Contraceptive ring novaring. Contraceptive ring novaring - instructions for use

NovaRing vaginal ring modern method contraception, which has a very high reliability and relative ease of use. Hormonal ring NovaRing is gaining more and more popularity and gets good reviews from gynecologists.

contraceptive ring is inserted into the vagina and remains there for 3 weeks. Once in the vagina, NuvaRing releases small doses of hormones that suppress the ovaries, prevent ovulation and make pregnancy impossible.

According to the manufacturer, the effectiveness of the NovaRing vaginal ring in preventing pregnancy is about 99%, however, according to independent studies, it is in the range of 92%. The NovaRing contraceptive ring is more reliable than birth control pills, and about the same effectiveness as.

Composition and form of release

Hormonal ring NuvaRing is available in the form of flexible transparent rings in packs of 1 and 3 pieces.

Each NovaRing ring contains the hormones etonogestrel (11.7 mg) and ethinyl estradiol (2.7 mg).

Benefits of the NovaRing vaginal ring

What are the advantages of NuvaRing? The contraceptive ring has the following benefits:

• Unlike birth control pills that need to be taken every day, the NovaRing hormonal ring needs to be inserted into the vagina only once a month (to be more precise, once every 4 weeks).
• Against the background of the constant use of NovaRing, menstruation becomes less painful and less plentiful.
• Data from some studies suggest that the use of NovaRing reduces the risk of ovaries.
• The NuvaRing ring adjusts to the individual characteristics of the female body, so it is not felt in any way by the woman herself or by her sexual partner.
• Unlike hormonal contraceptive injection NuvaRing ring does not cause symptoms and to.

Disadvantages of the contraceptive ring NovaRing

The main disadvantages of the NuvaRing ring are its price (higher compared to birth control pills) and the risk of the ring falling out if it is inserted incorrectly. The skill of inserting the ring correctly comes with experience.

In addition, the NuvaRing ring does not protect against sexually transmitted diseases (, etc.), therefore it is recommended only for women who have a permanent partner in whom she is confident.

Important information

Do not forget that the NovaRing ring is a hormonal method of contraception, which means that its use is associated with some risks. Do not start using NuvaRing on your own or on recommendations from friends. Before using the drug, consult a gynecologist and make sure that you have no contraindications to this method of contraception.

Contraindications to the use of the NovaRing ring

Stop using the NovaRing hormonal contraceptive ring if:

• You are or may be pregnant.
• You are breastfeeding.
• You are over 35 years old and you smoke.
• You have had venous thrombosis or have a tendency to form blood clots.
• You have high blood pressure.
• You often have headaches.
• You have diabetes.
• You have had breast cancer or other malignant diseases.
• You often experience bleeding from the vagina, and their cause is not clear to you.

In some situations, the use of NuvaRing is permissible after consultation with your doctor:

• At varicose veins veins.
• With elevated blood cholesterol levels.
• With a body weight of more than 90 kg.
• With epilepsy.
• In diseases of the gallbladder (cholecystitis, stones in gallbladder).
• For thyroid problems.

This is far from full list. If you are not sure whether NuvaRing is suitable for your disease or condition, consult your doctor.

Rules for using the NovaRing ring

The NovaRing hormonal ring should be inserted into the vagina for 3 weeks and removed on the same day of the week. A new ring must be inserted exactly after 7 days. In a week break, you may start menstruating.

For example, if you entered a ring on Monday at 8:00 pm, then you need to remove it exactly 3 weeks later on Monday at 8:00 pm and insert a new ring on the following Monday at approximately 8:00 pm.

Wash your hands thoroughly before inserting the ring. Take a comfortable position: standing with one foot on the toilet, squatting or lying down. Remove the ring from the package, squeeze it between your index finger and thumb, and insert it deep into your vagina. The ring will automatically take the desired position around the cervix. With the correct insertion of the ring, you will not feel it.

To remove the NuvaRing, wash your hands thoroughly, take a comfortable position, and pick up the ring with one or two fingers. The used ring can be disposed of in the trash can (but not in the toilet).

Does the contraceptive effect persist during the break?

During a week break contraceptive effect NuvaRing is saved and you do not need to use other methods of contraception. This is only true if, after the end of the break, you enter a new ring.

If you did not use hormonal contraceptives in the previous cycle

Insert the NovaRing contraceptive ring on the first day of your period. In this case, the contraceptive effect will come immediately. If for some reason you inserted the ring on days 2-5 of your period, then you should use it within the next 7 days.

How to switch to NuvaRing from birth control pills?

If your package of birth control pills contained 21 tablets, then enter the NuvaRing ring on the 7th day of the week break (that is, on the day you started taking the next package of pills).

If your OCs contained 28 tablets per pack, insert NuvaRing the day after the last 28 tablets.

How to use NuvaRing after childbirth?

The NovaRing hormonal ring should be inserted into the vagina no earlier than one month after childbirth. With the introduction of the ring in the first 4 weeks after childbirth, the risk of its loss is very high.

If you already had unprotected sex before inserting the ring, then you should first make sure that you are not pregnant, or wait until the first period begins.

If there is no menstruation yet, then you can start using the ring any day (after making sure that you are not pregnant). After inserting the ring, use additional funds contraception (condoms) for another 7 days.

Can NuvaRing be used while breastfeeding?

How to use NuvaRing after an abortion?

If the termination of pregnancy occurred at a period of less than 12 weeks, then the NovaRing ring can be inserted already on the day of the abortion. In this case, the contraceptive effect occurs immediately, and you do not need to use additional contraceptives. If you did not have time to insert the ring on the day of the abortion, then wait next menstruation and enter the ring on the first day of menstruation. Use condoms before your period starts.

