etonogestrel/ethinylestradiol intravaginal ring / Generic mfg. - LARVOL DELTA

Vaginal Contraception With NuvaRing Decreases Symptoms and Uterine Features of Adenomyosis: A Prospective Evaluation. (PubMed, Obstet Gynecol Surv) - "(Abstracted from Contraception 2025:150:111016, doi:10.1016/j.contraception.2025.111016) Adenomyosis occurs when ectopic endometrial glands invade the myometrium and can cause symptoms such as an enlarged uterus, heavy menstrual bleeding, pelvic pain, infertility, and pregnancy complications. It occurs in an estimated 20% of asymptomatic and 45% of symptomatic women, and risk factors for its development include age, endometriosis, multiple births, uterine surgery, spontaneous miscarriage, and cervical conditions."

Journal • Endometriosis • Gynecology • Infertility • Musculoskeletal Pain • Pain • Sexual Disorders • Women's Health

Effectiveness of the etonogestrel implant: an economic model of immediate postpartum use on pregnancy outcomes. (PubMed, J Med Econ) - "A Markov model with 1-year time horizon simulated pregnancy outcomes among 1,000 women 18-49 years initiating 1 of 8 hormonal contraceptives for postpartum contraception: progestin-only oral contraception (OC), combined OC, progestin-only injectable, etonogestrel/ethinyl estradiol vaginal ring, norelgestromin/ethinyl estradiol transdermal patch, 3- or ≥5-year levonorgestrel IUD, and the etonogestrel implant. The immediate postpartum provision of the etonogestrel implant produced the greatest cost savings due to fewer short-interval pregnancies and related expenditures. These results highlight the etonogestrel implant as a cost-effective option for clinicians seeking to reduce short-interval pregnancy and health system costs."

Journal • Long-acting Reversible Contraceptives

Trends and patterns of concurrent contraceptive use with antihypertensive treatment in women using real-word data: Veteran Affairs Corporate Data Warehouse (AHA 2025) - "Types of contraceptive medication include combined oral contraceptive pills (yaz, ortho tri-cyclen), progestin-only pills (emicronor), vaginal rings (NuvaRing), transdermal patch (Ortho Evra), and injection (Depo-Provera). The most prescribed antihypertensive medication were beta blockers (43.78%), followed by diuretics (39.91%), alpha blockers (32.80%) and ACEI/ARBs (30.79%, n=40,518). Despite the current guideline, very low concomitant use of contraceptives (12%) with ACEI/ARB was observed in the study. While ACEI/ARB is the least prescribed medication to treat hypertension for reproductive age women, its use has been steadily increasing over the past decade, while rates of concurrent contraceptive use has decreased placing women at an increased risk of teratogenic exposure during pregnancy. Future studies are warranted to investigate the cause and barriers of suboptimal concomitant contraceptive utilization with ACEI/ARBs and pregnancy outcomes, including low birth..."

Clinical • Cardiovascular • Hypertension

QUALITY ANALYSIS OF VIDEOS ABOUT THE VAGINAL RING CONTRACEPTIVE DISCLOSED ON SOCIAL NETWORK TIKTOK (FIGO 2025) - " A search was conducted using the Tiktok-scraper software for the 400 most popular videos on the social network Tiktok that addressed the topic of "nuvaring"... Among the videos, only 16.6% of them received a good rating, with adequate presentations and useful content for users. There is a need for adequate studies to evaluate the general scenario of medical content shared in the media, and it is also important to rethink the way content is produced for dissemination."

Gynecology

Vaginal Contraception with NuvaRing@ Decreases Symptoms and Uterine Features of Adenomyosis. A Prospective Evaluation. (PubMed, Contraception) - "In women with adenomyosis contraception with NuvaRing@ is useful and can be proposed because it reduces the clinical signs and the uterine ultrasound features of adenomyosis."

