Combined hormonal contraceptive (vaginal ring)

Ethinylestradiol with etonogestrel

Brand names: NuvaRing

Adult dose

Dose: 1 ring intravaginally for 21 days, then 7 days ring-free

Route: Vaginal

Frequency: 3-weekly

Clinical pearls

Bypasses first-pass metabolism — useful for women preferring non-daily dosing
MHRA VTE risk profile (higher than levonorgestrel COC)
FSRH guidance permits extended use (4-week continuous use)

Contraindications

Standard CHC contraindications

Side effects

Breakthrough bleeding
Vaginal discomfort/discharge
Ring expulsion
VTE (similar to 3rd-gen COC)
Headache

Interactions

Enzyme inducers
Vaginal antifungals (theoretical, generally not clinically significant)

Monitoring

BP
Migraine status
BMI
VTE risk factors

Reference: BNF; FSRH CHC guideline; UKMEC; MHRA Drug Safety Update; https://bnf.nice.org.uk/drugs/ethinylestradiol-with-etonogestrel/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways