Ethinyl estradiol with etonogestrel

What it is

The ring is a flexible, transparent, non-biodegradable loop of ethylene vinylacetate copolymer, 54 mm across and 4 mm thick, holding 11.7 mg etonogestrel and 2.7 mg ethinyl estradiol. Once in the vagina it releases on average 0.120 mg of etonogestrel and 0.015 mg of ethinyl estradiol per day over three weeks. It is not made with natural rubber latex.

What the research says

It prevents pregnancy. In three one-year trials in 2,834 women the pooled Pearl Index was 1.28 pregnancies per 100 woman-years, and 2.02 in the US arm; a Cochrane review of 18 trials found contraceptive effectiveness no different from the combined pill. Where the ring differs from the pill is in route-specific effects: more vaginitis and discharge, device expulsion and discomfort, but fewer of the systemic complaints. Danish national registry data put the venous thrombosis risk at 7.8 events per 10,000 exposure-years versus 2.1 in non-users of hormonal contraception.

Evidence grade: Well established.

How it works

Drug class: Combined hormonal contraceptive (CHC): synthetic estrogen (ethinyl estradiol) plus third-generation progestin (etonogestrel), delivered by a vaginal ring

The two hormones suppress the pituitary signals that drive ovulation, so an egg is usually not released. They also thicken cervical mucus, making it harder for sperm to get through, and thin the womb lining, making implantation less likely. (Source 1)

Boxed warning

Cigarette smoking increases the risk of serious cardiovascular events from combination hormonal contraceptive (CHC) use. This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked. For this reason, CHCs, including NuvaRing, should not be used by women who are over 35 years of age and smoke. [See Contraindications (4).]

(Source 2)

What it is used for

• Pooled Pearl Index 1.28 per 100 woman-years (95% CI 0.8 to 1.9) across 23,515 evaluable cycles in women under 35; 2.02 in the US study. A Cochrane review of 18 patch and ring trials found contraceptive effectiveness not significantly different from the comparison combined oral contraceptive. Evidence: established. (Source 3)
• A Cochrane review of 12 RCTs of continuous or extended-cycle combined hormonal contraceptives (pills, patches and rings together, not the ring alone) found similar pregnancy rates and safety profiles to 28-day cycling, with fewer menstrual symptoms. The review says variation in hormone type and regimen length made a formal meta-analysis impossible. Evidence: limited. (Source 4)

Interactions

• St John's wort (Hypericum perforatum) (label): St John's wort induces CYP3A4 and other enzymes, which lowers the hormone levels from the ring and can cause breakthrough bleeding or contraceptive failure. The label names it explicitly among products that may reduce effectiveness, and advises a back-up non-hormonal method continued for 28 days after stopping the inducer. (Source 5)
• Grapefruit juice (pharmacokinetic study): Grapefruit juice inhibits CYP3A4 and is listed alongside azole antifungals as able to raise estrogen and/or progestin blood levels. (Source 6)
• Ascorbic acid (vitamin C) and acetaminophen (paracetamol) (pharmacokinetic study): Both may raise ethinyl estradiol levels in the blood, thought to be by competing for the same conjugation pathway. (Source 6)
• Vaginal miconazole nitrate and other intravaginal products (pharmacokinetic study): Vaginal antifungal cream used at the same time as the ring raises hormone blood levels by up to 40%; separately, device breakage has been reported with concomitant intravaginal antimycotic, antibiotic and lubricant products. (Source 6)
• Diaphragm, cervical cap and female condom (pharmacokinetic study): The ring can get in the way of these barrier methods sitting correctly, so they are not recommended as the back-up method. Tampons, by contrast, do not affect hormone absorption. (Source 7)
• Atorvastatin (pharmacokinetic study): Atorvastatin increases ethinyl estradiol exposure by roughly a fifth to a quarter. (Source 6)
• Hepatitis C regimens containing ombitasvir/paritaprevir/ritonavir (clinical trial): This combination is contraindicated with the ring: liver enzyme rises of more than five times, and in some cases more than twenty times, the upper limit of normal were significantly more frequent in women taking ethinyl-estradiol-containing medicines. (Source 8)
• Alcohol (label): No alcohol interaction is described. The NuvaRing prescribing information does not mention alcohol anywhere, and we found no pharmacokinetic or outcome study of alcohol with the ring in the searches we ran. (Source 9)

