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

Like all hormonal contraceptives, NuvaRing can cause side effects — but most are mild and many resolve within the first few months of use. Understanding the difference between common, expected side effects and serious warning signs can help you feel confident using NuvaRing and know when it's time to call your doctor.

Important Warning: Boxed Warning for Smokers Over 35

NuvaRing carries a boxed warning — the FDA's most serious warning — that women who are over 35 years old and smoke cigarettes should not use NuvaRing. Smoking increases the risk of serious cardiovascular events including heart attack, blood clots, and stroke when using combination hormonal contraceptives. This risk increases with age and the number of cigarettes smoked.

Common Side Effects of NuvaRing

In clinical trials with over 2,500 women, the most commonly reported side effects of NuvaRing (occurring in 5-14% of users) were:

Vaginitis (vaginal irritation or discharge) — reported by 14.1% of users in clinical trials

Headache or migraine — reported by 9.8% of users

Upper respiratory tract infection — reported by 8.0% (note: this may be coincidental, not directly caused by NuvaRing)

Leukorrhea (increased vaginal discharge) — reported by 5.8% of users

Nausea — reported by 5.2% of users

Weight changes — 4.9% reported weight gain; NuvaRing is generally considered weight-neutral

Mood changes / depression — mood swings, depressed mood, or decreased libido can occur with hormonal contraceptives

Ring-related issues — ring expulsion, foreign body sensation, discomfort during sex (reported by 2.5% of users)

Breakthrough bleeding or spotting — occurs in 2-6.4% of NuvaRing users; usually improves after 2-3 cycles

Device-Related Issues: What to Know About Ring Expulsion

NuvaRing can occasionally fall out (expel) during exercise, straining during a bowel movement, or during sex. If this happens:

Rinse the ring with lukewarm water and reinsert it as soon as possible

If it was out for less than 3 hours: reinsert and continue — you're still protected

If it was out for more than 3 hours: reinsert and use backup contraception (condoms) for the next 7 days

Serious Side Effects: Call Your Doctor Immediately

Serious side effects are rare but can occur. Seek emergency medical attention or call your doctor right away if you experience:

Signs of a blood clot: pain, swelling, or redness in one leg; sudden chest pain; shortness of breath; coughing up blood

Signs of stroke: sudden severe headache, vision changes, weakness or numbness on one side of the body, difficulty speaking

Signs of heart attack: chest pain or pressure, pain spreading to jaw or arm, sweating, nausea

Signs of liver problems: yellowing of the skin or whites of the eyes (jaundice), severe abdominal pain

Severe allergic reaction: hives, difficulty breathing, swelling of the face, lips, or throat

Sudden vision changes: sudden loss of vision, blurred vision, or bulging eyes — may signal retinal vein thrombosis

NuvaRing and Blood Clot Risk

Studies have found that NuvaRing users have an approximately 6.5 times higher risk of venous thromboembolism (blood clots) compared to non-users of hormonal contraception. This sounds alarming, but context matters: the absolute risk for healthy, non-smoking women under 35 remains low. The risk is highest in the first year of use and when restarting after a break. Risk factors that increase the likelihood include smoking, obesity, history of blood clots, and prolonged immobility.

Side Effects vs. Those That Require Stopping NuvaRing

Stop NuvaRing and contact your provider if you experience: a blood clot, stroke, heart attack, unexplained vision changes, severe abdominal pain, jaundice, or if you become pregnant. Also stop NuvaRing at least 4 weeks before any major surgery (due to increased clot risk during prolonged immobility).

The Bottom Line

Most NuvaRing users experience only mild side effects — if any — particularly after the first few months of use. Serious complications are rare in healthy patients who don't smoke and don't have underlying cardiovascular risk factors. If you have questions about whether NuvaRing is safe for you, talk to your provider. Also see our guide on NuvaRing drug interactions to make sure your other medications are compatible.