Journal • Endometriosis • Gynecology • Musculoskeletal Pain • Pain • Women's Health

Heavy Menstrual Bleeding and Hormonal Therapy in Women with Type 1 von Willebrand Disease Enrolled on the Zimmerman Program. (PubMed, Clin Appl Thromb Hemost) - "Of these, 103 were hormone users, including oral contraceptives (71), medroxyprogesterone acetate (11), levonorgestrel IUD (11), contraceptive implant (3), and the etonogestrel/ethinyl estradiol vaginal ring (1) and (6) subjects were undergoing hormone replacement therapy...Age-adjusted BAT scores revealed that in all age groups, more than 70% of patients had abnormal bleeding scores.ConclusionHormonal therapy users had lower total BAT scores compared to non-users, though differences were not statistically significant. These findings suggest a potential but limited effect of hormone use on bleeding phenotype in women with type 1 VWD."

Journal • Cardiovascular • Gynecology • Hematological Disorders • Hemophilia • Long-acting Reversible Contraceptives • Thrombosis

A Tale Of Too Many Bone Stress Injuries (ACSM 2025) - "X-ray: No tibial cortical abnormalitiesMRI: Bilateral grade 1 stress responsesDEXA: L-spine Z-score -1.8 (osteopenia)Labs: Low estradiol (during NuvaRing withdrawal), Low vitamin D, Normal calcium, PTH, TSH, cortisolEstradiol increased after stopping NuvaRing (46 and 50.7 after 1 and 6 months)FINAL WORKING DIAGNOSIS: Bilateral tibial stress injuries due to low estrogen from NuvaRing useTREATMENT AND OUTCOMES: Reduce activity to 5,000 steps per day; stop running until symptoms improve. Consider cycling or swimmingPhysical therapy focusing on weight-bearing activities, gradually increasing stepsVitamin D (2000 IU) and calcium (600 mg twice daily); repeat DEXA in 2-3 years.Discontinue NuvaRing, leading to improved estrogen levels and return of regular menses.Consult gynecology for alternative contraception options.Continue monitoring nutrition; the patient, a nutritionist, remains in eating disorder remission."

Anorexia • Endocrine Disorders • Gynecology • Musculoskeletal Diseases • Orthopedics • Osteoporosis • Pain • Rheumatology

Cerebral Venous Thrombosis Following a Lumbar Puncture in a Patient Using NuvaRing. (PubMed, Am J Case Rep) - "Early diagnosis with MRI with magnetic resonance venography (MRV) and appropriate anticoagulation therapy are crucial for managing this complication. The combination of a NuvaRing and LP temporally associated with a CVT is unreported and likely increased her risk of thrombosis."

Journal • Cardiovascular • Hematological Disorders • Pain • Thrombosis

Assessing the Impact of Contraceptives on Bone Health Using 41Ca (clinicaltrials.gov) - P4 | N=6 | Active, not recruiting | Sponsor: Penn State University | Trial completion date: Dec 2024 ➔ Dec 2026 | Trial primary completion date: Dec 2024 ➔ Dec 2026

Trial completion date • Trial primary completion date • Orthopedics • IGF1 • IGFBP1

CEREBRAL VENOUS THROMBOSIS AND PULMONARY EMBOLISM FROM ETONOGESTREL/ETHINYL ESTRADIOL VAGINAL RING (SCCM 2025) - "Our case illustrates that CVRs have prothrombotic potential. Extensive CVST and de novo PE in our patient are a very rare manifestation of hormonal contraceptive vaginal ring associated VTE."