Stopping it

• Fertility returns quickly. The label reports that ovulation and spontaneous menstrual cycles came back in most women within a month of stopping the ring. (Source 3)
• There is no dependence or withdrawal syndrome. The label's stopping instructions are entirely about avoiding harm: stop if a thrombotic event occurs, and stop at least four weeks before and through two weeks after major surgery or prolonged immobilisation. (Source 10)
• If an enzyme inducer such as St John's wort has been used, the label advises continuing back-up non-hormonal contraception for 28 days after stopping it, because the effect on hormone levels outlasts the inducer. (Source 5)

What goes wrong

In Danish national registry data covering 9.4 million woman-years, vaginal ring users had 7.8 venous thrombosis events per 10,000 exposure-years against 2.1 per 10,000 in non-users of hormonal contraception. (Source 11)

• Cohort study, Moderate certainty.
• Size: 1,626,158 women; 9,429,128 woman-years; 3,434 confirmed first venous thrombosis events.
• Who: All non-pregnant Danish women aged 15-49 free of previous thrombotic disease or cancer, 2001-2010.
• How long: Ten years of follow-up.
• Result: Confirmed VTE 2.1 per 10,000 woman-years in non-users; ring users relative risk 6.5 (95% CI 4.7 to 8.9), 7.8 events per 10,000 exposure-years; versus levonorgestrel combined pill users, adjusted RR 1.9 (95% CI 1.3 to 2.7)
• Funding: Registry-based cohort, independent of the manufacturer; observational and therefore subject to confounding by indication.

Compared with non-users of hormonal contraception, and after adjustment for age, calendar year, and education, the relative risk of confirmed venous thrombosis in users of transdermal combined contraceptive patches was 7.9 (95% confidence interval 3.5 to 17.7) and of the vaginal ring was 6.5 (4.7 to 8.9). The corresponding incidences per 10,000 exposure years were 9.7 and 7.8 events.

A US retrospective cohort across four health plans found a somewhat higher venous thrombosis rate for new ring users than for new users of a levonorgestrel pill. (Source 12)

• Cohort study, Low certainty.
• Size: Four US health plans (Kaiser Permanente and Medicaid databases)
• Who: New users of the ring or of combined oral contraceptives.
• How long: Not stated in the label excerpt.
• Result: 11.4 VTE events per 10,000 woman-years for new ring users; 9.2 per 10,000 for new users of a levonorgestrel-containing pill; 8.2 per 10,000 for users of other combined oral contraceptives.
• Funding: FDA-funded study, reported in the manufacturer's label.

A retrospective cohort study using data from 4 health plans in the US (FDA-funded Study in Kaiser Permanente and Medicaid databases) showed the VTE incidence for new users of NuvaRing to be 11.4 events per 10,000 WY, for new users of a levonorgestrel (LNG)-containing COC 9.2 events per 10,000 WY, and for users of other COCs available during the course of the study 8.2 events per 10,000 WY.

The commonest adverse reactions in the ring trials were vaginal and device-related, with vaginitis in nearly 14% of users. (Source 13)

• Randomized trial, Moderate certainty.
• Size: 2,501 women aged 18 to 41, contributing 24,520 cycles of exposure.
• Who: Women using the ring in trials of 6 to 13 28-day cycles.
• How long: 6 to 13 cycles.
• Result: Vaginitis 13.8%; headache including migraine 11.2%; mood changes 6.4%; device-related events such as expulsion, discomfort or foreign body sensation 6.3%; nausea/vomiting 5.9%; vaginal discharge 5.7%; weight increase 4.9%; decreased libido 2.0%.
• Funding: Manufacturer trials reported in the FDA label; uncontrolled incidence figures with no placebo comparator.