If the termination of pregnancy occurred for a period of more than 12 weeks, then use the instructions from the section "How to use NuvaRing after childbirth."

What if I forget to remove NuvaRing after 3 weeks?

If you forgot to remove the NuvaRing ring in time, then try to remember how long ago you installed it:

• If the ring was inserted 4 weeks ago or less, then remove the ring as soon as possible and take a 7-day break. Insert a new ring on the 7th day after removing the previous one. You don't need to use additional methods contraception, since in this case the contraceptive effect of the NovaRing ring is preserved.
• If the ring was introduced more than 4 weeks ago, then the contraceptive effect may be reduced. In this case, you need to remember if you had unprotected sex. If you've had unprotected sex, then stop using the rings until you're sure you're not pregnant (do it or don't). If you have not had unprotected intercourse and you are sure that you are not pregnant, then insert a new ring immediately after removing the previous one and use additional methods of contraception for another 7 days.

What should I do if I forgot to put in a new NuvaRing after a week break?

Try to remember if you had unprotected sex after removing the previous ring. If so, do not insert a new ring until pregnancy has been ruled out.

If, after removing the previous ring, you did not have unprotected sex, insert a new ring as soon as possible and use additional methods of contraception (condoms) for another 7 days.

What to do if the NovaRing ring fell out?

If the NuvaRing is not inserted correctly, it may fall out of the vagina. In this case, the contraceptive effect may be reduced, and there is a risk of pregnancy.

If the ring fell out less than 3 hours ago, then wash it cool water and insert back into the vagina. In this case, the contraceptive effect is not impaired and the risk of pregnancy does not increase.

If the ring fell out more than 3 hours ago, then the contraceptive effect decreases.

• If this is the first or second week after inserting the ring, then after rinsing the ring with cool water, insert it back into the vagina and use additional methods of contraception (condoms) for another 7 days.
• If it is the third week after inserting the ring, then discard it and insert a new ring immediately. You may not be bleeding, or you may have spotting. This is fine. If for some reason you did not insert a new ring immediately, then wait for the bleeding (menstruation) to begin and insert a new ring in the first 7 days after removing the previous one.

How to delay unwanted menstruation with NuvaRing?

When using the NovaRing contraceptive ring, you have the opportunity to postpone the next period if for some reason they are undesirable (vacation, etc.)

To do this, install a new NuvaRing ring on the same day as the previous one was removed, without taking a 7-day break. Remove this ring after 3 weeks and then take a 7-day break, returning to the usual mode of using the ring.

In this case, you may experience spotting spotting. This is fine.

Bloody (brown) discharge when using the NovaRing ring

Against the background of the use of the contraceptive NuvaRing, spotting in the middle of the cycle is possible. it normal phenomenon which does not require discontinuation of the drug. Call your doctor if you have spotting almost every day or every day for a whole month.

The appearance of spotting in the middle of the cycle may also indicate that the ring has fallen out, and the contraceptive effect is reduced. In this regard, when spotting occurs, it is necessary to make sure that the ring is in place. To do this, wash your hands thoroughly and, having taken a comfortable position, insert one finger into the vagina, trying to find the ring.

Can tampons and NuvaRing be used at the same time?

Yes, there are no contraindications for this. In this case, of course, should be observed.

AT rare cases the ring may fall out when the tampon is removed, so you should regularly check that the ring is still in place when using tampons.

In what cases can the contraceptive effect of the NuvaRing ring decrease?

Taking certain medicines can lead to a decrease in the contraceptive effect of NovaRing. For example, when taking antibiotics, a woman is advised to use additional contraception (condoms) throughout the course of treatment and for another 7 days after the end of antibiotic treatment.

Before taking any medication, check with your doctor to see if it reduces the contraceptive effect of NuvaRing.

What to do if the period did not come in a week break?

In some women, against the background of the constant use of the NovaRing ring, menstruation may stop altogether.

If your period did not come during the week break, then try to remember if the ring fell out last month for more than 3 hours. If it fell out, then the contraceptive effect of the ring could be reduced, which means you need to do it.

If you used the ring in accordance with the instructions, then the probability of pregnancy is quite small. In this case, you can insert a new ring on the 7th day after removing the previous one. If you still don't get your period in the second cycle, see your doctor.

What should I do if pregnancy occurs during the use of the NovaRing ring?

In spite of high efficiency contraceptive ring NovaRing, in rare cases, against the background of its use, pregnancy occurs. If you suspect you may be pregnant, remove the ring from your vagina immediately and contact your doctor.

If the pregnancy is confirmed and you want to keep it, then there are no obstacles for this. The use of the ring does not increase the risk of fetal abnormalities, which means that you still have a high chance of having a healthy baby.

How to get pregnant after using the NovaRing ring?

If you are planning a pregnancy, then at the end of the third week of using the ring, remove it and do not install a new one. Pregnancy may occur in the next cycle after the end of the use of NovaRing.

The vaginal ring is smooth, transparent, colorless or almost colorless, without large visible damage, with a transparent or almost transparent area at the junction.

Active ingredients: ethinylestradiol 2.7 mg, etonogestrel 11.7 mg. Excipients: ethylene vinyl acetate copolymer (28% vinyl acetate), ethylene vinyl acetate copolymer (9% vinyl acetate), magnesium stearate.

pharmachologic effect

Combined hormonal contraceptive drug for intravaginal use. Contains etonogestrel, which is a progestogen, a derivative of 19-nortestosterone, and ethinylestradiol, which is an estrogen. The main mechanism of the contraceptive action of NovaRing is the inhibition of ovulation. The progestogen component (etonogestrel) inhibits the synthesis of LH and FSH by the pituitary gland and thus prevents the maturation of the follicle (blocks ovulation).

