat
stomach fullness
stomach pain or tenderness usually after eating a meal
sudden loss of coordination
sudden onset of slurred speech
sudden vision changes
sudden and severe weakness in the arm or leg on one side
sweating
swelling of the foot or leg on one side of the body
temporary blindness
vomiting with or without blood
yellow eyes or skin
Get emergency help immediately if any of the following symptoms of overdose occur:
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
itching of the vagina or genital area
pain during sexual intercourse
pain or tenderness around the eyes and cheekbones
stuffy or runny nose
thick, white vaginal discharge with or without a mild odor
tightness of the chest
Less common
Crying
depersonalization
false or unusual sense of well-being
hoarseness
mental depression
paranoia
quick to react or overreact emotionally
rapidly changing moods, mild feeling of sadness or discouragement that come and go
Incidence not known
Absent, missed, or irregular menstrual periods
bloody vaginal discharge
brown, blotchy spots on exposed skin
chills
clay-colored stools
contact lens intolerance
dark urine
decreased amount or quality of milk
fruit-like or unpleasant breath odor
increased hunger
increased thirst
increased urination
loss of appetite
medium to heavy, irregular vaginal bleeding between regular monthly periods, which may require the use of a pad or a tampon
rash
soreness, swelling, or discharge from the breast or breasts
trouble getting pregnant
unexplained weight loss
unusual tiredness or weakness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
More convenient option than birth control pills (no need to take it every day)
Can insert and remove the ring on your own
Very effective at preventing pregnancy when used as directed
Available as brand (NuvaRing) and lower-cost generics (EluRyng, Haloette, etonogestrel / ethinyl estradiol)
Need to remember when to remove the ring and when to insert a new one
Need to use a new vaginal ring for every cycle
Can accidentally come out during sex, bowel movements, or if it breaks
Not recommended for women over 35 years old who smoke because of higher risk of serious problems like blood clots and stroke
It’s important to follow the instructions on how to best insert and remove NuvaRing (etonogestrel / ethinyl estradiol). Please see the bottom of the Tips section for more information. Ask your provider or pharmacist if you have any questions.
Set up an alarm or reminder for when to take out your NuvaRing (etonogestrel / ethinyl estradiol) and when to insert a new one. Use the same day of the week and the same general time so the ring can work as well as it can. For example, if you inserted your ring on Sunday at 7 PM, you should remove the ring 3 weeks later on Sunday around 7 PM. Then, insert a new ring 1 week later on Sunday at about the same time.
During the one-week break when you’re not using NuvaRing (etonogestrel / ethinyl estradiol), you’ll usually have withdrawal bleeding (your period). This usually starts on the second or third day after removing the ring. It's completely fine if you’re still on your period when it’s time to insert a new ring. But if you completely miss your period, contact your provider. It’s possible you might be pregnant, so your provider might recommend a pregnancy test to check.
It’s possible you might get some spotting or light vaginal bleeding in between your periods. Spotting is more likely to happen during the first 3 months when you start using the vaginal ring. If you experience this type of bleeding and it doesn’t go away in a few days or if you experience unusual bleeding patterns after previously regular cycles, let your provider know. They might need to check why it’s happening or make changes to your birth control.
If the ring is accidentally taken out but placed back into the vagina within 3 hours, NuvaRing (etonogestrel / ethinyl estradiol) can still work to prevent pregnancy. Just make sure to rinse it with cool or lukewarm water and reinsert it as soon as possible or within 3 hours. Regularly check that the ring is in the vagina after certain activities (like before and after having sex).
If NuvaRing (etonogestrel / ethinyl estradiol) is out of the vagina for more than 3 continuous hours, if you forget to insert a new ring or remove it at the appropriate time, or if your ring breaks, ask your provider what you should do next. In these situations, you might need to use a back-up, non-hormonal birth control method (condom) along with using NuvaRing (etonogestrel / ethinyl estradiol). Avoid using vaginal products (like a diaphragm or female condom) as back-up methods, since NuvaRing (etonogestrel / ethinyl estradiol) might affect their placement and position in the vagina.
Talk to your provider if you’re experiencing new or worsening symptoms of depression while taking NuvaRing (etonogestrel / ethinyl estradiol). They can evaluate and help manage your symptoms, as well as decide whether you should continue using the vaginal ring.
Contact your provider if you experience new headaches or migraines that keep coming back, don’t go away, or are more severe while using NuvaRing (etonogestrel / ethinyl estradiol). You might have to stop this medication because certain types of migraines can raise the risk of stroke.
Wear sunscreen and avoid ultraviolet (UV) radiation exposure like tanning beds while using NuvaRing (etonogestrel / ethinyl estradiol). This medication can cause darkened patches to appear on the face and sometimes on other areas of skin that’s exposed to the sun.
Store unused NuvaRing (etonogestrel / ethinyl estradiol) in its original, individual packaging at room temperature and out of direct sunlight for up to 4 months or until the expiration date written on the package, whichever comes first.
NuvaRing (etonogestrel / ethinyl estradiol) doesn’t protect you from human immunodeficiency virus (HIV) infection and other sexually transmitted infections (STDs) like chlamydia and gonorrhea. Make sure to use a condom (but not vaginal products) during sex for protection.
How to insert and remove NuvaRing (etonogestrel / ethinyl estradiol)
Make sure to wash and dry your hands before and after inserting and removing the vaginal ring.
To insert: Lie down, squat, or stand with one leg up; make sure you're in a comfortable position. Press the sides of the ring together with your thumb and index finger. Insert the folded ring into the vagina. Use your index finger to gently push it further up.
To remove: Get into the same position as you would if you were inserting the vaginal ring. Put your index finger into your vagina. Once you find the ring, hook your finger through it. Take the ring out by gently pulling it down and forward.
NuvaRing (etonogestrel / ethinyl estradiol) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Women over 35 years old who smoke cigarettes
Smoking while using combined hormonal birth control like NuvaRing (etonogestrel / ethinyl estradiol) raises the risk of blood clots. Blood clots can sometimes lead to more serious problems, such as heart attack or stroke. This risk gets higher after the age of 35 and with the more cigarettes you smoke. For this reason, you shouldn't use NuvaRing (etonogestrel / ethinyl estradiol) if you're over 35 years of age and you smoke. Discuss other birth control options with your provider.
Risk factors: Women over 35 years old who smoke cigarettes | Personal or family history of blood clots | High blood pressure | Diabetes (high blood sugar) | Migraine headaches | Not moving for a long period of time, like after surgery or during travel
There’s a small risk that using combined hormonal birth control like NuvaRing (etonogestrel / ethinyl estradiol) can cause blood clots. These clots can block blood from reaching other parts of your body, like your legs, lungs, heart, or brain. Some clots can lead to complications, such as heart attacks or strokes.
Make sure you discuss using combined hormonal birth control with your provider before starting since there are many factors that raise the risk of blood clots. Tell your primary care provider at least a month before a planned surgery so they can discuss when you should stop and restart NuvaRing (etonogestrel / ethinyl estradiol). This helps lower your risk of blood clots during and after the surgery.
Stop using NuvaRing (etonogestrel / ethinyl estradiol) or take the ring out and go to the emergency room if you experience any of the following symptoms:
Stroke (clot near the brain): sudden weakness in one arm, leg, or on one side of the body; face drooping; changes in speech, vision, balance, or coordination; severe headache
Eye problems (clot in the eye blood vessels): double vision, partial or complete blindness, trouble seeing, other changes in vision
Pulmonary embolism (clot in the lungs): shortness of breath
Heart attack (clot near the heart): chest pain, arm pain, dizziness, cold sweat
Deep vein thrombosis (clot in the legs): swelling, tenderness, or pain in the leg
Risk factors: Tampon use
Some people using NuvaRing (etonogestrel / ethinyl estradiol) have reported having toxic shock syndrome (TSS). TSS is a life-threatening medical condition caused by certain bacterial infections and is typically linked with tampon use. In rare cases, people who used NuvaRing (etonogestrel / ethinyl estradiol) and tampons at the same time experienced TSS. Call your provider or get emergency help right away if you have flu-like symptoms, sunburn-like rash, muscle aches, vomiting, diarrhea, dizziness, or feeling faint. These can be symptoms of TSS.
Risk factors: History of liver problems | Using combined hormonal birth control for more than 8 years | Certain hepatitis C medications
Combined hormonal birth control like NuvaRing (etonogestrel / ethinyl estradiol) can cause damage to your liver. Talk to your provider before starting NuvaRing (etonogestrel / ethinyl estradiol) if you’re taking certain hepatitis C medications. You might not be able to take these medications together with NuvaRing (etonogestrel / ethinyl estradiol) because of a higher risk of liver damage. Rarely, combined hormonal birth control can also raise the risk of liver tumors if you’ve used it for a long time. If you experience symptoms of liver problems like yellowing of the skin or eyes, pain in the right upper stomach, or dark urine, stop using NuvaRing (etonogestrel / ethinyl estradiol) and contact your provider right away.
Risk factors: High blood pressure | Older age | Long-term use
People using combined hormonal birth control like NuvaRing (etonogestrel / ethinyl estradiol) have reported having higher blood pressure. While using this medication, your provider might ask you to check your blood pressure regularly to make sure it doesn’t get unusually high. Stop using NuvaRing (etonogestrel / ethinyl estradiol) if this happens. Most times, there are no obvious symptoms of high blood pressure. But if you notice changes in your vision, headache, a racing heart, or flushing, get medical help right away. This can mean your blood pressure is dangerously high. If you have blood pressure that isn’t under control or within blood pressure goals, don’t use this medication.