Common Adverse Reactions (≥ 2%): vaginitis (13.8%), headache (including migraine) (11.2%), mood changes (e.g., depression, mood swings, mood altered, depressed mood, affect lability) (6.4%), device-related events (e.g., expulsion/discomfort/foreign body sensation) (6.3%)

Thirteen per cent of women in the trials stopped the ring because of an adverse reaction, most often a device-related problem. (Source 14)

• Randomized trial, Moderate certainty.
• Size: 2,501 women across the trials.
• Who: Women using the ring in trials of 6 to 13 cycles.
• How long: 6 to 13 cycles.
• Result: 13.0% discontinued due to an adverse reaction; device-related events 2.7%, mood changes 1.7%, headache including migraine 1.5%, vaginal symptoms 1.2%.
• Funding: Manufacturer trials reported in the FDA label.

13.0% of the women discontinued from the clinical trials due to an adverse reaction; the most common adverse reactions leading to discontinuation were device-related events (2.7%), mood changes (1.7%), headache (including migraine) (1.5%) and vaginal symptoms (1.2%).

Ring-specific harms include vaginal or cervical erosion and ulceration, and cases where the ring adhered to or was overgrown by vaginal tissue and had to be cut out. (Source 15)

• Case series, Very low certainty.
• Size: Not quantified.
• Who: Women using the ring.
• How long: Any.
• Result: Vaginal/cervical erosion or ulceration reported; in some cases removal by a healthcare provider was needed, and where tissue had grown over the ring removal required cutting it.
• Funding: Manufacturer label, FDA-approved labelling.

Vaginal/cervical erosion or ulceration in women using NuvaRing has been reported. In some cases, the ring adhered to vaginal tissue, necessitating removal by a healthcare provider

Toxic shock syndrome has been reported in ring users, though a causal link has not been established. (Source 16)

• Case series, Very low certainty.
• Size: Not quantified.
• Who: Women using the ring, some of whom were also using tampons.
• How long: Any.
• Result: Causality not established.
• Funding: Manufacturer label, FDA-approved labelling.

Cases of TSS have been reported by NuvaRing users. TSS has been associated with tampons and certain barrier contraceptives, and, in some cases the NuvaRing users were also using tampons. A causal relationship between the use of NuvaRing and TSS has not been established.

In Danish national data, women using the vaginal ring were more likely to start an antidepressant than non-users of hormonal contraception. (Source 17)

• Cohort study, Low certainty.
• Size: 1,061,997 women, mean follow-up 6.4 years.
• Who: Danish women and adolescents aged 15 to 34 with no prior depression diagnosis or antidepressant prescription, 2000-2013.
• How long: Up to 14 years.
• Result: Relative risk of first antidepressant use 1.6 (95% CI 1.55-1.69) for vaginal ring users; 1.23 (95% CI 1.22-1.25) for combined oral contraceptives; risk peaked at 1.4 six months after starting.
• Funding: Registry-based cohort; association only, and the authors describe depression as a potential adverse effect rather than a proven one.

Limit of this finding: The spread figures printed for this cohort are impossible as written: a mean age of 24.4 years with a standard deviation of 0.001 years, and a mean follow-up of 6.4 years with a standard deviation of 0.004 years, would mean more than a million women were all within about an hour of the same age. These are almost certainly standard errors of the mean, printed as standard deviations. The quote reproduces the paper as printed. It does not affect the relative risks, which are what this finding rests on, but do not read "24.4 [0.001] years" as saying the women were all the same age.

users of a patch (norgestrolmin), 2.0 (95% CI, 1.76-2.18); users of a vaginal ring (etonogestrel), 1.6 (95% CI, 1.55-1.69); and users of a levonorgestrel intrauterine system, 1.4 (95% CI, 1.31-1.42).

