Disclaimer: I'm not a medical professional. I share my personal experiences and cite medical research when applicable. For diagnosis and treatment questions seek the advice of your dedicated medical care provider.
I stayed on the pill consistently throughout college, only fiddling slightly with different dosages. But, truth be told, I was not the poster child for consistency when it came to actually taking the pill. While I witnessed many of my girlfriends diligently popping their birth control to the tune of a daily iPhone alarm, I just couldn't get into a routine. I'd reach for my pack at 4 p.m. one day, 10 a.m. the next, or forget all together and pop three pills on Wednesday after missing Monday and Tuesday's doses. This was not healthy or effective*. So, when I graduated from Johns Hopkins and moved to Washington, D.C. to start my career, I decided to kick the non-habit-habit and look into a newer form of non-oral contraceptive that might fit my lifestyle better. I'd seen ads for different options all over TV, after all.
I found a women's health practice I liked, that staffed a mixture of physicians and midwives and decided to own up to my timing issues in hopes of finding a prescription that better fit my carefree lifestyle. Pretty quickly (we're talking a 5-minute intake conversation), my new doctor and I landed on me trying NuvaRing, the monthly hormonal vaginal ring insert.
For reference, NuvaRing works by slowly and steadily releasing small amounts of ethinyl estradiol (synthetic estrogen) and etonogestrel (synthetic progesterone), which are absorbed vaginally through the vaginal epithelium. The majors pros to this method are both obvious and subtle. On the obvious side, it's convenient to have a "set it and forget it" contraception for 21 days. This always-on release mechanism allows for a lower continuous dose of hormones, which is less disruptive (i.e. spiky) for users. Less obvious, but still positive, is the mechanism by which NuvaRing works - its placement in the vagina allows it to bypass some digestive gastrointestinal absorption concerns that oral pills may raise*.
Under this new regimen, I'd pick up a 3-pack of NuvaRings at the pharmacy to keep me child-free for the next business quarter. I'd then tuck two rings into the back of my fridge, and the third high-up into my body, positioning it next to my cervix, where it would stay for 21 days, comfortable and practically unnoticed.
I liked the NuvaRing quite a lot. Beyond reassuring me that no real user error could result in me getting pregnant, going on the ring ~*mysteriously*~ coincided with a rapid and near-complete end to my ongoing UTI and yeast infection problem (See my experience on the combination pill for more on this). Unfortunately, however, one new and startling side-effect did arise.
About a year into using the NuvaRing I started experiencing sudden, intense and severe non-menstrual bleeding during my most intimate moments. These occurrences were painless, but dramatic (like throw out the sheets and call the doctor extreme). And while I only bled like this a few times, these instances was terrifying. In addition, although I didn't understand the linkage at the time, I became extremely iron deficient and anemic from losing so much blood - and I'd remain that way for a few years. My undiagnosed anemia made it hard for me to exercise, made me constantly cold and tired, and made my hair fall out*. After consulting my doctors a few times with no obvious explanation for the bleeds, we reasoned it might be that my vaginal ring was just bothering me.
It was time for yet another switch. This was 2016 and right around the time of the U.S. election. With many very liberal friends living in Washington D.C., I heard fears echoed all over the city about fair access to birth control for women. The IUD actually entered into vogue at this time, in part as a way to hold onto contraception throughout an entire republican presidency. And while I liked the idea of trying an IUD as a non-hormonal birth control method, my doctors swiftly batted the idea down. After all, with such a negative experience with a physical device next to my cervix on the ring, how could a surgically implanted physical device pose less risk to me?
I agreed with my doctors - but I was running out of options...
Read my other hormonal birth control experiences:
*Resources:
Cochrane Library: Skin patch and vaginal ring versus combined oral contraceptives for contraception
A large study conducted in India on Nuvaring acceptability and adherence found that non-period bleeding (intra-cycle) was rare on this method of hormonal birth control at under 4% likelihood. Every body certainly is different! Source: Multicenter Study of Contraceptive Vaginal Ring (NuvaRing®) in Normal Daily Practice in Indian Women