Cardiovascular • Cerebral Hemorrhage • Hematological Disorders • Musculoskeletal Pain • Oncology • Pain • Pulmonary Embolism • Respiratory Diseases • Rheumatology • Venous Thromboembolism • PROS1

Effects of a Vaginal Contraceptive Ring on Vaginal Microbiota and Local Immunity (clinicaltrials.gov) - P4 | N=81 | Completed | Sponsor: University of Washington | N=120 ➔ 81

Enrollment change • Vaginitis

RING-PCOS: Does Vaginal Delivery of Combined Hormonal Contraception Affect the Risk of Metabolic Syndrome in Overweight/obese Women with PCOS (clinicaltrials.gov) - P4 | N=28 | Recruiting | Sponsor: Andrea Roe, MD, MPH | N=40 ➔ 28 | Trial completion date: Dec 2024 ➔ Dec 2025 | Trial primary completion date: Dec 2024 ➔ Dec 2025

Enrollment change • Trial completion date • Trial primary completion date • Metabolic Disorders • Obesity • Polycystic Ovary Syndrome

HIGH-RISK PULMONARY EMBOLISM ASSOCIATED WITH HORMONAL VAGINAL CONTRACEPTIVE RING (NUVARING) (CHEST 2024) - "Pulmonary Embolism Response Team was activated and a decision to administer intravenous alteplase (100 mg) was made, with vasopressors for hemodynamic support...NuvaRing was discontinued, and the patient was discharged home on day 5 on apixaban... Hormonal vaginal contraceptive rings may pose similar VTE risk as CHCs. Providers should exercise equal caution in recommending hormonal VR as for CHCs. Life-threatening PE may occur in healthy individuals using VR, even with prolonged use."

Cardiovascular • Hematological Disorders • Immunology • Inflammatory Arthritis • Myocardial Infarction • Pain • Pulmonary Disease • Pulmonary Embolism • Respiratory Diseases • Venous Thromboembolism

Use of an Ethinyl Estradiol/Etonogestrel Vaginal Ring Alters Vaginal Microbial Communities in Women with HIV. (PubMed, J Infect Dis) - "Combined ENG/EE IVR therapy was associated with an increase in Lactobacillus-dominant vaginal microbial communities in WWH and may benefit those with bacterial vaginosis. EE levels were altered by the vaginal microbiota."

Journal • Human Immunodeficiency Virus • Infectious Disease • Vaginitis

Next-Generation Contraceptive Intravaginal Ring: Comparison of Etonogestrel and Ethinyl Estradiol In Vitro and In Vivo Release from 3D-Printed Intravaginal Ring and NuvaRing. (PubMed, Pharmaceutics) - "No signs of toxicity were noted regarding general health, colposcopy, or histological analysis in sheep after CLIPHIGH IVR administration. Our results provided (1) a comparison of ENG and EE release between a 3D-printed IVR and NuvaRing in vitro and in vivo, (2) a preclinical pharmacokinetic benchmark for vaginally delivered ENG and EE and (3) the generation of a 90-day CLIP IVR that will be utilized in future work to support the development of a long-acting ENG/EE IVR combined with an antiretroviral for the prevention of HIV and unplanned pregnancy."

Journal • Preclinical • Human Immunodeficiency Virus • Infectious Disease

RING-PCOS: Does Vaginal Delivery of Combined Hormonal Contraception Affect the Risk of Metabolic Syndrome in Overweight/Obese Women With PCOS (clinicaltrials.gov) - P4 | N=40 | Recruiting | Sponsor: Andrea Roe, MD, MPH | Trial completion date: Jul 2024 ➔ Dec 2024 | Trial primary completion date: Jul 2024 ➔ Dec 2024

Trial completion date • Trial primary completion date • Metabolic Disorders • Obesity • Polycystic Ovary Syndrome

Intravesical misplacement of vaginal contraceptive ring: a video report and review of the literature. (PubMed, Facts Views Vis Obgyn) - "This video report illustrates an effective technique for NuvaRing ® extraction, especially when appropriate graspers are unavailable. Adequate instruction on NuvaRing® insertion should always be emphasised."