Serious events reported after marketing include stroke, arterial thromboembolism and myocardial infarction, anaphylaxis, ring breakage and vaginal injury. (Source 18)

• Case series, Very low certainty.
• Size: Spontaneous reports from a population of uncertain size.
• Who: Post-approval users of the ring and their male partners.
• How long: Post-approval.
• Result: Frequency cannot be reliably estimated; includes penile local reactions in male partners and device breakage with concomitant intravaginal antimycotic, antibiotic and lubricant products.
• Funding: Manufacturer label, FDA-approved labelling.

Vascular disorders: arterial events (including arterial thromboembolism and myocardial infarction), aggravation of varicose veins

What the evidence supports

In the registration trials the ring prevented pregnancy with a Pearl Index of about 1.3 per 100 woman-years. (Source 3)

• Randomized trial, Moderate certainty.
• Size: 2,834 women enrolled; 2,356 women under 35 completed 23,515 evaluable cycles.
• Who: Women aged 18-40 in North America, Europe, Brazil and Chile; 93% Caucasian; women with BMI 30 kg/m2 or above were excluded.
• How long: One year.
• Result: Pooled Pearl Index 1.28 (95% CI 0.8, 1.9) per 100 woman-years; US study Pearl Index 2.02 (95% CI 1.1, 3.4)
• Funding: Manufacturer trials reported in the FDA label.

The pooled pregnancy rate (Pearl Index) was 1.28 (95% CI [0.8, 1.9]) per 100 women-years of NuvaRing use. In the US study, the Pearl Index was 2.02 (95% CI [1.1, 3.4]) per 100 women-years of NuvaRing use.

Across randomised trials the ring was no better and no worse than the combined pill at preventing pregnancy, and ring users generally had fewer side effects except in the vagina. (Source 19)

• Systematic review, Moderate certainty.
• Size: 18 trials in total; 12 vaginal ring trials, 11 of them of the etonogestrel plus ethinyl estradiol ring.
• Who: Women using the ring or a combined oral contraceptive.
• How long: Trial durations vary.
• Result: Contraceptive effectiveness not significantly different; ring users had more vaginitis and leukorrhea but less vaginal dryness, and less nausea, acne, irritability, depression and emotional lability.
• Funding: Cochrane review; the review rated the evidence quality as moderate for the ring.

Compared to the COC users, ring users had more vaginitis and leukorrhea but less vaginal dryness. Ring users also reported less nausea, acne, irritability, depression, and emotional lability than COC users.

Continuous or extended-cycle use of combined hormonal contraceptives - pills, patches and rings pooled together rather than the ring on its own - gave similar pregnancy rates and safety to the standard 28-day cycle, with fewer menstrual symptoms. (Source 4)

• Systematic review, Moderate certainty.
• Size: Twelve randomized controlled trials.
• Who: Women using combined hormonal contraceptives (pills, patches or rings pooled; not ring-specific) continuously or in extended cycles versus 28-day cycles.
• How long: Varies by trial.
• Result: Similar pregnancy rates and safety profiles; extended or continuous groups fared better for headaches, genital irritation, tiredness, bloating and menstrual pain; endometrial assessments all normal.
• Funding: Cochrane review; the review notes variation in hormone type and regimen length made formal meta-analysis impossible.

Study findings were similar between 28-day and extended or continuous regimens in regard to contraceptive efficacy (i.e., pregnancy rates) and safety profiles.

What the evidence does not support

Randomised trials do not support the ring being any more effective at preventing pregnancy than the combined pill, and pregnancy data were missing from a third of the ring trials. (Source 20)

• Systematic review, Moderate certainty.
• Size: 12 vaginal ring trials within an 18-trial review.
• Who: Women using the ring versus a combined oral contraceptive.
• How long: Trial durations vary.
• Result: Contraceptive effectiveness not significantly different; pregnancy data available from two-thirds of ring trials.
• Funding: Cochrane review; quality of evidence rated moderate for the ring.

