NuvaRing is a hormonal method of birth control that was introduced in 2003. It is a small plastic ring that is inserted into the vagina once a month and releases a constant dose of estrogen and progesterone. The amount of hormones released into the blood­stream with the NuvaRing is lower than in both oral contraceptives and the patch (Hatcher & Nelson, 2004; we will talk more about the patch later in this chapter). Each ring costs approximately $30 to $35, and the initial office visit often costs between $35 and $125.

How It Works Like birth control pills, NuvaRing works by inhibiting ovulation, increasing cervical mucus, and rendering the uterus inhospitable to implantation (Hatcher & Nelson, 2004). The ring is inserted deep inside the vagina, and moisture and body heat activate the release of hormones. Each ring is left in place for 3 weeks and then taken out for 1 week. During this last week a woman will usually begin her period.

Effectiveness The NuvaRing has not been available long enough to have docu­mented typical use rates. However, it is a very effective method of birth control, and per­fect use effectiveness rates are generally around 99.7% (Hatcher & Nelson, 2004).

Effectiveness rates may be lower when other medications are taken, when the unopened package is exposed to high temperatures or direct sunlight, or when the ring is left in the vagina for over 3 weeks.

Hormonal RingAdvantages Like other hormonal methods of birth control, the NuvaRing has a high effectiveness rate; does not interfere with spontaneity; reduces the flow of menstruation, menstrual cramps, and premenstrual syndrome; and increases menstrual regularity (Hatcher & Nelson, 2004). It also provides lower levels of hormones than some of the other combined-hormone methods. In addition,

NuvaRing may also offer some protection from ovarian and en­dometrial cancer and ovarian cysts. Fertility is quickly restored when the ring is removed.

Подпись:Disadvantages A woman using NuvaRing must be comfortable touching her genitals and placing the ring inside her vagina. The NuvaRing offers no protection against STIs and may cause a variety of side effects, including breakthrough bleeding, weight gain or loss, breast tenderness, nausea, mood changes, changes in sexual desire, increased vaginal irritation, and discharge. However, many of these side effects dissipate with regular use. Because this method is new, there are no data on extended use.

Cross-Cultural Use We don’t know a lot about NuvaRing use outside the United States. The necessity of touching the genitals may lead to lower usage rates throughout the world. Even so, NuvaRing has been used safely and effectively outside the United States, and research has found that it has been well tolerated (Bjarnadottir et al., 2002; Mulders & Dieben, 2001).