I had unusual spotting with NuvaRing. Please advise.

Question

Hi doctor,

Last month, I had an unusual spotting during the time I was using Nuvaring. That never happened before. So, I decided to take the ring off, but during that time, it was menstruation. I never had a normal flux, just spotting all the time. At first, kind of brown and after, redder and then brown again. Because that was not normal for me, I went to a gynecologist that did a Pap test (I do not know the results yet), but prescribed me a gel for five nights called Nidagel. After a week without the ring, I put a new one and today, a week before the cycle, I notice that the spotting has started again. I am super worried.

Answer 1

Hello,

Welcome to icliniq.com.

Nuvaring is Etonogestrel and Ethinyl estradiol containing contraceptive. Hormones have its own side effects and appear a bit differently in every individual female. Combined contraceptives have short-term effects like abnormal bleeding, spotting, mood variations, breast engorgement, etc., and long-term effects like stroke, migraine, high blood pressure, venous thromboembolism, breast, and endometrial cancer. You might have bleeding as a side effect of Nuvaring or there could be other possibilities as well. Cervical pathology like dysplasia, erosion, cervical or endometrial polyp, any local inflammatory lesion, pelvic infection, or hormonal effects.

It is better to have one high vaginal swab as well to exclude any pelvic pathology. Collect HVS and smear reports and discuss here or with your gynecologist. This brown discharge shows old clotted blood around NuvaRing. Oral contraceptive itself has side effects of irregular bleeding. So, if you have been on Nuvaring for years, I suggest replacing it with other contraceptives. Mirena reduces periods bleed gradually but again hormonal contraceptives have its own side effects. Better to have one local outpatient hysteroscopic examination to clear all local causes.