Effectiveness was not significantly different for the methods compared. Pregnancy data were available from half of the patch trials but two-thirds of ring trials.

Where the evidence is mixed

Cochrane rated the ring evidence moderate quality, and downgraded for missing randomisation and outcome-assessment detail and high losses to follow-up. (Source 20)

• Systematic review, Moderate certainty.
• Size: 18 trials.
• Who: Women using patch, ring or combined oral contraceptive.
• How long: Trial durations vary.
• Result: Effectiveness not significantly different for the methods compared; ring users generally had fewer adverse events than COC users but more vaginal irritation and discharge.
• Funding: Cochrane review.

The quality of the evidence for this review was considered low for the patch and moderate for the ring. The main reasons for downgrading were lack of information on the randomization sequence generation or allocation concealment, the outcome assessment methods, high losses to follow up, and exclusions after randomization.

The manufacturer-cited TASC surveillance study found ring users' venous thrombosis rate similar to combined pill users, not higher. (Source 21)

• Cohort study, Low certainty.
• Size: Not stated in the label excerpt; a large prospective observational study.
• Who: New users, switchers and restarters of the ring or combined oral contraceptives, representative of routine clinical users.
• How long: 24 to 48 months of follow-up.
• Result: VTE incidence 8.3 per 10,000 woman-years in ring users vs 9.2 per 10,000 in combined oral contraceptive users; 8.9 per 10,000 for COCs not containing desogestrel or gestodene.
• Funding: The label states these studies were required or sponsored by regulatory agencies; TASC was conducted by Dinger and colleagues.

The results showed a similar risk of VTE among NuvaRing users (VTE incidence 8.3 per 10,000 WY) and women using COCs (VTE incidence 9.2 per 10,000 WY).

On breast cancer, the studies the label summarises are about combined oral contraceptives in general and not about the vaginal ring: across them, ever-use shows no association, while current or recent use shows a small increase in two of three studies. (Source 22)

• Cohort study, Low certainty.
• Size: Five studies of ever-use and three of current or recent use.
• Who: Users of combined oral contraceptives (not ring-specific)
• How long: Varies.
• Result: Ever-use effect estimates 0.90 to 1.12; current or recent use relative risk 1.19 to 1.33 in two studies, rising from 1.03 with under a year of use to about 1.4 with more than 8-10 years.
• Funding: Observational studies summarised in the manufacturer's label.

The other two studies found an increased relative risk of 1.19 - 1.33 with current or recent use.

Where the research disagrees

Whether the vaginal ring carries a higher risk of venous thrombosis than combined pills

• Lidegaard and colleagues, Danish national registry (BMJ 2012), national registry cohort of 1.6 million women: Compared with users of combined oral contraceptives containing levonorgestrel, the adjusted relative risk of venous thrombosis in users of transdermal patches was 2.3 (1.0 to 5.2) and of the vaginal ring was 1.9 (1.3 to 2.7). (Source 11)
• The TASC surveillance study, as reported in the FDA-approved label, prospective observational surveillance study required or sponsored by regulatory agencies: The results showed a similar risk of VTE among NuvaRing users (VTE incidence 8.3 per 10,000 WY) and women using COCs (VTE incidence 9.2 per 10,000 WY). (Source 21)
• FDA-funded US retrospective cohort across four health plans, as reported in the label, retrospective cohort: A retrospective cohort study using data from 4 health plans in the US (FDA-funded Study in Kaiser Permanente and Medicaid databases) showed the VTE incidence for new users of NuvaRing to be 11.4 events per 10,000 WY, for new users of a levonorgestrel (LNG)-containing COC 9.2 events per 10,000 WY, and for users of other COCs available during the course of the study 8.2 events per 10,000 WY. (Source 12)

