Combined hormonal contraceptive, vaginal route
ATC code: G02BB01 (Etonogestrel and ethinylestradiol (vaginal ring))
Flexible polymer ring releases 120 µg etonogestrel and 15 µg ethinylestradiol daily. Systemic estrogen dose is lower than in COCs (~50% of oral), but hemostatic effect persists – VTE risk comparable to 3rd-gen COCs (8-10 per 10,000 woman-years). Suppresses ovulation via FSH/LH suppression. Pearl Index 0.3 perfect-use.
First line
Regular contraception for reproductive-age women. Per SEGO 2023, a convenient alternative to COCs when daily pill-taking is difficult. Inserted for 21 days, then 7-day ring-free interval with withdrawal bleed. No daily memory required – one action per month.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
NuvaRing during breastfeeding. MEC 2015 category 4 first 6 weeks postpartum due to VTE risk. Category 2 after 6 weeks with established lactation. Ethinylestradiol reduces milk supply even at low systemic dose. Progestin-only is preferred.
Opens the checker prefilled with this drug. Pick the second one from your regimen.
Remove and stop using if pregnant.
Estrogen reduces milk supply. WHO MEC first 6 weeks – category 4. Etonogestrel RID about 0.7%, Hale L3.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Etonogestrel + Ethinylestradiol (vaginal ring) is evaluated for the following indications with varying evidence strength: Contraception (evidence tier A), Contraception during breastfeeding (evidence tier D). See the full indication matrix with dosing and citations above on this page.
Common side effects of Etonogestrel + Ethinylestradiol (vaginal ring) (≥ 1 in 100): Headache, Vaginitis, Vaginal discharge, Breast tenderness, Decreased libido. See the Safety section for uncommon and serious reactions.
FDA category X. Remove and stop using if pregnant.
Estrogen reduces milk supply. WHO MEC first 6 weeks – category 4. Etonogestrel RID about 0.7%, Hale L3.
Etonogestrel + Ethinylestradiol (vaginal ring) is contraindicated in: VTE; Thrombophilia; Smoking after 35; Migraine with aura; HTN. Full list in the Safety section.