FIRST PERSON | For years, I avoided hormone-based contraceptives for fear of rare but serious side effects, such as blood clots. However, given the failure rates of non-hormonal methods -- including condoms and diaphragms -- I decided to switch to a hormone-based method. My doctor, like many practitioners, believed that NuvaRing was somewhat safer than combined oral contraceptives, which I chose to eschew for their high doses. She believed that NuvaRing was safer than higher-hormone pills and injections -- but, as a recent study revealed, she was wrong.
It is true that overall blood levels of synthetic estrogen and progesterone are slightly lower in NuvaRing users than in women who take combined oral contraceptives, or mainstream birth control pills. Because NuvaRing is absorbed directly through membranes that are physically close to the ovaries, a far lower dose of hormone must enter the bloodstream for the drug to be effective. This means that NuvaRing tends to cause fewer estrogenic side effects, such as weight gain and breast pain, than birth control pills. The risk of serious side effects like blood clots, however, seems to be just as high for NuvaRing users as for users of birth control pills.
In a comprehensive review investigating the long-term effects of NuvaRing and other non-oral methods of hormonal birth control, scientists discovered that women using NuvaRing had rates of blood clots slightly higher than users of combined oral contraceptives, and considerably higher than women using progestin-only "mini pills" or non-hormonal birth control. They estimated that, if all women using NuvaRing switched to ordinary oral contraceptives, it would prevent about one case of blood clots per 10,000 women.
These numbers, of course, are still relatively low. The risk of blood clots for women using hormonal contraceptives is fairly low regardless of the type of contraceptive being used. The risk to a woman's health caused by birth control is only considered to be significant if she is over 35 and a smoker. Nevertheless, the risk is present, and it's worth reevaluating your birth control if you depend on NuvaRing or any other hormonal contraceptive. As for myself, I'll be staying on the NuvaRing with a new-found understanding of the risk -- but this study highlights the need for more research and understanding of the risks of hormonal contraception. Perhaps, in time, we will develop highly effective birth control techniques with far lower risks than those that dominate today's market.
Juniper Russo is a health advocate, freelance writer, and dedicated mom living in Chattanooga, Tenn.
- Family Planning
- oral contraceptives
- blood clots