How much

• Reference intake: Dosing is fixed by the product, not titrated. As a position, the FDA-approved NuvaRing label (Organon LLC, label version dated 2025) describes a ring containing 11.7 mg etonogestrel and 2.7 mg ethinyl estradiol that releases on average 0.120 mg/day of etonogestrel and 0.015 mg/day of ethinyl estradiol over a three-week period of use. (Source 23)
• Upper limit: There is no dose range and therefore no maximum dose: one ring is worn for three weeks, then removed for a ring-free week. The label sets no upper limit beyond that single fixed-dose product. (Source 23)
• Studied: The three one-year registration trials enrolled 2,834 women aged 18-40, with 23,515 evaluable cycles analysed in women under 35; women with a BMI of 30 kg/m2 or above were excluded. (Source 3)
• Studied: The safety database comprises 2,501 women aged 18 to 41 contributing 24,520 cycles of exposure in trials lasting 6 to 13 28-day cycles. (Source 24)

A common belief, and what the research shows

The belief: Because the hormones go in vaginally rather than through the stomach, the ring avoids the clot risk of the pill.

What the research shows: The route changes where the hormone is absorbed, not what it does to clotting. Danish national registry data found "the relative risk of confirmed venous thrombosis in users of transdermal combined contraceptive patches was 7.9 (95% confidence interval 3.5 to 17.7) and of the vaginal ring was 6.5 (4.7 to 8.9)" compared with non-users, against 2.1 confirmed events per 10,000 woman years in non-users. The manufacturer-cited TASC study found a risk similar to pills rather than higher, so the comparison with pills is genuinely disputed - but no source finds the ring free of the risk, and the boxed warning about smoking over 35 applies to it exactly as it does to the pill.

Questions and answers

What is it?

It is a soft, clear, flexible plastic ring about 54 mm across and 4 mm thick, made of ethylene vinylacetate copolymer, that sits in the vagina. It holds 11.7 mg of the progestin etonogestrel and 2.7 mg of the estrogen ethinyl estradiol and releases a steady small amount of each over three weeks. It contains no natural rubber latex. (Source 23)

What does it do in the body?

The two hormones suppress the pituitary hormones that trigger ovulation, so usually no egg is released. They also thicken cervical mucus so sperm find it harder to get into the uterus, and change the womb lining so implantation is less likely. (Source 1)

Is it good or bad for you?

For preventing pregnancy it works: about 1.3 pregnancies per 100 woman-years in the trials, no different from the combined pill in randomised comparisons. The cost is a raised clot risk - 7.8 venous thrombosis events per 10,000 exposure-years in Danish registry data against 2.1 in non-users - plus local effects such as vaginitis in 13.8% and device problems in 6.3%. There is a boxed warning: women over 35 who smoke should not use it. (Source 25)

How do you get more of it?

This is a prescription device, not something to get more of. The dose is fixed by the product: one ring, worn three weeks, giving on average 0.120 mg of etonogestrel and 0.015 mg of ethinyl estradiol a day. A few things raise the blood levels rather than the dose - grapefruit juice, vitamin C, paracetamol, atorvastatin and vaginal miconazole cream, which can lift levels by up to 40%. (Source 6)

If it is harmful, what reduces it?

The ring is removed, and because the hormones are delivered locally and continuously, stopping is simply taking it out. Ovulation and normal cycles returned in most women within a month. The label says to stop it if a clotting event happens, and to stop it at least four weeks before and two weeks after major surgery. (Source 10)

Why might someone be low in it or missing it?

Someone may not be using the ring because it is contraindicated - smoking over 35, a history of deep vein thrombosis or pulmonary embolism, cerebrovascular or coronary disease, uncontrolled hypertension, migraine with aura - or because they stopped it. In the trials 13.0% discontinued because of an adverse reaction, most often a device-related problem, mood change or headache. (Source 14)

Which whole foods contain it or feed it?

No food contains these hormones; they are synthetic. Food matters only through interactions. Grapefruit juice inhibits the CYP3A4 enzyme and is listed as able to raise estrogen and progestin blood levels, and vitamin C may raise ethinyl estradiol levels. No alcohol interaction is described anywhere in the prescribing information. (Source 6)

What happens if you do not have it?

