NuvaRing Birth Control Device Use Can Cause Blood Clots and Related Serious Side Effects

Pulmonary Embolism, Deep Vein Thrombosis, Stroke, and Heart Attacks Are Associated With Contraceptive Vaginal Ring Use

NuvaRing is a contraceptive vaginal ring manufactured by Organon USA, Inc. which was approved for sale on the U.S. market in October 2001. Since that time there have been numerous reports of serious side effects associated with NuvaRing involving blood clots, some of which have resulted in death. Specifically, NuvaRing has been linked to two types of blood clot related conditions: pulmonary embolism (PE); and deep vein thrombosis (DVT). These blood conditions can cause strokes and heart attacks.

NuvaRing is a combined contraceptive vaginal ring, with ethinyl estradiol (EE) being the estrogen part and etonogestrel being the progestin part. NuvaRing releases 15 micrograms of ethinyl estradiol and 120 micrograms etonogestrel per day.

On the positive side, medical journal articles have reported on studies which show that NuvaRing has the same contraceptive efficacy as low-estrogen-dose birth control pills.

On the negative side, however, NuvaRing has a relatively high dose of etonogestrel, a metabolite of desogestrel, which has been recognized as a dangerous progestin.

An article published in the October 9, 2003 edition of The New England Journal of Medicine, “Combination Estrogen–Progestin Oral Contraceptives”, discusses how desogestrel is harmful:

Two recent meta-analyses both concluded that the use of low-estrogen oral contraceptives containing one of the so-called third-generation progestins, desogestrel or gestodene, increases the risk of venous thromboembolism [i.e., serious blood clots] more than low-estrogen formulations containing levonorgestrel — by a factor of 1.5 to 1.8. These differences in risk appear to be real and cannot be accounted for by methodologic problems in the studies or the analyses....

The elevation in the risk of [venous thromboembolic events among users of low-estrogen formulations containing desogestrel] is greatest in the first year after use is initiated, but an elevated risk persists beyond the first year. Women are not at increased risk for venous thromboembolism, myocardial infarction, or ischemic stroke after they cease taking oral contraceptives. [footnotes omitted]

Given that blood clot-related conditions like pulmonary embolism (PE) and deep vein thrombosis (DVT) -- not to mention strokes and heart attacks -- can lead to significant functional disability and possibly death, the level of warning about these serious side effects on the current NuvaRing Physician’s Insert, or label, seems insufficient.