Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Nuvaring.
Blood Clots: As with any hormonal contraceptives, there is a risk of developing blood clots. Tell your doctor if you have a history of blood clots or are at risk of developing blood clots. Inform your doctor if you are planning an upcoming surgery, as there is an increased risk of blood clot formation when using combination hormonal contraceptives. Stroke symptoms, such as confusion, difficulty speaking, loss of coordination, sudden headache or vision changes may occur as a result of a clot blocking blood flow to the brain. Symptoms of blood clots in other parts of the body include: sharp pain in the chest, pain in the calf, sudden shortness of breath, or coughing up blood. If you experience any of these symptoms, contact your doctor immediately, as blood clots can be life threatening.
Blood pressure: People with high blood pressure should discuss with their doctor how Nuvaring may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Nuvaring, and whether any special monitoring is needed. You may need to visit your doctor more frequently to have your blood pressure checked while using Nuvaring.
Occasionally, high blood pressure may develop with the use of hormonal contraceptives. This may require stopping Nuvaring.
Cigarette smoking and heart disease: Cigarette smoking increases the risk of serious heart disease and death. Hormonal contraceptives such as the ring also increase this risk, particularly as a woman gets older. Women over 35 years of age who are smokers should not use hormonal birth control. All women are urged not to smoke while taking Nuvaring.
Other factors that increase your risk of heart disease include diabetes, high blood pressure, abnormal cholesterol levels, or a family history of these conditions. It is unclear whether taking the birth control pill increases this risk. Talk to your doctor if you have concerns.
Diabetes: Nuvaring may cause an increase in blood sugar levels (may cause a loss of blood glucose control) and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using Nuvaring.
If you have diabetes, discuss with your doctor how Nuvaring may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Nuvaring, and whether any special monitoring is needed.
Depression: Hormones, such as etonogestrel - ethinyl estradiol, have been known to cause mood swings and symptoms of depression. If you have depression or a history of depression, discuss with your doctor how Nuvaring may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Nuvaring, and whether any special monitoring is needed.
If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking Nuvaring contact your doctor as soon as possible.
Eye disorders: Women who are using hormonal contraceptives such as this ring may experience fluid buildup in the cornea of the eye that can cause vision changes. This fluid buildup may also mean that your contact lenses may not fit as well as they used to, especially if you have hard contact lenses. Soft contact lenses usually do not cause problems. If your contact lenses feel uncomfortable, talk to your eye doctor.
Fibroid tumours: Nuvaring may worsen fibroid tumours (noncancerous growths in the uterus), causing sudden enlargement, pain, or tenderness. If you notice these effects, contact your doctor.
Gallbladder disease: The use of hormonal contraceptives increases the risk of developing gallbladder disease. People with a history of gallbladder disease should discuss with their doctor how Nuvaring may affect their medical condition and whether any special monitoring is needed. You will probably need to have regular tests to ensure that Nuvaring is not making your condition worse.
Heart disease: Like other hormonal contraceptives, etonogestrel - ethinyl estradiol causes several effects in the body that can contribute to heart disease. If you have heart disease or are at risk of developing heart disease, discuss with your doctor how Nuvaring may affect the medical condition, how the medical condition may affect the dosing and effectiveness of Nuvaring, and whether any special monitoring is needed. Contact your doctor as soon as possible if you develop symptoms of heart problems such as shortness of breath, chest pain, rapid heartbeat, or swollen ankles.
Liver cancer: Although extremely rare, the use of hormonal contraceptives has been associated with the growth of liver tumours. Talk to your doctor if you have any concerns.
Liver disease: Women who have or have had jaundice or other liver disease or who are at high risk for it should discuss with their doctor how Nuvaring may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Nuvaring, and whether any special monitoring is needed. You will probably need to have regular liver tests while you are using Nuvaring.
Other medical conditions: Women with conditions affecting the vagina, such as prolapsed (dropped) uterus, may be more likely to have the ring slip out of the vagina. If the ring slips out repeatedly, consult your doctor.
People with High Cholesterol, Kidney Disease, or Epilepsy should discuss with their doctor how Nuvaring may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Nuvaring, and whether any special monitoring is needed. You will probably need to have regular blood tests to ensure that Nuvaring is not making your condition worse.
People with heart disease, migraine Headaches, or mental depression should discuss with their doctor how Nuvaring may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Nuvaring, and whether any special monitoring is needed. You will probably need to have regular appointments with your doctor to ensure that Nuvaring is not making your condition worse.
Return to fertility: There may be a delay in menstrual periods after stopping hormonal contraceptives. There is no evidence that the use of the contraceptive vaginal ring leads to decrease in fertility. After stopping use of the ring, you should delay pregnancy until at least one normal menstrual cycle has occurred in order to date the pregnancy. An alternative birth control method should be used during this time. If you do not menstruate for 6 months or more after stopping hormonal birth control, such as the ring, notify your doctor.
Risk of cancer: The use of hormonal contraceptives increases the risk of breast and cervical cancer in women before Menopause (around age 50). If you have been using hormonal contraceptives for a long time (more than 8 years), started using them at an early age, or have a family history of cancer (mother or sister), you are at an increased risk of cancer, and should be examined by your doctor on a yearly basis.
If you are using hormonal birth control, you should learn how to do a breast self-exam. Notify your doctor any time you detect a lump. In a few women, the use of birth control pills may speed up the growth of a breast cancer that has not yet been diagnosed. A yearly clinical breast examination is also recommended because, if a breast cancer should develop, medications that contain estrogen may cause the cancer to grow quickly.
Seizures: Estrogens may increase the risk of seizures in people with seizure disorders. If you have a history of epilepsy or medical conditions that increase the risk of seizures, discuss with your doctor how Nuvaring may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Nuvaring, and whether any special monitoring is needed.
Sexually transmitted infections (STIs): Nuvaring, as with other combined hormonal contraceptives, does not protect against HIV/AIDS and other STIs (formerly known as sexually transmitted diseases or STDs). It is recommended that latex condoms be used in combination with Nuvaring for protection against these infections.
Pregnancy: Nuvaring should not be used during pregnancy. If you become pregnant while taking Nuvaring, or think that you may be pregnant, contact your doctor as soon as possible.
Breast-feeding: Nuvaring passes into breast milk. If you are a breast-feeding mother and are using the etonogestrel - ethinyl estradiol vaginal ring, it may affect the quality and amount of breast milk produced. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using Nuvaring have not been established for children. Nuvaring should not be used by females less than 18 years of age.