The Pearl Index, an indicator that reflects the frequency of pregnancy in 100 women during the year of contraception, when using the drug NuvaRing is 0.96. Against the background of the use of the drug, the pain and intensity of menstrual-like bleeding decreases, the frequency of acyclic bleeding and the likelihood of developing iron deficiency conditions decrease. In addition, there is evidence of a reduced risk of endometrial and ovarian cancer with the use of the drug. NuvaRing does not reduce bone mineral density.

Indications for use

• intravaginal contraception.

Mode of application

NuvaRing is inserted into the vagina once every 4 weeks. The ring is in the vagina for 3 weeks and then removed on the same day of the week that it was placed in the vagina; after a week break, a new ring is introduced. For example: if the NuvaRing was inserted on Wednesday at about 10 pm, then it should be removed on Wednesday after 3 weeks at about 10 pm; on the next Wednesday, a new ring is introduced.

Bleeding associated with the cessation of the drug usually begins 2-3 days after removal of NovaRing and may not completely stop until a new ring is installed.

Getting Started with Nuvaring

• Hormonal contraceptives were not used in the previous menstrual cycle
  NuvaRing should be administered on the first day of the cycle (i.e. the first day of menstruation). It is allowed to install the ring on the 2-5th day of the cycle, however, in the first cycle, in the first 7 days of using NovaRing, additional use of barrier methods of contraception is recommended.
• Switching from taking combined oral contraceptives
  NuvaRing should be administered at last day free interval in taking combined hormonal contraceptives (pills or patch). If a woman has been taking the combined hormonal contraceptive correctly and regularly and is sure that she is not pregnant, she can switch to using the vaginal ring on any day of the cycle. The duration of the interval in taking hormonal contraceptives should not exceed the recommended period.
• Switching from progestin-based contraception (mini-pill, implant, or injectable contraception) or progestogen-releasing intrauterine device (IUD)
  A woman taking mini-pills can switch to the use of NuvaRing on any day (the ring is inserted on the day the implant or IUD is removed or on the day of the next injection). In all these cases, the woman must use a barrier method of contraception during the first 7 days after the introduction of the ring.
• After an abortion in the first trimester of pregnancy
  NuvaRing can be used immediately after an abortion. In this case, there is no need for additional use of other contraceptives. If the use of NuvaRing immediately after an abortion is undesirable, the use of the ring should be done in the same way as if hormonal contraceptives were not used in the previous cycle. In the interval, a woman is recommended alternative method contraception.
• After childbirth or abortion in the second trimester of pregnancy
  The use of NuvaRing should begin within the 4th week after childbirth (if the woman is not breastfeeding) or abortion in the second trimester. If the use of NuvaRing is started in more than late dates, then additional use of barrier methods of contraception is necessary in the first 7 days of using NovaRing. However, if sexual intercourse has already taken place during this period, it is necessary to first exclude pregnancy or wait for the first menstruation before using NovaRing.

The contraceptive effect and cycle control may be impaired if the patient does not comply with the recommended regimen. To avoid losing the contraceptive effect in case of deviation from the regimen, the following recommendations should be followed.

Extension of the break in the use of the ring

If during the break in the use of the ring there were sexual intercourse, pregnancy should be excluded. How longer break the higher the chance of pregnancy. If pregnancy is ruled out, insert a new ring into the vagina as soon as possible. Over the next 7 days, an additional barrier method contraception, such as a condom.

If the ring has been temporarily removed from the vagina

If a the ring remained outside the vagina less than 3 hours, the contraceptive effect will not decrease. The ring should be reinserted into the vagina as soon as possible.

If a the ring was out of the vagina for more than 3 hours during the first or second week of use, the contraceptive effect may be reduced. The ring should be placed in the vagina as soon as possible. For the next 7 days, you must use a barrier method of contraception, such as a condom. The longer the ring has been out of the vagina and the closer this period is to the 7-day break in the use of the ring, the higher the likelihood of pregnancy.

If a the ring has been outside the vagina for more than 3 hours during the third week of its use, the contraceptive effect may be reduced. The woman should discard this ring and choose one of two methods:

1. Immediately install a new ring. Keep in mind that a new ring can be used within the next 3 weeks. In this case, there may be no bleeding associated with the cessation of the drug. However, spotting of blood or bleeding in the middle of the cycle is possible.
2. Wait for bleeding associated with the termination of the drug, and introduce a new ring no later than 7 days after removing the previous ring. This option should only be selected if the ring has not been previously broken during the first 2 weeks.

Extended use of the ring

If NuvaRing was used no more than a maximum period of 4 weeks, then the contraceptive effect remains sufficient. You can take a week off from using the ring, and then introduce a new ring. If NuvaRing remained in the vagina more than 4 weeks, then the contraceptive effect may worsen, therefore, before the introduction of a new ring, pregnancy must be excluded.

To change the time of onset of menstrual bleeding

To postpone (prevent) menstrual-like withdrawal bleeding, you can enter a new ring without a week break. The next ring must be used within 3 weeks. This may cause bleeding or spotting. Further, after the usual weekly break, you should return to the regular use of NuvaRing.

To bear the onset of bleeding on another day of the week, it may be recommended to take a shorter break from using the ring (for as many days as necessary). The shorter the break in ring use, the more likely it is that there will be no bleeding after ring removal and that bleeding or spotting will occur while the next ring is in use.

