Should I switch from NuvaRing to Annovera at age 38?

Question

Hello doctor,

I am 38 years old and have been using the NuvaRing for birth control for the past three years. While it has been effective for contraception overall, I often experience discomfort and can sometimes feel the ring during daily activities, which has become quite bothersome.

During my recent gynecology visit, my doctor mentioned the Annovera as a longer-term alternative, and I wanted to understand more before deciding whether to switch.

I would like to know:

At 38 years old, could Annovera be more comfortable to use compared to NuvaRing?
I read that Annovera is slightly larger in size. Does that make it more noticeable or uncomfortable during regular activities?
Since Annovera also contains segesterone acetate and ethinyl estradiol, does it carry similar hormonal side effects?
I experienced mild spotting and breast tenderness while using NuvaRing. Could switching to Annovera improve these symptoms, or might they become worse at my age?

I would appreciate your advice on whether changing to Annovera would be a reasonable option in my situation.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query.

I understand why you are considering a change, especially since the discomfort you are experiencing with the ring can become frustrating over time. Let me explain the differences in a simple way so you can better understand what to expect.

Annovera (Segesterone acetate and Ethinyl estradiol) is a reusable vaginal ring that is designed to last for one year, whereas NuvaRing (Etonogestrel/Ethinyl estradiol) is replaced every month. Although Annovera (Segesterone acetate and Ethinyl estradiol) is slightly larger in size, many women still find it comfortable because the material is softer and more flexible. However, comfort can vary from person to person.

Since you are already able to feel the NuvaRing (Etonogestrel/Ethinyl estradiol) during daily activities, there is a possibility that you may also notice Annovera at times. That said, a larger size does not necessarily mean it will feel more uncomfortable. In some cases, women actually prefer the feel of Annovera (Segesterone acetate and Ethinyl estradiol) because of its flexibility.

Both rings contain estrogen-based hormones, so they can cause similar side effects, including:

Mild spotting.
Breast tenderness.
Headaches.
Mood changes.
Nausea.

Annovera contains a different type of progestin called segesterone acetate, so your body may respond differently after switching. Some women notice improvement in side effects, some feel no major difference, and others may experience temporary adjustment symptoms during the first few months.

The spotting and breast tenderness you experienced with NuvaRing (Etonogestrel/Ethinyl estradiol) are relatively common hormonal side effects and do not mean the contraceptive is not working properly.

At age 38, the most important consideration is whether you have any estrogen-related risk factors, such as:

Smoking.
Migraine with aura.
High blood pressure.
A personal history of blood clots.

If none of these apply to you, vaginal ring contraceptives are often still considered an appropriate option.

If the discomfort continues regardless of the ring type, it would also be reasonable to discuss other factors with your gynecologist, including:

Ring positioning.
Insertion technique.
Alternative contraceptive methods such as an IUD (intrauterine device), implant, patch, or pills.

Overall, switching to Annovera (Segesterone acetate and Ethinyl estradiol) could be a reasonable option, but it is difficult to predict in advance whether it will feel more comfortable for you personally. Sometimes a short adjustment period is needed before you can truly tell which method suits your body better.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.