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Specific Safety Concerns With Etonogestrel/Ethinyl Estradiol Vaginal Ring

Specific Warnings and Precautions for Etonogestrel/Ethinyl Estradiol Vaginal Ring

Warnings and precautions to be aware of prior to using etonogestrel/ethinyl estradiol vaginal ring include the following:
 
  • Smoking cigarettes greatly increases the risk of serious etonogestrel/ethinyl estradiol vaginal ring side effects (such as heart attacks, strokes, and blood clots). This risk is particularly high for smokers over the age of 35.
     
  • Combined oral contraceptives (which are very similar to etonogestrel/ethinyl estradiol vaginal ring) increase the risk of blood clots, strokes, and heart attacks. It is assumed that etonogestrel/ethinyl estradiol vaginal ring also has these risks. These risks are quite small for healthy, young nonsmokers. Make sure to tell your healthcare provider if you have ever had a blood clot, stroke, heart attack, or chest pain.
     
  • Combined oral contraceptives may also slightly increase the risk of breast cancer or cervical cancer. It is assumed that etonogestrel/ethinyl estradiol vaginal ring also has these risks.
     
  • Oral contraceptives increase the risk of benign (non-cancerous) liver tumors. Very rarely, these tumors can rupture and cause serious problems. It is assumed that etonogestrel/ethinyl estradiol vaginal ring also shares this risk. If you have liver disease, etonogestrel/ethinyl estradiol vaginal ring may not be the best choice for you.
     
  • Let your healthcare provider know if you have any sudden vision changes, as this may be a sign of a blood clot in the eyes (a possible side effect of etonogestrel/ethinyl estradiol vaginal ring and other hormonal contraceptives).
     
  • Hormonal contraceptives (such as etonogestrel/ethinyl estradiol vaginal ring) may make gallbladder disease worse. If you have had a problem with your gallbladder, etonogestrel/ethinyl estradiol vaginal ring may not be the best contraceptive method for you.
     
  • Etonogestrel/ethinyl estradiol vaginal ring may increase blood sugar, particularly in women with diabetes. Your healthcare provider may need to monitor you more closely.
     
  • Hormonal contraceptives (including etonogestrel/ethinyl estradiol vaginal ring) can increase your blood pressure. This can be a problem if you already have high blood pressure.
     
  • Etonogestrel/ethinyl estradiol vaginal ring can change your menstrual bleeding patterns. Some women have breakthrough bleeding (bleeding between periods), while others may not have a period at all. It is normal to have shorter and lighter periods while using etonogestrel/ethinyl estradiol vaginal ring. If you notice any unusual changes in your bleeding patterns, let your healthcare provider know. If you miss a period, you should make sure you are not pregnant.
     
  • Etonogestrel/ethinyl estradiol vaginal ring can affect your cholesterol. Your healthcare provider may need to check your cholesterol levels after you start etonogestrel/ethinyl estradiol vaginal ring, especially if you already have high cholesterol.
     
  • There have been a few very rare cases of toxic shock syndrome in women who use etonogestrel/ethinyl estradiol vaginal ring. It is not clear whether these cases were due to etonogestrel/ethinyl estradiol vaginal ring, tampon usage, or other causes.
     
  • Sometimes, hormonal contraceptives may make depression worse. Let your healthcare provider know if you develop new or worsening depression symptoms.
     
  • Occasionally, etonogestrel/ethinyl estradiol vaginal ring (as well as any other hormonal contraceptive) can cause eye changes that make it more difficult to wear contact lenses.
     
  • Etonogestrel/ethinyl estradiol vaginal ring can interact with a number of different medications (see Drug Interactions With Etonogestrel/Ethinyl Estradiol Vaginal Ring for more information).
     
  • Etonogestrel/ethinyl estradiol vaginal ring is considered a pregnancy Category X medication. This means that it should not be used during pregnancy (see NuvaRing and Pregnancy).
     
  • Contraceptive hormones (such as the ones in etonogestrel/ethinyl estradiol vaginal ring) pass through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see NuvaRing and Breastfeeding). Combined hormonal contraceptives (such as etonogestrel/ethinyl estradiol vaginal ring) are not usually recommended for breastfeeding women.
     
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