Potential questions

No. There is no danger of NuvaRing® being pushed too far up in the vagina or getting lost. NuvaRing® cannot go farther than the cervix.

The muscles of your vagina will keep NuvaRing® securely in place, even during exercise or sex. You can check the contraceptive ring periodically with your finger. In the rare instance that NuvaRing® does slip out follow the directions below:

• Out for less than three hours: If it does slip out, and if it has been out less than three hours, you should still be protected from pregnancy. Rinse NuvaRing®  with cool-to-lukewarm (not hot) water and re-insert it as soon as possible, at the latest within three hours. If you've lost NuvaRing®, you must insert a new contraceptive ring and stay on the same schedule you would have followed if you were still using the lost ring.
  
• If NuvaRing® is out of the vagina for more than three continuous hours: During Weeks 1 and 2: If the ring has been out of the vagina for more than three continuous hours during the 1st or 2nd week of use, contraceptive effectiveness may be reduced. Reinsert ring as soon as you remember and use an extra method of birth control, such as male condoms or spermicide, until the ring has been used continuously for seven days.
  
  During Week 3: If NuvaRing® slips out of the vagina for more than three continuous hours during the 3rd week of the three-week use period, throw the ring away and choose one of the following two options.
  
  1. Insert a new ring immediately. Inserting a new ring will start the next three-week use period. You may not experience a period from your previous cycle. However, breakthrough spotting or bleeding may occur
  
  2. Have your period and insert a new ring no later than seven days (7x24 hours) from the time the previous ring was removed or expelled. This option should only be chosen if the ring was used continuously for the preceding seven days.
  
  In addition, a barrier method such as condoms or spermicides must be used until the ring has been used continuously for seven days.

Women with conditions affecting the vagina, such as a prolapsed (dropped) uterus, may be more likely to have NuvaRing® slip out of the vagina. If NuvaRing® slips out repeatedly, you should consult with your healthcare provider.

NuvaRing® has been demonstrated to be safe if left in the vagina as directed. NuvaRing® is also non-absorbent and odorless.

Most women do not feel NuvaRing®, but if you do, slide it farther into your vagina. While the nerve endings of your vulva are very sensitive to the touch, the ones in the upper vagina are not. In a survey among thousands of NuvaRing® users, most partners did not feel NuvaRing®.

Smoking
Cigarette smoking increases the risk of serious cardiovascular side effects when you use combination oral contraceptives, including NuvaRing®. This risk increases even more if you are over age 35 and if you smoke 15 or more cigarettes a day. Women who use combination hormonal contraceptives, like NuvaRing®, are strongly advised not to smoke.

Breastfeeding
Do not breast-feed while using NuvaRing®. Some of the medicine may pass through the milk to the baby and could cause yellowing of the skin (jaundice) and breast enlargement in your baby. NuvaRing® could also decrease the amount and quality of your breast milk.

Some medications
The hormones in NuvaRing® can interact with many other medicines and herbal supplements. Tell your healthcare provider about any medicines you are taking, including prescription medicines, over-the-counter medicines, herbal remedies, and vitamins.

The blood levels of the hormones released by NuvaRing® were increased when women used a vaginal medication (miconazole nitrate) for a yeast infection while NuvaRing® was in place. The pregnancy protection of NuvaRing® is not likely to be changed by use of these products. The blood levels of these hormones were not changed when women used vaginal, water-based spermicides (nonoxynol or N-9 products) along with NuvaRing®.

Certain drugs and herbal supplements may interact with combined hormonal contraceptives to make them less effective in preventing pregnancy or cause an increase in breakthrough bleeding. Such drugs include rifampin, drugs used for epilepsy such as barbiturates (for example, phenobarbital), carbamazepine, and phenytoin, primidone, topiramate, phenylbutazone, modafinil, and some drugs used for HIV such as ritonavir. Pregnancies and breakthrough bleeding have been reported by users of combined hormonal contraceptives who also used the herbal supplement St. John’s Wort. You may need to use a nonhormonal method of contraception during any cycle in which you take drugs that can make oral contraceptives less effective. Be sure to tell your healthcare provider if you are taking or start taking any other medications, including non-prescription products or herbal products while using NuvaRing®.

