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NuvaRing

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NuvaRing is a popular birth control device marketed by Merck & Co. However, some recent studies suggest that women who use NuvaRing might be more likely to experience heart attacks and strokes, as well pulmonary embolism, deep vein thrombosis and other dangerous blood clots.

What is NuvaRing?

NuvaRing, the first and only contraceptive ring, was developed by Organon and brought to market in 2001. In 2007, Organon was acquired by Schering-Plough for $14 billion. Merck & Co completed a $41 billion merger with Schering-Plough just two years later.

NuvaRing is small flexible ring about 2 inches in diameter that a woman inserts into the vagina once a month to prevent pregnancy. Once it’ inserted, the ring remains in place for three weeks. It is removed on the fourth week, at which time a woman will experience her normal menstrual period.

Since its introduction, more than 5.5 million NuvaRing prescriptions have been written worldwide. International sales of the device hit $623 million in 2012. NuvaRing‘s popularity is largely a product of its convenience. While it is just as effective as birth control pills, women who use NuvaRing don’t have to worry about taking a pill every day.

How Does NuvaRing Work?

NuvaRing releases a continuous daily dose of 0.120 mg of etonogestrel (progestin) and 0.015 mg of ethinyl estradiol (estrogen). The device is 99% effective at preventing pregnancy. The hormones in NuvaRing prevent an egg from leaving the ovary, thereby preventing conception. They also cause cervical mucus to thicken, making it more difficult for sperm to enter a woman’s reproductive system.

NuvaRing Side Effects

Common NuvaRing side effects include:

• Vaginal infections and irritation
• Vaginal itching or discharge
• Headache
• Nausea
• Vomiting
• Bloating
• Stomach cramps
• Changes in weight or appetite
• Breast pain/tenderness/swelling
• Headache, nervousness
• Dizziness
• Tired feeling
• Freckles or darkening of facial skin
• Increased hair growth
• Loss of scalp hair
• Problems with contact lenses
• Changes in menstrual periods
• Decreased sex drive
• Other side effects associated with hormonal contraceptives

NuvaRing Cardiovascular Complications

The most serious NuvaRing side effects include potentially deadly cardiovascular complications such as:

• Heart attack
• Stroke
• Pulmonary embolism
• Deep vein thrombosis
• Blood clots

Some recent studies suggest that women who use NuvaRing might be more likely to suffer these complications compared to those using other hormonal contraceptives.

• 2011: Research funded by the U.S. Food & Drug Administration (FDA) suggested that Nuvaring increased the risk of blood clots, including deep vein thrombosis and pulmonary embolism, by 56% in comparison to older birth control pills. The FDA speculated that combined hormonal contraceptives, including the etonogestrel/ethinyl estradiol vaginal ring, “potentially result in higher sustained exposure to estrogen and hence, increased thromboembolic risk.”
• 2012: A study published in the British Medical Journal found that NuvaRing users had a 6.5 times higher risk of blood clots compared to women who did not use any form of hormonal birth control. The chance of experiencing a dangerous blood clot was 90% higher among users the device than it was for women taking combined oral contraceptives containing levonorgestrel.

NuvaRing Litigation

In 2008, a federal multidistrict litigation was established in the U.S. District Court, Eastern District of Illinois for all federally-filed NuvaRing lawsuits involving the device’s alleged cardiovascular side effects. The NuvaRing litigation would eventually include more than 1,500 cases. In 2014, Merck agreed to settle nearly all of the claims for $100 million.