Risk factors: Conditions that make the vagina more likely to have irritation or ulcers
Since NuvaRing (etonogestrel / ethinyl estradiol) is inserted into your vagina, it can sometimes cause irritation in this area. Rarely, it can cause injuries in the vagina or cervix, such as erosion or ulcers. If you have problems with your vaginal or cervical health or if you have concerns about how NuvaRing (etonogestrel / ethinyl estradiol) might affect these areas, speak to a provider to see if this medication is a good option for you. Contain your provider right away if you’re experiencing vaginal itching, burning, or unusual discharge while you're using NuvaRing (etonogestrel / ethinyl estradiol).
Risk factors: History of gallbladder condition
Though rare, NuvaRing (etonogestrel / ethinyl estradiol) might cause new or worsening gallbladder problems. Tell your provider if you’ve had gallbladder problems in the past so they can follow up with you more often. Get medical help if you experience any of the following symptoms so your provider can check your gallbladder: yellowing of the skin or eyes, fever, chills, nausea or vomiting with severe pain in the right upper stomach, dark urine, or light-colored stools.
Risk factors: History of prediabetes or diabetes | Personal or family history of high triglycerides (fat) in the blood
NuvaRing (etonogestrel / ethinyl estradiol) can raise your sugar and cholesterol levels in the blood. If you have a history of having high blood sugar, your provider might recommend that you check your blood sugar levels more often to make sure they don’t get unusually high.
Women with high triglyceride levels in the blood who are taking hormonal birth control might have a higher risk of developing pancreatitis (inflammation of the pancreas). Contact your provider as soon as possible if you experience sudden or gradual, severe stomach pain; pain that spreads to your back; fever, nausea; or vomiting. These might be signs of pancreatitis.
Risk factors: History of breast cancer | Current, long-term, or recent users of combined hormonal birth control
Based on studies, it’s unclear whether there’s a link between using combined hormonal birth control and the risk of breast cancer or cervical cancer. But it's possible that combined hormonal birth control like NuvaRing (etonogestrel / ethinyl estradiol) can potentially affect the risk of developing these cancers. NuvaRing (etonogestrel / ethinyl estradiol) contains the hormones estrogen and progestin. And some cancers, like breast cancer, can be hormone-dependent, which means that they can rely on hormones like estrogen to grow and survive. Some studies suggest that there's a slightly higher risk of breast or cervical cancer if you’ve been taking oral birth control pills for a longer period of time.
As a precaution, don’t use NuvaRing (etonogestrel / ethinyl estradiol) if you currently have or have had breast cancer. If you’re worried about your risk of breast or cervical cancer or have questions, consider talking with your provider about your birth control options.
Dosage | Quantity | Price as low as | Price per unit |
---|---|---|---|
0.12mg/0.015mg | 1 ring | $48.00 | $48.00 |
Each vaginal ring releases 0.12 mg of etonogestrel and 15 mcg of ethinyl estradiol per day.
Weeks 1 to 3: Insert one ring into the vagina. Then, keep it in place for the next 3 weeks. Remove the ring at the end of week 3.
Week 4: Don’t use any rings this week.
Continue to repeat this 4-week cycle to prevent pregnancy. Insert a new ring on the first day of your next cycle (7 days after you remove the old one).
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
At high risk for developing a blood clot
History of blood clots, stroke, or heart attack
Women over the age of 35 who smoke or have migraine headaches
Uncontrolled high blood pressure
Coronary artery disease (CAD)
Certain heart rhythm problems, like atrial fibrillation (AFib)
Liver tumors or liver disease
Currently pregnant
Currently have or have had breast cancer
Abnormal vaginal bleeding that your provider doesn’t know about or you haven’t gone to them about
Take certain hepatitis C medications like Viekira Pak, containing ombitasvir, paritaprevir, and ritonavir; with or without dasabuvir
Prevention of pregnancy
Prevent pregnancy
By signing up, I agree to GoodRx's Terms and Privacy Policy, and to receive marketing messages from GoodRx.
American Cancer Society. (2023). What is cervical cancer?
American College of Obstetricians and Gynecologists. (2023). Abnormal uterine bleeding.
American College of Obstetricians and Gynecologists. (2023). Birth control.
Amneal Pharmaceuticals LLC. (2022). EluRyng- etonogestrel and ethinyl estradiol ring [package insert]. DailyMed.
Centers for Disease Control and Prevention. (2023). Contraception.
French, V. (2023). What you should know about breakthrough bleeding with birth control. The American College of Obstetricians and Gynecologists.
Mayne Pharma Inc. (2022). Haloette- etonogestrel and ethinyl estradiol insert, extended release [package insert]. DailyMed.
MedlinePlus. (n.d.). Vascular diseases.
National Cancer Institute. (2018). Oral contraceptives and cancer risk.
Organon & Co. (2023). Frequently asked questions.
Organon & Co. (2023). Instructions for use: NuvaRing.
Organon LLC. (2023). NuvaRing- etonogestrel and ethinyl estradiol insert, extended release [package insert]. DailyMed.
Prasco Laboratories. (2023). Etonogestrel/ethinyl estradiol- etonogestrel and ethinyl estradiol insert, extended release [package insert]. DailyMed.
Tholey, D., et al. (2023). Cholestasis. Merck Manual Consumer Version.
Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.