If anyone has used birth control, give NuvaRing a call

NuvaRing the modern method of contraception


1 NuvaRing the modern method of contraception Information on vaginal contraception For passing on to your users

2 Dear doctor, this brochure is intended for delivery to patients for whom you have prescribed NuvaRing. The brochure serves as a supplement to your informative discussion and explains how it works, how it is used and possible side effects of the contraceptive ring and provides answers to the most frequently asked questions. We wish you many satisfied users. Your MSD SHARP & DOHME GMBH 2

3 Contents NuvaRing the contraceptive ring 6 NuvaRing at a glance 7 How does NuvaRing work? 8 How is NuvaRing used? 12 When can NuvaRing be started? 15 Frequently asked questions about use 16 Questions about compatibility 21 Would you like to know more? 24 3

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5 Dear reader, times are changing. Since the 1960s, the lifestyle and attitude towards life of women have been redefined. Modern women today live self-determined and spontaneously. In addition, body and health awareness are top priorities. For a long time, the pill held a special position and with good reason: It offers a high level of contraception security and is generally well tolerated. There are now contraceptive methods that are just as safe and well tolerated as the pill, but differ in terms of application, such as: B. the contraceptive ring. This brochure provides information on the contraceptive ring, how it works, how it is used and how it is tolerated. Take a few minutes to learn more about a modern method of contraception. 5

6 NuvaRing the birth control ring The birth control ring is a soft, flexible ring made from a silicone- and latex-free medical plastic called EVA poly (ethylene-covinylacetate). It is inserted into the vagina by the user once a month. There it hugs the body flexibly and releases the female sex hormones estrogen and progestin from the moment of onset for 21 days. Since the ring sits in the vagina, the hormones are absorbed into the blood directly through the vaginal mucosa. To ensure reliable contraception, a lower dose of estrogen is sufficient than with other combined hormonal contraceptive methods. 6th

7 NuvaRing at a glance To be used once a month, the contraceptive ring is inserted into the vagina by the user herself. The ring remains there for 3 weeks, followed by a ring-free week. Mode of action Over 3 weeks, continuous release of hormones through the vaginal mucosa into the blood. Estrogen dose. Evenly low tolerance within the 3 weeks. The contraceptive ring is generally well tolerated - the intestinal tract is bypassed, there is no loss of effectiveness in the case of gastrointestinal upset such as vomiting or diarrhea 7

8 How does NuvaRing work? like the pill, but by vaginal application The contraceptive ring is the vaginal application of the combined hormonal contraception. It is inserted into the vagina once a month and continuously releases two female sex hormones (an estrogen and a progestin) over a period of three weeks, which are absorbed into the blood through the vaginal mucous membrane. This prevents ovulation, among other things, just as reliably as with the birth control pill and at the same time thickens the mucus in the cervix so that it becomes impermeable to sperm. A fertilization of the egg cell is prevented. Vaginal contraception: the contraceptive ring is used in the vagina 8

9 with a consistently low dose of estrogen Today women only want to take in as much hormone as is essential for reliable contraception and a stable cycle. Many combined oral hormonal contraceptives contain a daily dose of 20 or 30 μg of estrogen. In comparison, the contraceptive ring releases only 15 µg of estrogen per day and is just as reliable as the conventional pill. The ring releases the hormones evenly over 21 days. bypassing the gastrointestinal tract Since the contraceptive ring is in the vagina, the hormones can be absorbed into the blood directly through the vaginal wall without going through the stomach and intestines. Thus, a low dose of estrogen is sufficient. 9

10 How does NuvaRing work? with high contraception safety The gastrointestinal tract is completely bypassed with the vaginal contraception with the ring. That is why the contraceptive ring offers a high level of contraceptive security even for gastrointestinal diseases such as vomiting and diarrhea. The safety of contraception can also be increased, since it is not possible to forget the pills. The pearl index of the contraceptive ring is below 1! Pearl Index The reliability of a contraceptive method is indicated by the Pearl Index. This refers to every 100 women who use a certain method of contraception for 1 year. An index of 1 means that out of those 100 women, one will become pregnant every year. Without additional contraception, the Pearl Index in women between 20 and 30 years of age is around 85 (approx. 85% of women who do not use contraception will get pregnant in one year). In other words, the smaller the Pearl Index, the more reliable the contraceptive method. 10

11 with one application per month The contraceptive ring is inserted into the vagina independently by the woman 1 per month. The ring then remains in the vagina for 3 weeks without interruption. A ring-free week follows. You can find detailed information about the application on the pages JULY JULY 1 a month!