Ring damage

In rare cases, when using NovaRing, a ring rupture was observed. The core of the NovaRing ring is solid, so its contents remain intact, and the release of hormones does not change significantly. If the ring breaks, it usually falls out of the vagina. If the ring breaks, a new ring must be inserted.

Ring drop

Sometimes there was a prolapse of NuvaRing from the vagina, for example, when it was inserted incorrectly, when removing a tampon, during intercourse, or against a background of severe or chronic constipation. In this regard, it is advisable for a woman to regularly check the presence of the NuvaRing ring in the vagina.

Incorrect insertion of the ring

In very rare cases, women have inadvertently injected NovaRing into the urethra. When symptoms of cystitis appear, the possibility of incorrect insertion of the ring must be considered.

Rules for using NovaRing

The patient can independently insert NovaRing into the vagina. To introduce the ring, a woman should choose the most comfortable position for her, for example, standing, raising one leg, squatting, or lying down. NuvaRing must be squeezed and passed into the vagina until comfortable position rings. Exact position NuvaRing in the vagina is not decisive for the contraceptive effect.

After insertion, the ring must remain in the vagina continuously for 3 weeks. If the ring is accidentally removed, it must be rinsed with warm (not hot) water and inserted into the vagina immediately.

To remove the ring, you can pick it up with your index finger or squeeze it between your index and middle fingers and pull it out of the vagina.

Side effect

When using Nuvaring, the following side effects may occur:

Contraindications for use

• venous thrombosis (including history), including deep vein thrombosis, pulmonary embolism;
• arterial thrombosis (including history), including stroke, transient disorders cerebral circulation, myocardial infarction and / or precursors of thrombosis, including angina pectoris, transient ischemic attack;
• heart defects with thrombogenic complications;
• changes in blood parameters that indicate a predisposition to the development of venous or arterial thrombosis, including resistance to activated protein C, antithrombin III deficiency, protein C deficiency, protein S deficiency, hyperhomocysteinemia and antiphospholipid antibodies (cardiolipin antibodies, lupus anticoagulant);
• migraine with focal neurological symptoms;
• arterial hypertension (systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥100 mm Hg);
• diabetes mellitus with vascular damage;
• pancreatitis incl. in history, in combination with severe hypertriglyceridemia;
• severe liver disease, until the normalization of its function;
• liver tumors (including history);
• hormone-dependent malignant tumors(for example, breast cancer), established, suspected or in history;
• bleeding from the vagina of unknown etiology;
• pregnancy (including intended);
• lactation period;
• surgical interventions followed by prolonged immobilization;
• smoking (15 or more cigarettes per day) in women aged 35 and older;
• hypersensitivity to the components of the drug.

Carefully the drug should be prescribed in the presence of any of the following disease conditions or risk factors; in such cases, the doctor must carefully weigh the benefit-risk ratio of using NovaRing:

• venous or arterial thrombosis (in brothers and sisters and / or parents);
• obesity (body mass index over 30 kg/m2);
• dyslipoproteinemia;
• varicose veins (in combination with thrombophlebitis of superficial veins);
• atrial fibrillation;
• diabetes;
• systemic lupus erythematosus;
• hemolytic-uremic syndrome;
• epilepsy;
• chronic inflammatory bowel disease (Crohn's disease and ulcerative colitis);
• sickle cell anemia;
• congenital hyperbilirubinemia (Gilbert, Dubin-Johnson, Rotor syndromes);
• chloasma;
• fibromyoma of the uterus;
• fibrocystic mastopathy;
• conditions that make it difficult to use the vaginal ring: cervical prolapse, bladder hernia, rectal hernia, severe chronic constipation;
• adhesions in the vagina;
• smoking (less than 15 cigarettes per day) in women 35 years of age and older.

In case of exacerbation of diseases, deterioration of the condition, or the appearance of other risk factors, a woman should also consult a doctor and, possibly, stop the drug.

Although a causal relationship has not been conclusively proven, caution should be exercised when prescribing NuvaRing if, during the use of any other hormonal contraceptives or a previous pregnancy, the development or worsening of the following conditions / diseases was noted: jaundice and / or itching associated with cholestasis, formation of stones in the gallbladder, porphyria, Sydenham's chorea, herpes of pregnancy, otosclerosis with hearing loss, (hereditary) angioedema.

Recurrence of cholestatic jaundice and / or cholestasis with itching, which were observed during pregnancy or previous use of sex hormones, is the basis for discontinuing the use of NuvaRing.

The use of NuvaRing during pregnancy and lactation

The use of NovaRing during pregnancy, suspected pregnancy and lactation is contraindicated. NovaRing is contraindicated during the period breastfeeding. NuvaRing is able to influence lactation, reduce the amount and change the composition breast milk. small quantities contraceptive steroids and/or their metabolites may be excreted in milk.

Application for violations of liver function

NuvaRing is contraindicated in serious illnesses liver (until normalization of function indicators).

special instructions

Before the appointment or resumption of the use of the drug NuvaRing should be carried out medical examination: analyze history (including family history) and exclude pregnancy; measure blood pressure; conduct an examination of the mammary glands, pelvic organs, including a cytological examination of smears from the cervix; conduct some laboratory tests to exclude contraindications and reduce the risk of possible side effects of the NovaRing drug. The frequency and nature of medical examinations are carried out by a specialist, taking into account the individual characteristics of each woman, but at least once every 6 months.

The patient should read the instructions for use of the NuvaRing drug and follow all recommendations.

It should be borne in mind that NovaRing does not protect against HIV infection (AIDS) and other sexually transmitted diseases.

Women aged 40 and older, women with cervical intraepithelial neoplasia, and women who smoke at any age require additional consultation gynecologist before prescribing NovaRing.