Journal • Review • Video • Anesthesia • Gynecology • Musculoskeletal Pain • Pain

Comparative Bioavailability Study of Ethinyl Estradiol/Etonogestrel Vaginal Ring (clinicaltrials.gov) - P1 | N=36 | Completed | Sponsor: Evestra Inc. | Recruiting ➔ Completed

Trial completion

Anxiety With Panic Attacks - Lacrosse (ACSM 2024) - "She is on escitalopram and hydroxyzine hcl for GAD w/panic attacks and MDD. NuvaRing for contraception...Eliquis started.3...CRP 160.47, BNP 550, WBC 13.22, Ddimer 7.89, Trop 219, Lactate 4.9EKG: Sinus tach. Right axis deviation.CXR: Trace left pleural effusion.Echo: Abnormal septal wall motion d/t RV pressure overload. RV enlarged w/reduced systolic function."

Cardiovascular • CNS Disorders • Fatigue • General Anxiety Disorder • Hematological Disorders • Mood Disorders • Pain • Psychiatry • Pulmonary Disease • Pulmonary Embolism • Respiratory Diseases

High adherence to intermittent and continuous use of a contraceptive vaginal ring among women in a randomized controlled trial in Kigali, Rwanda. (PubMed, Front Glob Womens Health) - "In this study, we explored adherence of contraceptive vaginal ring (NuvaRing®) use in Kigali, Rwanda using a mixed methods approach...Comprehensive adherence data triangulation allowed for a deeper understanding of context-driven behaviour that shaped adherence patterns and challenges. Our data categorisation and triangulation approach has shown potential for implementation in future vaginal ring studies aiming to better understand and measure adherence."

Adherence • Journal • Infectious Disease

RING-PCOS: Does Vaginal Delivery of Combined Hormonal Contraception Affect the Risk of Metabolic Syndrome in Overweight/Obese Women With PCOS (clinicaltrials.gov) - P4 | N=40 | Recruiting | Sponsor: Andrea Roe, MD, MPH | Trial completion date: Dec 2023 ➔ Jul 2024 | Trial primary completion date: Dec 2023 ➔ Jul 2024

Trial completion date • Trial primary completion date • Metabolic Disorders • Obesity • Polycystic Ovary Syndrome

Pelvic Perspectives: Unveiling the Imaging Findings and Complications of Female Pelvic Devices (RSNA 2023) - "Contraceptive devices: Types of IUDs (Copper, hormonal), Intravaginal contraception (NuvaRing), CT, KUB, MRIand safety note, Ultrasound, Malpositioned IUDs 3...Menstrual Products: Imaging findings of tampons, menstrual cups, CT, MRI 6. Quick cases with multiple choice questions: Malpositioned IUD, Pessary on CT of patient with POP, Vaginal placement of catheter"

Long-acting Reversible Contraceptives

Medical Devices of the Female Pelvis: Multimodality Patterns, Pitfalls, and Pearls (RSNA 2023) - "Finally, we will present radiologic examples of device mimics that could lead to pitfalls in imaging evaluation. *Table of Contents/Outline: Pessaries Pessary Mimic: Menstrual cup Pessary Mimic: NuvaRing Pessary Mimic: Tampon Intrauterine devices (IUDs) Essure devices Tubal ligation clips Embolization coils Ureteral stents Foley catheter Rectal tube"

Long-acting Reversible Contraceptives

"It's already in your body and it's preventing": a qualitative study of African female adolescent's acceptability and preferences for proxy HIV prevention methods in Cape Town, South Africa. (PubMed, BMC Public Health) - P=N/A | "Expanding the availability of diverse products could provide adolescents with multiple choices in HIV prevention for the uninitiated."

Journal • Human Immunodeficiency Virus • Infectious Disease • Long-acting Reversible Contraceptives

RING-PCOS: Does Vaginal Delivery of Combined Hormonal Contraception Affect the Risk of Metabolic Syndrome in Overweight/Obese Women With PCOS (clinicaltrials.gov) - P4 | N=40 | Recruiting | Sponsor: Andrea Roe, MD, MPH | Trial completion date: Aug 2023 ➔ Dec 2023 | Trial primary completion date: Aug 2023 ➔ Dec 2023

Trial completion date • Trial primary completion date • Metabolic Disorders • Obesity • Polycystic Ovary Syndrome • APOB