12 How is NuvaRing used? Insertion It is easiest to insert the contraceptive ring into the vagina while standing, with one foot on the toilet or on a chair. But you can also crouch or lie down. Whichever position you choose, the method of insertion is always the same. Choose the position that is most comfortable for you. Wash and dry your hands and remove the ring from the packaging. You can save the packaging for disposing of the ring after use. Hold the ring between your thumb and forefinger and pinch the opposite sides of the ring together. 12th

13 Insert the ring into your vagina like a tampon. If you can still feel the ring, gently push it a little further until you can no longer feel it. There is no risk of the ring being inserted too deep into the vagina or being lost. The exact position of the contraceptive ring in the vagina is not critical and does not affect its safety. After insertion, leave the ring in the vagina for three weeks. 13th

14 How is NuvaRing used? Removal Remove the contraceptive ring at approximately the same time three weeks after it was inserted on the same day of the week as it was inserted. You can remove the ring by hooking your index finger on the lower edge or by grasping the ring between your index and middle fingers and pulling it out of the vagina. Your menstrual period will usually start two to three days after you remove the ring. It can still persist when you put the new ring in place. For the greatest possible contraceptive safety, always use the contraceptive ring on the same day of the week and at the same time. For example: you put the ring in on Wednesday at 10:00 p.m., then remove it 3 weeks later on Wednesday at 10:00 p.m. On the following Wednesday at 10:00 p.m. you will put the new ring on, even if your menstrual period continues. If you put the ring on more than three hours late, the protection against conception may be impaired. Important: Even in the ring-free week you are reliably protected against pregnancy. 1. Ring application 2. Ring application Days bleeding Ring-free week 14

15 When can I start using NuvaRing? Previous method of contraception No hormonal contraception Combined hormonal method with estrogen and progestin (pill or plaster) Minipill (progestogen-only pill) Contraceptive stick (implant) Hormone injection Hormone IUD Time of use of the contraceptive ring Day 1 of the menstrual cycle (i.e. on the 1st day of the menstrual period) Day 2 up to 5 of the menstrual cycle No later than the first day after the pill-free or patch-free interval or on the first day after taking the last active-ingredient-free tablet You can stop taking the minipill on any day and insert the contraceptive ring at the usual time the next day, on which the implant is removed day on which the next injection would be due day on which the IUD is removed Do you need additional protection (e.g. condom) for the first 7 days? No Yes No Yes Yes Yes Yes 15

16 Frequently Asked Questions about Usage Can the NuvaRing slip out? The round shape and the flexibility of the contraceptive ring ensure a good fit in the vagina. In some cases, the ring has been expelled during intercourse, severe constipation, removal of the tampon, or a prolapse of the uterus. If the birth control ring accidentally slips out, simply rinse it off with cold or lukewarm (not hot) water and reinsert it as normal. Contraceptive protection will not be affected if the ring has been out of the vagina for less than three hours. If it has been out of the vagina for more than three hours, the safety of contraception may be impaired. Please read the instructions for use. Can NuvaRing be lost in the body? The ring cannot get lost in your body due to its nature and the female anatomy. How do I know the NuvaRing is properly seated? The exact position of the ring in the vagina is not critical and does not affect the reliability of the contraceptive effect. You shouldn't feel the ring after inserting it. If you do feel it, gently push it a little further. 16

17 Can I use tampons while using the NuvaRing? Yes. You can safely use tampons while using the contraceptive ring. When changing a tampon, you should carefully pull out the tampon while it is lying down and, before inserting the new tampon, check that the contraceptive ring is in the vagina and has not been accidentally removed with the tampon. Can I go to sports or to the swimming pool with NuvaRing? If the ring is properly seated, you should not feel it and if it is correctly inserted, you can safely walk into fresh water, salt water and chlorinated water. Can I feel the NuvaRing during intercourse? More than 80% of the women who took part in a clinical study did not, or only rarely, noticed the contraceptive ring during sexual intercourse. Will my partner feel the NuvaRing during intercourse? In a clinical study, over 70% of men said that they rarely or rarely felt the ring during intercourse. When you feel it, it was rarely found annoying. 17th

18 FAQs about use Can I take the NuvaRing out during intercourse? You should also keep the ring in the vagina during intercourse. It is possible to remove the ring as an exception and for a maximum of 3 hours. After that, however, it should be left in the vagina continuously for 24 hours in order to maintain the contraceptive effect. What should I do if the NuvaRing has been temporarily out of the vagina? Inside the vagina, the birth control ring slowly releases hormones into the body to prevent pregnancy. If the ring has been out of the vagina for more than three hours, it may no longer protect you against pregnancy. Therefore, the ring must never be outside the vagina for more than three hours within a 24-hour period. If it has been out of the vagina for more than three hours, please refer to the instructions for use. Can i reschedule my period? Even if it does not correspond to the recommended instructions for use, in exceptional cases you can stop your bleeding by inserting a new ring immediately after removing the previous d. H. skip without observing a ring-free week. The second ring can then remain in the vagina for another three weeks

