Haloette Side Effects: What to Expect and When to Call Your Doctor

Haloette (etonogestrel/ethinyl estradiol vaginal ring) is generally well tolerated, but like all combination hormonal contraceptives, it can cause side effects. Most are mild and improve after the first few months of use. Some, however, are serious and require immediate medical attention. Here's what you need to know.

Boxed Warning: Smoking and Cardiovascular Risk

Haloette carries a boxed warning — the FDA's most serious label warning — related to smoking. Cigarette smoking increases the risk of serious cardiovascular events from combination hormonal contraceptive use, including heart attack and stroke. This risk increases with age and the number of cigarettes smoked. Women over 35 years of age who smoke should not use Haloette.

Common Side Effects of Haloette

These side effects occur in 2% or more of users in clinical trials and are generally manageable:

Vaginitis (vaginal infection or irritation): The most commonly reported side effect. The ring may slightly alter the vaginal environment. Keeping the ring clean and avoiding douching can help.

Headache (including migraine): One of the more common side effects. If you experience new or worsening migraines, especially with visual aura, contact your provider — new migraines with aura are a contraindication to continued use.

Mood changes: Depression, mood swings, and affect changes have been reported. If you experience significant mood changes, tell your provider. You may need to switch contraceptive methods.

Nausea and vomiting: Common in the first few months, often improving over time. Less common than with oral contraceptive pills because Haloette bypasses first-pass liver metabolism.

Vaginal discharge: Increased or changed vaginal discharge is reported in some users. If discharge has an unusual color, odor, or is accompanied by itching, see your provider to rule out infection.

Weight changes: Weight gain has been reported, though clinical studies have not consistently demonstrated a clear causal link between vaginal ring contraceptives and significant weight gain.

Breast tenderness or pain: Often temporary and improves after the first few cycles.

Menstrual changes: Spotting or breakthrough bleeding between periods, especially in the first 1–3 cycles. Periods may also become lighter or more regular.

Device-related discomfort: Some users feel the ring or experience foreign body sensation, especially initially. If inserted correctly, most users (and partners) do not notice it during intercourse.

Decreased libido: Reduced sexual interest is reported by some users. If significant, discuss with your provider.

Serious Side Effects: When to Stop Haloette and Seek Help Immediately

Stop using Haloette and seek emergency medical care immediately if you experience any of the following:

Signs of blood clot (DVT/PE): Sharp pain, swelling, or redness in the leg; sudden shortness of breath; chest pain; coughing up blood

Signs of stroke: Sudden severe headache, confusion, difficulty speaking, loss of coordination, visual changes, or one-sided weakness

Signs of heart attack: Chest pain or pressure, pain radiating to the arm or jaw, nausea with chest discomfort

Toxic shock syndrome (TSS): Rare but possible. Signs include sudden high fever, rash (especially on palms or soles), vomiting, diarrhea, dizziness, muscle aches, and feeling faint. Remove the ring immediately and get emergency care.

Liver problems: Jaundice (yellowing of skin or eyes), severe abdominal pain, dark urine — discontinue the ring and contact your provider

Severe allergic reaction: Hives, difficulty breathing, swelling of the face, lips, tongue, or throat — call 911 immediately

When to Call Your Doctor (Non-Emergency)

Contact your provider (not 911) if you experience:

New or worsening headaches or migraines

Significant mood changes or depression

Unexplained heavy vaginal bleeding

Missed period — especially if you've had unprotected intercourse or the ring was out for more than 3 hours

High blood pressure reading if you're monitoring at home

For more information on drug interactions that can affect Haloette's safety or effectiveness, see our guide: Haloette Drug Interactions: What to Avoid.

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