Without contraception, pregnancy becomes likely; with the ring, the pregnancy rate in trials was 1.28 per 100 woman-years. Stopping also removes the raised clot risk and the local vaginal effects. Fertility comes back fast: ovulation and spontaneous menstrual cycles returned in most women within a month of stopping. (Source 3)

How can you test for it?

There is no routine blood test for the ring's hormones and no test of whether it is working, other than the absence of pregnancy. The label's monitoring is clinical: blood pressure in women with controlled hypertension, glucose in prediabetic and diabetic women, and evaluation of a missed period. One caveat is that these hormones change the blood levels of binding globulins, which can disturb thyroid and other hormone test results. (Source 26)

References

1. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, section 12.1 Mechanism of Action. 2025. Read the source
2. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, BOXED WARNING: CIGARETTE SMOKING AND SERIOUS CARDIOVASCULAR EVENTS. 2025. Read the source
3. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, section 14 Clinical Studies. 2025. Read the source
4. Cochrane Database of Systematic Reviews. Continuous or extended cycle vs. cyclic use of combined hormonal contraceptives for contraception.. 2014. PMID 25072731, DOI 10.1002/14651858.CD004695.pub3. Read the source
5. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, section 7.1 Effects of Other Drugs on CHCs (substances decreasing plasma concentrations). 2025. Read the source
6. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, section 7.1 Effects of Other Drugs on CHCs (substances increasing plasma concentrations). 2025. Read the source
7. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, section 2.5 Use with Other Vaginal Products. 2025. Read the source
8. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, section 5.4 Risk of Liver Enzyme Elevations with Concomitant Hepatitis C Treatment. 2025. Read the source
9. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, section 7 Drug Interactions. 2025. Read the source
10. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, section 5.1 Thromboembolic Disorders and Other Vascular Problems (when to stop). 2025. Read the source
11. BMJ. Venous thrombosis in users of non-oral hormonal contraception: follow-up study, Denmark 2001-10.. 2012. PMID 22577198, DOI 10.1136/bmj.e2990. Read the source
12. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, section 5.1 Thromboembolic Disorders and Other Vascular Problems (US retrospective cohort). 2025. Read the source
13. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, section 6.1 Clinical Trials Experience (Common Adverse Reactions). 2025. Read the source
14. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, section 6.1 Clinical Trials Experience (Adverse Reactions Leading to Study Discontinuation). 2025. Read the source
15. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, section 5.7 Vaginal Use. 2025. Read the source
16. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, section 5.2 Toxic Shock Syndrome (TSS). 2025. Read the source
17. JAMA Psychiatry. Association of Hormonal Contraception With Depression.. 2016. PMID 27680324, DOI 10.1001/jamapsychiatry.2016.2387. Read the source
18. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, section 6.2 Postmarketing Experience. 2025. Read the source
19. Cochrane Database of Systematic Reviews. Skin patch and vaginal ring versus combined oral contraceptives for contraception.. 2013. PMID 23633314, DOI 10.1002/14651858.CD003552.pub4. Read the source
20. Cochrane Database of Systematic Reviews. Skin patch and vaginal ring versus combined oral contraceptives for contraception. (Authors’ conclusions). 2013. PMID 23633314, DOI 10.1002/14651858.CD003552.pub4. Read the source
21. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, section 5.1 Thromboembolic Disorders and Other Vascular Problems. 2025. Read the source
22. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, section 6.2 Postmarketing Experience (breast cancer studies). 2025. Read the source
23. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, section 3 Dosage Forms and Strengths. 2025. Read the source
24. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, section 6.1 Clinical Trials Experience (exposure). 2025. Read the source
25. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Highlights of Prescribing Information, boxed warning excerpt. 2025. Read the source
26. Organon LLC / DailyMed (U.S. National Library of Medicine). NUVARING (etonogestrel and ethinyl estradiol) insert, extended release - Full Prescribing Information, section 5.9 Carbohydrate and Lipid Metabolic Effects. 2025. Read the source