The effectiveness of the drug NovaRing may decrease if the regimen is not followed.

During the use of NuvaRing, acyclic bleeding (spotting or sudden bleeding) may occur. If such bleeding occurs after regular cycles against the background of the use of NuvaRing in accordance with the instructions, you should contact your attending gynecologist to conduct the necessary diagnostic studies, incl. to rule out cancer and pregnancy. Diagnostic curettage may be required.

Some women do not bleed after the ring is removed. If NuvaRing has been used as directed, it is unlikely that the woman is pregnant. If the recommendations of the instructions are not followed and there is no bleeding after the removal of the ring, as well as in the absence of bleeding in two cycles in a row, pregnancy must be excluded.

The most important risk factor for developing cervical cancer is infection with the human papillomavirus (HPV). Epidemiological studies have shown that long-term use combined hormonal contraceptives leads to an additional increase in this risk, but it remains unclear how this is related to other factors. The positive role of regular examinations of a woman by a gynecologist and the use of barrier methods of contraception are obvious. There is no information on an increased risk of developing cervical cancer in HPV-infected women using NovaRing.

Research has found slight increase relative risk (1.24) of developing breast cancer in women taking combined hormonal oral contraceptives, but this risk gradually decreases over 10 years after drug withdrawal. Breast cancer is rare in women under 40 years of age, so the additional incidence of breast cancer in women who have received or continue to use combined oral contraceptives is small compared to common risk development of breast cancer. There is evidence that in women who took oral combined contraceptives, breast cancer is less common than in women who have never used such drugs. The possibility of the influence of the drug NovaRing on the incidence of breast cancer is being studied.

In rare cases, women who took combined oral contraceptives observed benign tumors liver and even less often - malignant. In some cases, these tumors led to the development life threatening bleeding into the abdominal cavity. If there is severe pain in the upper abdomen, liver enlargement or signs of intra-abdominal bleeding in a woman using NovaRing, a liver tumor should be excluded.

Although many women taking hormonal contraceptives experience a slight increase in blood pressure, clinically significant hypertension is rare. A direct relationship between the use of hormonal contraceptives and the development arterial hypertension not installed. However, if a constant increase in blood pressure is noted during the use of NovaRing, the patient should contact the attending gynecologist; in such cases, the ring should be removed, antihypertensive therapy should be prescribed, and the issue of choosing the most appropriate method of contraception, incl. possible resumption of the use of the drug NovaRing.

Although estrogens and progestogens can affect peripheral insulin resistance and tissue glucose tolerance, there is no evidence to support the need to change hypoglycemic therapy during the use of hormonal contraceptives. However, women with diabetes should be under constant medical supervision when using NovaRing, especially in the first months of contraception.

The use of contraceptive steroids may interfere with the results of certain laboratory research, including biochemical parameters liver function, thyroid gland, adrenals and kidneys, plasma levels of transport proteins (eg, corticosteroid-binding globulin and sex hormone-binding globulin), lipid/lipoprotein fractions, carbohydrate metabolism and indicators of coagulability and fibrinolysis. Indicators, as a rule, change within normal values.

Serious surgical intervention (including on lower limbs) is a contraindication to the use of the drug. In the case of a planned operation, it is recommended to stop using the drug at least 4 weeks in advance, and resume no earlier than 2 weeks after full recovery motor activity.

Women who are predisposed to the development of chloasma should avoid exposure during the use of NuvaRing. sunlight and ultraviolet radiation.

The degree of exposure and possible pharmacological effects of ethinyl estradiol and etonogestrel on the mucous membrane of the head and the skin of the penis have not been studied.

Influence on the ability to drive vehicles and control mechanisms

Given the pharmacodynamic properties of the drug NovaRing, it is not expected to affect the ability to drive a car and use complex equipment.

Overdose

Serious consequences of an overdose of hormonal contraceptives are not described. Suggested symptoms: nausea, vomiting, slight vaginal bleeding in young girls.

Treatment: carry out symptomatic therapy. There are no antidotes.

drug interaction

Interactions between hormonal contraceptives and other drugs may lead to the development of acyclic bleeding and / or contraceptive failure. Possible interaction with drugs that induce microsomal enzymes, which can lead to increased clearance of sex hormones.

The effectiveness of the drug NovaRing may decrease with the simultaneous use of antiepileptic drugs. medicines(phenytoin, phenobarbital, primidone, carbamazepine, oxcarbazepine, topiramate, felbamate), anti-tuberculosis drugs (rifampicin), antimicrobials(ampicillin, tetracycline, griseofulvin), possibly antiviral drugs(ritonavir) and medicines containing St. John's wort.

When treating any of the listed drugs, a woman should temporarily use a barrier method of contraception in combination with NuvaRing or choose another method of contraception. In the treatment of drugs that cause the induction of liver enzymes, the barrier method (condom) should be used during treatment and within 28 days after the withdrawal of such drugs.

If concomitant therapy is to be continued after 3 weeks of ring use, then the next ring must be administered immediately without the usual interval.

During treatment with antibiotics (excluding amoxicillin and doxycycline), it is necessary to use a barrier method of contraception (condom) during treatment and for 7 days after their withdrawal. If concomitant therapy is to be continued after 3 weeks of ring use, then the next ring must be administered immediately without the usual interval.

As a result of studies of the pharmacokinetics of the effect on the contraceptive efficacy and safety of the NuvaRing drug, when it was used simultaneously with antifungal agents and spermicides, it was not revealed. With the combined use of suppositories with antifungal agents, the risk of ring rupture slightly increases.