19 time away and a new ring is inserted as usual after a week without rings. Spotting (drops or stains of blood) or breakthrough bleeding may occur while using the new ring. 1. Ring application 2. Ring application Days Do not start a ring-free week on day 21: Remove the ring and put in a new ring immediately. Is the preventive effect impaired by vomiting or diarrhea? No. In contrast to the birth control pill, the hormones in the contraceptive ring enter the body directly through the vaginal wall and not through the digestive tract. Therefore indigestion, vomiting and / or diarrhea have no influence on the effectiveness of the ring. Does NuvaRing protect against sexually transmitted diseases? No: The contraceptive ring does not protect you against sexually transmitted diseases, because it is only used to prevent pregnancy. You must use a condom to protect against sexually transmitted diseases. 19th

20 Frequently Asked Questions about Usage What does NuvaRing look like? The contraceptive ring is a flexible, milky, colorless to almost colorless oval to round ring with a transparent seam and a diameter of 54 mm. How do I store NuvaRing? After it has been handed over to the pharmacy, the contraceptive ring no longer needs to be stored in the refrigerator and can be kept for up to 4 months in the original packaging. Do not store above 30 C and do not freeze. When traveling by air, contraceptives belong in hand luggage, they can freeze in the hold. What should I do if I accidentally drop the NuvaRing on the floor after opening the pouch? Simply rinse the ring with cold or lukewarm (not hot) water and then insert it as normal. 20th

21 Questions about tolerance When is NuvaRing out of the question for me? In some situations, like other combined hormonal contraceptives, you must not use the contraceptive ring. Please read the instructions for use carefully. Talk to your doctor if any of the following applies to you: you have had a blood clot (thrombosis) in a blood vessel in your body or risk factors for thrombosis, you have had or have had any symptoms of a heart attack or stroke Migraines with aura, diabetes with vascular changes, severe liver disease and / or liver tumors, malignant diseases of the genital organs or breasts or if they are suspected. You have unexplained vaginal bleeding, inflammation of the pancreas (associated with high blood lipid levels) or you are over-sensitive to any of the active ingredients or other components of the contraceptive ring. Can I use NuvaRing if I smoke? Smoking increases the risk of cardiovascular diseases, especially vascular occlusions, which can lead to heart attacks and strokes. This is especially important if you are older than 35 years and smoke more than 15 cigarettes a day. If smokers want to use the contraceptive ring, you should discuss this in detail with their gynecologist. Smokers are advised to give up smoking when using hormonal birth control. 21

22 Compatibility questions How does NuvaRing affect my skin? Estrogens generally have a positive effect on the skin, they can counteract skin impurities and / or acne. This positive effect can also occur when using the contraceptive ring. However, it can also make acne worse. How does NuvaRing affect my weight? Use of the contraceptive ring may be associated with weight gain, similar to the use of other combined oral contraceptives. Can NuvaRing cause mood swings? Mood swings have occasionally been reported by women using the birth control ring. Mood swings can also occur with other hormonal birth control methods. 22nd

23 What should I watch out for when taking other medication? The additional intake of some medications can lead to intermenstrual bleeding and / or reduce the effectiveness of the contraceptive ring, so that contraceptive protection is no longer guaranteed. This is known with some medicines used to treat epilepsy, tuberculosis, HIV infection or other infections. Herbal medicines such as B. St. John's wort lead to loss of contraceptive protection. The contraceptive ring can also affect the effectiveness of other medicines. It is therefore important that you tell your doctor what other medicines or herbal products you are taking. Also, tell any other doctor or dentist who prescribes medication that you are using the birth control ring. For further risks and side effects, read the instructions for use and ask your doctor or pharmacist. 23

24 Would you like to know more? You can find further support on the Internet or over the phone! Diverse, personal and so professional that you will feel completely at ease! Exclusively for you: You will find further information and support at, regardless of whether you have just started using the contraceptive ring or are already an experienced user. Simply enter the approval number of your NuvaRing packaging on the homepage (back of the packaging) and you will have access to an exclusive offer for NuvaRing users. Reminder service: You can conveniently and free of charge order an SMS or reminder service at which reminds you to insert and remove the contraceptive ring. MSD Infocenter: / (free of charge) Do you have a special request and would you prefer to find out more about the contraceptive ring personally? Then just give us a call: From Monday to Thursday 8:00 a.m. to 6:00 p.m. and Friday from 8:00 a.m. to 5:00 p.m. 24

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28 The MSD Infocenter will be happy to answer any questions you may have about the contraceptive ring. WOMN / 13 Telephone: / (free of charge) Mon Thu from 8:00 a.m. to 6:00 p.m. Fri from 8:00 a.m. to 5:00 p.m. MSD SHARP & DOHME GMBH Lindenplatz Haar