Diaphragm
While using NuvaRing®, you should not rely upon a diaphragm when you need a back-up method of birth control because NuvaRing® may interfere with the correct placement and position of a diaphragm.

Lab tests
If you are scheduled for any laboratory tests, tell your doctor or healthcare provider you are using NuvaRing®. Contraceptive hormones may change certain blood tests results.

This rarely happens. NuvaRing® can slip out while you're removing a tampon, straining with severe constipation, or during intercourse.

• Out for less than three hours: If it does slip out, and if it has been out less than three hours, you should still be protected from pregnancy. Rinse NuvaRing®  with cool-to-lukewarm (not hot) water and re-insert it as soon as possible, at the latest within three hours. If you've lost NuvaRing®, you must insert a new contraceptive ring and stay on the same schedule you would have followed if you were still using the lost ring.
  
• If NuvaRing® is out of the vagina for more than three continuous hours: During Weeks 1 and 2: If the ring has been out of the vagina for more than three continuous hours during the 1st or 2nd week of use, contraceptive effectiveness may be reduced. Reinsert ring as soon as you remember and use an extra method of birth control, such as male condoms or spermicide, until the ring has been used continuously for seven days.
  
  During Week 3: If NuvaRing® slips out of the vagina for more than three continuous hours during the 3rd week of the three-week use period, throw the ring away and choose one of the following two options.
  
  1. Insert a new ring immediately. Inserting a new ring will start the next three-week use period. You may not experience a period from your previous cycle. However, breakthrough spotting or bleeding may occur
  
  2. Have your period and insert a new ring no later than seven days (7x24 hours) from the time the previous ring was removed or expelled. This option should only be chosen if the ring was used continuously for the preceding seven days.
  
  In addition, a barrier method such as condoms or spermicides must be used until the ring has been used continuously for seven days.

Women with conditions affecting the vagina, such as a prolapsed (dropped) uterus, may be more likely to have NuvaRing® slip out of the vagina. If NuvaRing® slips out repeatedly, you should consult with your healthcare provider.

After three weeks of ring use, NuvaRing® should be removed for one week and then a new ring should be inserted. If the ring-free interval has been extended beyond one week, the possibility of pregnancy should be considered, and an additional method of contraception, such as male condoms or spermicide, must be used until NuvaRing® has been used continuously for seven days. If you know or suspect you are pregnant, do not use NuvaRing®.

If NuvaRing® has been left in your vagina for up to one extra week (four weeks in total or less), remove it and insert a new ring after a one-week ring-free break.

If NuvaRing® has been left in place for more than four weeks, you may not be adequately protected against pregnancy and you must check to be sure you are not pregnant. If you know or suspect that you're pregnant, do not use NuvaRing®.

If you are not pregnant, insert a new ring. You must use an extra method of birth control, such as male condoms or spermicide, until the new NuvaRing® has been in place for seven days in a row.

You must check to be sure that you are not pregnant if:

1. you miss a period and NuvaRing® was out of the vagina for more than three hours during the three weeks of ring use
2. you miss a period and waited longer than one week to insert a new ring
3. you have followed the instructions and you miss two periods in a row
4. you have left NuvaRing® in place for longer than four weeks

If you know or suspect that you’re pregnant, do not use NuvaRing®. See your healthcare provider as soon as possible.

Simply stop -- your normal fertility should return in a short period of time. Results of a clinical study conducted by Organon would indicate that return to normal ovulation typically occurs within 13 to 28 days following removal of NuvaRing®.*

As with other hormonal contraceptives, NuvaRing® does not protect against HIV infection and other sexually transmitted diseases.

NuvaRing® is unlikely to cause an overdose because it releases a steady amount of contraceptive hormones over a long period of time. However, never use more than one ring at a time.

Symptoms of combined hormonal contraceptive overdose include nausea, vomiting and vaginal bleeding. If you suspect you have overdosed, see your healthcare provider immediately.