Hormonal contraceptives can cause a violation of the metabolism of other drugs. Accordingly, their plasma and tissue concentrations may increase (eg, cyclosporine) or decrease (eg, lamotrigine).

For exclusion possible interaction it is necessary to study the instructions for use of other drugs.

The use of tampons does not affect the effectiveness of NuvaRing. In rare cases, the ring may be accidentally removed when the tampon is removed.

As follows from the instructions, the Novaring hormonal ring provides women with an exceptionally high level of protection against unwanted pregnancy. Reviews confirm the reliability of the tool, the convenience of its use. Hormonal contraception has become widespread in recent years due to its numerous advantages. Which of them can boast of "Novaring"?

Essence of the question

The two most popular modern approach to contraception - hormonal means and barrier methods. Both have pluses and minuses. Hormonal contraceptives (not last place among them is the contraceptive ring "Novaring") according to the instructions to use as easy as shelling pears, and the effectiveness of these methods exceeds 95%. Reliable in their effect, these pregnancy prevention options are easy to use. There are pills that are meant to be taken at the same time, patches that need to be applied once a week, injections, implants, rings. All hormonal contraceptives are divided into those having one active compound or two.

Among the most convenient, distinguished by good reviews from doctors, is Nuvaring. Instructions for use, enclosed by the manufacturer in the package, gives a detailed idea of ​​the rules for the direct installation of the drug, the features of its operation. The manufacturer does not hide the mechanism by which the product works, what strengths and weaknesses it has, possible side effects. It would be fair to mention right away that negative reactions on the ring are found, but quite rarely, mostly all of them are weak and pass some time after the start of regular use.

What is this about?

As follows from the instructions, Novaring is a contraceptive ring that belongs to the category of combined hormonal drugs. The product contains estrogen, progestogen in microscopic doses. Visually, this is a flexible ring with a diameter of 5.5 cm, a thickness of 8.5 mm. The product is made from hypoallergenic raw materials and is designed to be placed in the vagina. Once inserted, the ring releases microscopic doses of hormonal compounds into the environment every day. Correct Dosage conditioned membrane system, the basis of high-tech development for women.

The instructions for use of the Novaring contraceptive ring indicate that the drug is able to suppress the process of ovulation. Hormonal action corrects the quality of uterine mucus, increasing the viscosity. The promotion of spermatozoa in such conditions is noticeably difficult, which is an additional mechanism of protection against unplanned pregnancy.

Reliable and safe

As can be seen from the reviews, instructions, the Nuvaring ring rarely becomes a source of side effects, as it is intended for direct injection into the area of ​​​​action, which significantly distinguishes it from contraceptives used orally. The feature is a really important plus. The agent does not come into contact with the tissues of the stomach, intestines, does not adversely affect the liver, while guaranteeing the regular intake of microscopic doses of the necessary hormones into the body. Therefore, the chance of side effects is minimized, especially when compared to more traditional hormone formats to prevent pregnancy. Reviews also confirm that negative reactions are rare (but do occur).

The Nuvaring instructions indicate the reliability indicators obtained in the course of numerous specific experiments. Scientists have confirmed that the remedy is effective, safe, effective. With regard to the ring, a calculation was calculated based on statistical data: it was revealed how many women out of a hundred who used the medication all year round became pregnant. A detailed study gave a result of 96% efficiency. But for oral medications, this parameter varies between 10-90%.

Multifaceted Action

From the instructions of "Novaring" it follows that the drug not only prevents unwanted pregnancy, but also has additional positive qualities. The most pronounced positive effect on the menstrual cycle. Under the influence of active compounds, it becomes more regular, each monthly bleeding less painful, not as profuse as without the use of the ring.

At the same time, the manufacturer in the instructions for Nuvaring (photos are presented in the article) draws attention to the fact that the drug was developed strictly as a method of preventing unwanted conception. The ring does not reduce the risk of contracting pathologies transmitted through intimate contact. "Novaring" is optimal if a woman has one permanent healthy partner, that is, the risk of infection is minimal.

Sometimes you can't

Instructions for use "Novaring" (photo of the ring are presented in the article) draws attention to cases when the product cannot be used. There are a lot of contraindications - this is typical of any hormonal contraceptives (and other compounds with hormones). First of all, it should be noted hypersensitivity to the active compounds used by the manufacturer. The ring cannot be used high blood pressure, thrombosis, heart attack, stroke, diabetes. The tool is not intended for persons suffering from severe violations of the functionality of the pancreas, liver, as well as in the detection of neoplasms, tumor processes in the liver. It is unacceptable to resort to Nuvaring if a hormonally dependent malignant neoplasm is diagnosed.

About certain cases, the instruction of the Novaring ring contains a mention in the category of application especially carefully, carefully. These are heart defects, overweight. Before the first installation of a contraceptive, it is necessary to read the instructions in detail in order to assess the extent to which it is suitable for a particular woman, which you need to pay special attention to when using. As new significant information about the effect of the drug on female body the manufacturer will supplement the accompanying documentation.

I want a baby!

The instruction of the Nuvaring ring contains unambiguous instructions on the rules of conduct if it was decided to abandon contraception in order to become pregnant. In such a situation, stop using the medication, wait for a while until it returns to normal natural cycle menstruation. In most cases, pregnancy does not have to be expected for more than a couple of months, usually within a month after contraception has been discontinued.

The manufacturer recommends to refrain from "Novaring" during breastfeeding. Reviews of doctors and the instructions of "Novaringa" agree on this: professionals also advise not to practice the use of the ring. The components contained in it can adversely affect the volume of milk produced by the mammary glands. There is a risk of changing the composition of the natural product. If during the period of using the ring the fact of conception is revealed, the contraceptive should be urgently removed. Its use during the period of gestation is strictly contraindicated.

