Side effects of nuvaring

As proof that all roads, even contraceptive ones, lead to Beyoncé, I’d like to humbly suggest tweaking her iconic “Single Ladies” lyrics as such: If you like not being pregnant, you should maybe put a ring in it. “It” being your vagina, obviously. At the very least, you should consider doing so, because according to Mary Jane Minkin, M.D., a clinical professor of obstetrics and gynecology at Yale Medical School, “NuvaRing is an excellent method of contraception.” But it doesn’t get as much time in the spotlight as its more well-known sistren, the birth control pill and the IUD. It’s time to change that. Here, ob/gyns explain nine facts anyone who often forgets to take the Pill should absolutely know about NuvaRing.

1. NuvaRing is a flexible, hormone-secreting plastic ring that’s pretty similar to birth control pills.

Using a combination of estrogen and synthetic progesterone, NuvaRing suppresses ovulation and thickens cervical mucus, making it harder for determined sperm to wriggle their way to an egg, says Minkin.

Like the Pill, NuvaRing has a 9 percent failure rate with typical use, according to the Centers for Disease Control and Prevention. That means nine out of every 100 women relying on it will get pregnant within the first year of non-perfect use.

2. But instead of taking it orally, you insert it into your vagina, where it stays for a few weeks at a time.

“You pinch it together, aim toward your back like you’re putting in tampon, and it pops into place,” says Minkin. “The exact position of the ring doesn’t matter,” says Planned Parenthood, although if you can still feel it after insertion, you should push it farther in.

NuvaRing’s hormones are effective for up to 28 days, according to its website, but you can remove it after three weeks, wait seven days, then replace it with a fresh one. That week sans hormones allows for your period, if you like getting one as reassurance that you’re not pregnant.

3. It’s a great option if you want hormonal birth control, don’t want to take a pill every day, but also aren’t ready for an IUD.

” is a little more immune to people forgetting than the Pill,” says Minkin. She describes it as perfect for someone who loves what hormonal birth control has to offer—relief from period pain in addition to pregnancy prevention, for example—but isn’t a fan of remembering to take something every single day. At the same time, it doesn’t require the commitment level of an IUD, making it a good middle ground.

4. But you have to be comfortable touching your vagina, magical organ that it is.

Since NuvaRing needs to be inside your vagina in order to work, you have to actually put it in there. Inserting it can feel pretty odd at first, but Minkin says you get the hang of it pretty quickly.

Removal is pretty simple—”Hook your finger under the forward rim and gently pull it out of the vagina,” Planned Parenthood recommends—but it can definitely feel like you’re really scrounging around in there, especially in the beginning. Make sure you always wash your hands before insertion, removal, or any other time your fingers come into contact with your vagina. If this is all too much vagina-touching for you, you may be better off with another birth control option.

5. In addition to preventing pregnancy, the ring can also make your period less awful—or let you skip it all together.

“NuvaRing is designed for contraception, but it can also be used for period control,” board-certified ob/gyn Antonio Pizarro, M.D., tells SELF. If you don’t want a period at all, NuvaRing may help. “There are people who use it continuously, , and that’s perfectly OK,” says Minkin. After all, it’s safe to skip your period when you’re on the Pill, and it’s the same for NuvaRing. “The only problem with using it like this is that some people get breakthrough bleeding,” says Minkin.

6. The side effects are very similar to the Pill’s.

Since NuvaRing and the Pill function in basically the same way, you can expect the same side effects from them, says Minkin. There are great ones like less cramps, potentially lighter periods (that’s the other part of the period control bit Pizarro mentioned), and clearer skin. But there are also issues like vaginal dryness and lower libido, or slightly increased risks of blood clots and stroke.

7. Speaking of blood clots, people have a lot of questions about whether NuvaRing makes them more likely than other types of hormonal birth control.

“With any contraception of this kind, there are risks of stroke and blood clots, but those risks are very low,” says Pizarro. “The literature doesn’t have anything that has convinced me that NuvaRing is more or less dangerous than other forms of combined hormonal contraception like the Pill.”

Skin patch or vaginal ring compared to pills for birth control

We found 18 trials that met our inclusion criteria. Of six patch studies, five examined the marketed patch containing norelgestromin plus ethinyl estradiol (EE); one studied a patch in development that contains levonorgestrel (LNG) plus EE. Of 12 vaginal ring trials, 11 examined the same marketing ring containing etonogestrel plus EE; one studied a ring being developed that contains nesterone plus EE.

