NuvaRing Accident

[shmancypants]

Hi! I've been on the Nuvaring for two years now. Sometimes I choose to skip my periods by leaving a ring in for four weeks and then inserting a new one after the four week mark. That was my plan this time around. However, I accidentally took out my old ring and inserted a new ring one day earlier than I was supposed to. Does this increase my risk of pregnancy?

For future reference, if I decide on the fourth week that I want my period, is it safe to take it out for a week?

Thank you!!

[Heather]

The ring will only provide hormones for three weeks, so when people want to use it to suppress periods, they will switch to a new ring after the three weeks, not after four.

So, what you did ultimately makes no difference, since your ring had already stopped doing what it does a week before anyway (and so long as a new ring is put in after no more than seven days after the three week period, you are protected for that week in between).

[shmancypants]

thanks but multiple health care providers have told me it works for up to four weeks and that it's completly safe to do (it just hasn't been FDA approved yet, so they won't advertise it).

[Heather]

For those over 18, we have studies that show that so far, so long as someone has four periods per year at least, it is likely safe to do with the pill. We do not yet have any study for those under 18, however, nor much study on usng the ring or patch for suppression, which is why those methods are not yet approved for this.

Really, the deal with leaving the same ring in for more than three weeks is more an infection concern than anything else. Usually, what is advised for those wanting to suppress periods is using the ring for three weeks, then putting a new ring in.
Again, the ring is not yet well studied or approved for this, but here is one typical example of the directions for suppressing with the ring anyway: http://contraception.about.com/od/presc ... period.htm

But if your provider has specifically told you to do it this way for some reason, then figure that is likely okay, or they have a reason for prescribing it that way. If you are not sure, you can just check in with them.

[shmancypants]

yup, they've told me to use it whichever way. i'm just confused because i've skipped my period multiple times on and off with no problems, but this time i'm experiencing a little dark bleeding (which started yesterday). its been one week since i last had sex, and i'm due to change my ring tomorrow.

[Heather]

Well, menstrual suppression does not always haooen when people attempt it regardless, but again, this is not the way to do this with the ring, so I am actually surprised it has suppressed them for you often at all.

Do know, too, that when people suppress often, they are going to have some spotting and will sometimes have flow regardless.

[shmancypants]

alright. since i hadn't yet met the full third week mark when i last had sex, i should have been protected, right? since the ring had been in for at least a week? he pulled out before ejaculating, too.

[Heather]

As I already explained, the way you have been using the ring and the way you used it this time does not suggest any cause for concern to me about reduced effectiveness.

[shmancypants]

hi again. thanks for your help. i'm getting really worried. i took the ring out yesterday morning, and today the dark brown discharge has gotten thinner (less discharge-y) and bright red, with a few clumps--different from the color/consistency of my periods, and although it's light, the rate at which it's coming out is pretty constant. i'm also experiencing light cramps, on and off. my period doesn't usually start until two or three days after i take my ring out. should i be concerned? and the guy i had sex and i with have both been tested for STDs. does this resemble implantation bleeding? i'm really hoping it's just my hormones from the ring and not cervical cancer or anything.. it's just odd to me that i've been using the right like this for two years now without ever experiencing anything like this before.

i'm sorry if i'm being redundant. it's just that this has been all i've been able to think about for the past three days. i really ought to stop googling these symptoms

[Redskies]

Okay. Well, first thing: please, for your own well-being, stop with the google! It's a thing we say pretty often around here - Dr Google is really the worst doctor in the world. For any combination of symptoms, any of us searching are going to find a whole selection of large and scary-sounding things in a general search. For anyone without medical training, a general internet search isn't going to help figure out symptoms at all, but is going to give you an extra problem: anxiety. So, nope

It's sounding like you might benefit from having a clearer understanding of how your method works. Your ring releases a small amount of hormone into your body constantly. The way those hormones work and prevent pregnancy is the same as in the combination pill, so the explanations of the hormones here: Three questions about taking the birth control pill (and plenty of answers) and here: How do birth control pills really work, even during the placebo period? apply to you too.

Putting a new ring in one day early won't decrease your contraceptive coverage, because your body is still getting the hormones that do their thing to prevent pregnancy. Make sense? The issues happen if you change it late, or if you leave it out when you shouldn't, because then your body might not have enough of the hormones to prevent pregnancy.

I'm not quite sure what you're asking with your question at the end of your first post. If you're asking about having a ring in for 3 weeks, then out for 1, new ring in for 3, out for 1: that's standard usage of the ring and absolutely fine, and you have its full contraceptive effect for the whole of that time, as explained in the links above. If you're asking about having a ring in for 4 weeks and then out for 1 week: no, your ring will very likely not give you its full contraceptive coverage, so we strongly suggest you don't do that. Whether you leave the old ring in for the 4th week, or take it out and have a ring-free week, you should always start a new ring no later than 4 weeks after you put the first one in.

I'm not completely sure from your description, so, apologies if I misunderstood, but I think you're saying that you just completed the fourth week of a ring? If so, it's unsurprising that you're having some bleeding: when people try to do menstrual suppression with hormonal methods, they do sometimes get a withdrawal bleed and/or breakthrough bleeding anyway, as Heather explained. It's more unusual that you haven't had it before than that you're having it now. Provided that your STI tests and other reproductive healthcare were recent, I see no reason to be concerned about the flow you're describing, and no reason to think it's anything other than an ordinary bleed.