How to use correctly?

Regarding how to install the product for the first time, the Nuvaring instructions for use contain clear and consistent instructions. However, the most reasonable option is to seek help from a doctor. An experienced gynecologist will help you understand the remedy, tell you the basic rules for its use, and warn you about common mistakes that can reduce the effectiveness of the drug. It is believed that the drug is convenient to use, since it is not required to control every day. At the same time, the ring is installed immediately for three weeks, after which it is removed. On which day of the week the contraceptive was delivered, on the same day it should be removed.

According to the instructions for using the Nuvaring ring, after removing the item, you must wait seven days and enter a new copy. During this period, withdrawal bleeding occurs. The logic, as you can see, is similar to the use of oral contraceptives, and the only difference is the lack of daily monitoring of the dose of the drug - hormones are injected automatically, it is only important to track the passage of a three-week, seven-day time intervals.

Accuracy won't hurt

In the instructions for use of the Novaring ring, the manufacturer draws attention to the fact that the beginning of the use of the drug requires special attention. The first seven days to reduce the likelihood of unwanted pregnancy, it is reasonable to use barrier contraceptive measures. Before the very first installation of the product, you should consult a doctor. The doctor will examine the client, formulate a conclusion regarding the possibility of using the ring, and also give individual recommendations on its use. In some specific cases, the rules may differ from common practice.

How to put it right?

All the features of the procedure are described in the instructions for use of the Nuvaring ring. Reviews confirm that there is nothing complicated in this procedure. You should start by choosing a comfortable position for the introduction of the drug: you can stand, sit, lie down. The object is compressed, inserted into the vagina. Once in the area of ​​​​permanent location, he automatically takes correct form, adjusting to the characteristics of the female body with all its individual specific features.

The removal process, as stated in the instructions for the use of "Novaring", is not more difficult. The ring is squeezed with two fingers and pulled out. As a rule, a couple of days after this point, withdrawal bleeding begins. In some cases, by the day when you need to put a new ring, the discharge has not yet stopped. This is not a reason to delay the application of the instance - a new ring is introduced, shortly after which the spotting will completely stop until a new cycle.

Negative effects: what to prepare for?

Instructions for use "Novaring" draws attention to the possibility of side effects. The probability of their occurrence is minimized due to the local release of active components, but it is impossible to completely exclude the absence of a negative response of the body. Of the relatively frequent unpleasant phenomena note the headache. Some women complained of dizziness, emotional swings, sometimes even provoking depression. Nuvaring is known to cause weight gain or problems in rare cases. digestive system, stool disorders.

Instructions for use "Novaring" contains references to the possibility of vaginal discharge when using the ring. There is a risk of urinary tract infections. In rare cases, the mammary glands become more sensitive, disturb painful sensations. Reactions can be local - discomfort during intimate contact, anxiety associated with the sensation of a foreign body inside the body.

Appearances and passwords

If, after reading the instructions for using Nuvaring, a woman decides in favor of this particular method of contraception, it makes sense to visit a convenient pharmacy to purchase a copy. Currently, two forms of release are on sale: one and three copies per pack. A smaller version costs about 1300 rubles, for a package with three products they will ask about 3500 rubles.

The manufacturer, doctors strongly recommend visiting a qualified doctor for a full examination of the body before making a decision in favor of the drug. At the consultation, the specialist will tell you what are the main pros and cons different methods, will recommend the best approach, taking into account the individual characteristics, lifestyle of the patient, as well as physiological needs women. Do not forget about personal preferences, because a contraceptive should be easy to use.

Do not mix concepts!

Some people think that hormonal and barrier are two different words denoting the same remedy. Some decide in favor of Nuvaring, being afraid to use regular pills, mini-dranks, as they affect the hormonal background. Make no mistake: Nuvaring is also a drug that affects the concentration of hormones in a woman's blood. The contraceptive ring is not mechanical contraceptive.

To provide barrier contraception, it makes sense to pay attention to caps, diaphragms, spirals. But the ring is an exclusively hormonal drug that helps prevent conception. In order not to get confused in concepts, when choosing the optimal method for yourself, it would be reasonable to first study how different methods and funds, and only then make a decision in favor of a specific name.

It's curious

Currently, on the shelves of pharmacies in our country, the contraceptive ring is represented by the only name - this is the described drug "Novaring". It was invented by Dutch scientists, first went on sale in 2001, and is now widely distributed both in European powers and in America.

Application features

To achieve maximum efficiency and safety, Nuvaring is installed simultaneously with the start of a new menstrual cycle. If you enter the drug later, but within the first five days from the start of menstruation, the entire cycle will need to use additional barrier methods to prevent unwanted pregnancy. Nuvaring is safe and is used after a spontaneous, medical abortion. It is advisable to put the ring on the day after the event.

If a woman has planned an intimate act with a partner with respect to whom there is a risk of contracting sexually transmitted diseases, in addition to the ring, additional barrier methods of contraception must be used, since the remedy only corrects the hormonal background, but cannot protect against infection. AT general case this method is considered optimal if a woman has one permanent partner and both are regularly tested for STDs.

No savings!

The removed Nuvaring contraceptive ring is not intended for reuse. The copy must be thrown away, and after a seven-day break, install a new one or start using other means to prevent unwanted conception. For more than three weeks, a medical object in a woman's body should not be.