Contraceptive effectiveness was not significantly different for the patch or ring versus the comparison COC. Compliance data were limited. Patch users showed better compliance than COC users in three trials. For the norelgestromin plus EE patch, ORs were 2.05 (95% CI 1.83 to 2.29) and 2.76 (95% CI 2.35 to 3.24). In the levonorgestrel plus EE patch report, patch users were less likely to have missed days of therapy (OR 0.36; 95% CI 0.25 to 0.51). Of four vaginal ring trials, one found ring users had more noncompliance (OR 3.99; 95% CI 1.87 to 8.52), while another showed more compliance with the regimen (OR 1.67; 95% CI 1.04 to 2.68).

More patch users discontinued early than COC users. ORs from two meta-analyses were 1.59 (95% CI 1.26 to 2.00) and 1.56 (95% CI 1.18 to 2.06) and another trial showed OR 2.57 (95% CI 0.99 to 6.64). Patch users also had more discontinuation due to adverse events than COC users. Users of the norelgestromin-containing patch reported more breast discomfort, dysmenorrhea, nausea, and vomiting. In the levonorgestrel-containing patch trial, patch users reported less vomiting, headaches, and fatigue.

Of 11 ring trials with discontinuation data, two showed the ring group discontinued less than the COC group: OR 0.32 (95% CI 0.16 to 0.66) and OR 0.52 (95% CI 0.31 to 0.88). Ring users were less likely to discontinue due to adverse events in one study (OR 0.32; 95% CI 0.15 to 0.70). Compared to the COC users, ring users had more vaginitis and leukorrhea but less vaginal dryness. Ring users also reported less nausea, acne, irritability, depression, and emotional lability than COC users.

For cycle control, only one trial study showed a significant difference. Women in the patch group were less likely to have breakthrough bleeding and spotting. Seven ring studies had bleeding data; four trials showed the ring group generally had better cycle control than the COC group.

If you’ve read recent media coverage about NuvaRing, you could be excused for thinking that that the contraceptive ring is deadly and should be yanked off the market immediately. But hold on.

A Vanity Fair article from early 2014 focused heavily on lawsuits alleging harms from the device — especially from dangerous blood clots.1 What that and other sensational articles fail to do, however, is put the potential risk from NuvaRing in the context of either normal risks or risks from other hormonal birth control options. Nor do they discuss the real magnitude of risk of any of these options. Blogger Jessica Grose calls these “birth control scare stories” and notes the media’s love affair with this type of content.2

NuvaRing, a hormonal birth control, is inserted into the vagina. It contains a combination of estrogen and etonogestrel, a form of progestin that’s different from what’s in the most common low-dose combined birth control pills. All hormonal birth control with estrogen carries some risk of blood clots, which are technically called venous thromboembolisms (VTE), and can be fatal.3 But, the risks of VTE from the most common low-dose combined oral contraceptives are quite small.

We’ll talk about NuvaRing’s increased risks below, but first, some background. The latest Food and Drug Administration (FDA) safety announcement estimates that, for every 10,000 women taking birth control pills, between 3 and 9 cases of blood clots may occur per year.4 It’s important to note that blood clots don’t occur just among women taking birth control: there is a higher risk of experiencing blood clots during pregnancy (5 to 20 cases annually per 10,000 women); women who aren’t pregnant and don’t take birth control pills have between 1 to 5 blood clots annually, per 10,000 women.

Newer types of birth control pills that contain the progestin drospirenone (e.g., Yasmin, Yaz) are thought to cause a greater risk for blood clots than the “normal” birth control pills the estimates are based on.5 The newer pills have come under scrutiny in Europe and the United States recently.6 Some women’s health advocates — including the NWHN and Our Bodies Ourselves — have called on the FDA to take drospirenone-containing pills off the market, since they pose a greater clot risk without offering any clear benefits over older types of pills.

The factors a woman considers when weighing the risks and benefits of NuvaRing or any other contraceptive method — whether it contains hormones or not — vary from woman to woman. The pill works for some women, while others appreciate the convenience and reduced chance of missing a dose provided by alternatives like NuvaRing and the patch. For some, that’s worth the slightly elevated risk of experiencing blood clots.

Part of the problem in determining what’s “best” for you is the lack of clarity about the increased risk that may come from using NuvaRing. Indeed, different studies have yielded different results: A British Medical Journal (BMJ) study found about a 90 percent increased risk;7 an FDA drug safety paper reports a 56 percent increased risk;8 other studies have reported “similar” rates of VTE between NuvaRing and regular oral contraceptives.9

Let’s consider the actual numbers, looking at the BMJ study, which has the most alarming findings. The 90 percent increased risk of clots from NuvaRing would result in 7.8 incidents of VTE per 10,000 exposure years. That means, if 1,000 women used NuvaRing for 10 years, there would be about 8 incidents of VTE among them, vs. 3 – 9 for pill users.10 The fact is, while different methods of hormonal birth control carry different levels of risk, in general, hormonal birth control is very safe for most women. What is of greater concern, however, is that women aren’t given this information to help their decision-making.

