Withdrawal bleeding

The good cycle control achieved with the use of NuvaRing is characterized by regular withdrawal bleeding.^5,6 This is defined as the scheduled bleeding that occurs during the ring-free or pill-free week. In general, most contraceptive users consider monthly withdrawal bleeding to be an advantage because it provides reassurance that pregnancy has not occurred. However, light bleeding for a short period is usually preferred. With NuvaRing, withdrawal bleeding occurs during almost every cycle of use and is usually confined to the ring-free days.^5,6

Importantly, clinical studies have shown that irregular bleeding outside of the ring-free week is less frequent with NuvaRing when compared to the pill-free week of two different COCs. In a study of 247 women, the incidence of irregular bleeding was ≤ 5% for NuvaRing versus 5.4%–38.8% for COCs.⁶ In another study of 1030 women, the incidence of breakthrough bleeding or spotting over the course of 13 treatment cycles (each treatment cycle = 1 month of contraceptive cover) was significantly less with NuvaRing than with a COC containing 30 μg of ethinylestradiol and 150 μg of levonorgestrel (see Figure).⁵

Breakthrough spotting and bleeding* during use of NuvaRing (3-week ‘ring in’ period) or COC (while pill-taking). Adapted from Oddsson et al.⁵

*Breakthrough spotting was classified as the need to use one or fewer pad or tampon per day and breakthrough bleeding as the need to use more than one pad or tampon per day while the ring was inserted or pills were being taken.

Expiry 10/11 - NUV.10.GB.27040.AV

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