Proper use of the contraceptive ring can prevent the formation of fibroids. It is known that among the women using "Novaring" there are fewer women suffering from endometriosis. Research has shown that at acne, excessive fat skin"Novaring" normalizes activities sebaceous glands, which leads to improvement appearance.

special case

In the instructions attached to the drug, the manufacturer indicates that Nuvaring is not recommended for use by women who smoke. The remedy should not be selected if autoimmune pathologies, disorders in the work of the heart, stones in the gallbladder. You should not use hormonal birth control until adulthood, especially without consulting a doctor. If there is a prolapse of the vaginal walls, prolapse of the uterus, the ring is also ineffective. Do not use this method of contraception before surgery, in the presence of wounds, inflammatory processes genitals. If surgery is scheduled best option- already a month before the event, completely abandon any hormonal drugs to prevent pregnancy.

Where to stop?

In comparison with other options for preventing conception presented on pharmacy shelves, Nuvaring has both positive sides, as well as disadvantages. When compared with oral contraceptives, you should pay attention to the dosage of hormonal compounds. Mostly, drugs are delivered to the body daily 30 mcg active substance, while the ring is a source of a third less volume. Due to this, the effectiveness is not reduced, but the risk of side effects is reduced.

Another important positive moment- independence from the way of life, the characteristics of the character of a woman. It is known that many people forget to take pills on time, which are intended to be used every day at the same time, which leads to a low effectiveness of the contraceptive program. Applying the ring, you can not think about it at all, you just need to remember twice a month about the need to install and remove the drug. Every day, the device automatically injects into the female body required amount hormones, you can not think about it at all. At the same time, the condition of the hair, skin integuments improves, the pain syndrome that accompanies menstrual bleeding is stopped. If this becomes necessary, you can shorten the monthly cycle or lengthen it a little, which is especially convenient if a trip or vacation is planned. True, before shifting the cycle, you need to consult a gynecologist.

There are always cons next to the pros.

Along with the positive qualities of "Novaring" has some weaknesses. In particular, only then the ring shows reliability and efficiency when used in strict accordance with the instructions, while maintaining the regime specified by the manufacturer. To weaknesses It is worth mentioning the abundance of contraindications. It is known that when the genital organs are infected, the ring can cause an exacerbation of the process, since the amount of secretions in the volume increases somewhat. There is a possibility of spontaneous loss, so it is important to regularly check whether the contraceptive is in place.

Of the negative points, it is worth mentioning and enough high cost rings, especially when compared to some hormonal contraceptives. The manufacturer draws attention to the fact that the drug is sold only in certified pharmacies. It is strongly not recommended to purchase it at other points, as there is a risk of encountering a fake.

Contraceptives and sex drive

It is known that some hormonal preparations negatively affect a woman's libido. It is believed that in the general case, Nuvaring does not have such an effect due to a reasonable dosage of estrogen. If tablets were previously used, the transition to Nuvaring is carried out on the eighth day after using the latter. If mini-pills were previously used, you can start using the ring on any convenient day, but for the first week, additionally use barrier methods to prevent conception.

NovaRing is a modern combined hormonal agent contraception in the form of a vaginal ring. Active ingredients are: ethinylestradiol 2.7 mg and etonogestrel 11.7 mg. This contraceptive also contains excipients such as vinyl acetate and magnesium stearate.

How does NuvaRing work?

The main mechanism of contraceptive action this drug is ovulation inhibition. The progestogen component (etonogestrel) inhibits the synthesis of LH and FSH by the pituitary gland and thus prevents the maturation of the follicle (blocks ovulation).

NuvaRing is inserted into the vagina once every 4 weeks. The ring is in the vagina for 3 weeks and then removed on the same day of the week that it was placed in the vagina; after a week break, a new ring is introduced. Discontinuation bleeding usually begins 2 to 3 days after the ring is removed and may not completely stop until a new ring is placed.

When using this contraceptive according to the instructions, the contraceptive effectiveness of this drug reaches 99%

During the use of NovaRing-a, acyclic bleeding (spotting or sudden bleeding) may occur. If such bleeding is observed after regular cycles while using this method of contraception in accordance with the instructions, you should contact your gynecologist for the necessary diagnostic tests, incl. to rule out cancer and pregnancy.

Most of the most common side effects of using this contraceptive system usually go away within 2-3 months.

The most common side effects of using NuvaRing are:

• bleeding and/or brown discharge between periods;
• irregular, prolonged brown vaginal discharge;
• vaginitis, cervicitis, candidiasis;
• soreness of the mammary glands (mastodynia);
• nausea and vomiting;
• decreased libido.

Restoration of fertility after using Nova Ring usually takes one or two months. During this period, irregular periods and/or irregular brown discharge or complete absence menstruation (amenorrhea).

Some women after using Nova Ring observe brown discharge and / or irregular menstruation within 6-8 months after stopping the use of this contraceptive. This condition is more likely in women with a history of irregular menstruation.

How to install NovaRing

A woman inserts a contraceptive ring into the vagina on her own, choosing a comfortable position for this: lying, squatting, or standing, leaning her back against the wall and lifting one leg. The introduction of the ring is made during menstruation (1st - 5th day). Hands must be washed clean. NuvaRing should be squeezed with fingers, reducing its diameter, and inserted as deep as possible into the vagina. The smooth ring will slip inside the body unimpeded. If after this you feel uncomfortable, adjust the ring with your fingers. Having taken the correct position, it will become imperceptible. It does not matter in what exact place the ring is fixed in the vagina: the absence of discomfort is an indicator of correct insertion.

After the introduction of the contraceptive ring, it is not removed for three weeks. If accidental removal of NovaRing occurs (for example, along with a tampon), it is washed warm water and return to their original position.

When the time comes to remove the hormonal ring, it is gently pulled out by hooking it with the index finger, or by holding it between the middle and index fingers.