There have also been allegations that Organon — the company that made NuvaRing, which Merck now owns — maneuvered to keep clot risk information off the product label during the FDA approval process.11 The NuvaRing label lacks the “black box warning” which is printed on the birth control patch label and notes the product has a higher clot risk than contraceptive pills.12 NuvaRing’s product label simply notes that smokers may have “serious cardiovascular events.”13 The NuvaRing website includes some information comparing the risk to combined oral contraceptives, but we believe this important safety information should also be on the FDA-approved label in the same manner as it is on the patch’s label.

Cindy Pearson, NWHN’s Executive Director, and a strong advocate for close review of drug safety, has responded to the concerns, saying:

The most heartbreaking part of the Vanity Fair article are the accounts of women who never knew that the contraceptive ring delivered a higher dose of hormones and is slightly more risky than pills. No clinician should offer women these products without fully disclosing the risks, and encouraging women to try alternative, safer forms of contraception if they haven’t already done so.14

Agreed. While the risk to an individual woman may be low with any of these birth control methods, womenmust be informed that some options — including the ring, the patch, and the drospirenone-containing pills — may be more risky than older combined oral contraceptive pills. And, health care providers need to stay on top of the evidence so that they can actively discuss the benefits and risks of all options with the women they see. All women should have the information they need to make the best choices for their own health.

This article was written by: Rachel R. Walden

Rachel R. Walden, MLIS is a medical librarian and blogger for Women’s Health News and Our Bodies Our Blog.

4. Food and Drug Administration (FDA), “Drug Safety Communication: Updated information about the risk of blood clots in women taking birth control pills containing drospirenone,” Silver Spring: FDA, February 14, 2014. Available online at: http://www.fda.gov/drugs/drugsafety/ucm299305.htm

8. Combined Hormonal Contraceptives (CHCs) and the

Risk of Cardiovascular Disease Endpoints

10. Food and Drug Administration (FDA), Combined Hormonal Contraceptives (CHCs) and the

11. Siddiqui S, “Side Effects May Include Death: The Story Of The Biggest Advance In Birth Control Since The Pill,” Huffington Post, posted on December 18, 2013 at:

Top things to know:

  • Concern about weight gain with birth control use is common and may keep some people from using it
  • For a minority of people, hormonal birth control likely does cause weight gain
  • For most people the combined hormonal pill, patch, and ring do not appear to cause weight gain and the hormonal IUD likely doesn’t cause weight gain
  • The implant and the shot may contribute to weight gain in some people

Birth control and weight

A common belief people have about hormonal birth control is that it will cause weight gain (1-3). Some people may gain weight while using hormonal birth control, while others may experience bloating or changes in body composition (the amount and distribution of body fat) which could make them feel like they’re gaining weight. Concern about side effects like weight gain keeps some people from using hormonal birth control (4). People who report gaining weight while using hormonal birth control (such as the pill and the shot) are more likely to stop using it (5-7).

It’s important to note that what is considered to be an ideal weight or body type is impacted by social and cultural beliefs that are continually changing.

Unfortunately in some cultures, there is harmful pressure to conform to standards that may not be realistic. Even scientific measures such as body mass index (BMI) cannot adequately classify who is healthy or not. As it relates to birth control, some people may fear weight gain, some may desire it, and others may not consider it important at all.

Changes in hormone levels during puberty and menopause can impact body composition. Starting from puberty, estrogen causes body fat to be deposited on the chest, thighs, hips and butt (8). The hormonal changes that occur during and after menopause cause an increase in body fat, particularly around the abdomen (8,9). Some people experience an increase in weight around menopause, but this is believed to be related to aging more so than hormonal changes (8,9). Hormones also likely impact food intake over the menstrual cycle. Food intake decreases during the follicular phase (the first half of the cycle when estrogen is the dominant hormone) until ovulation (release of an egg from the ovary), then increases during the luteal phase (the second half of the cycle when progesterone is dominant) (8).

What your healthcare provider might say

Combined hormonal contraceptives are birth control methods that contain two hormones (estrogen and progestin) and include most pills, the patch, the ring, and some shots. Progestin-only contraceptives contain just a form of progestin hormone and include the implant, most intrauterine devices (IUDs), a shot, and certain pills.

There is not enough evidence to say that combined hormonal contraceptives cause weight changes, but if they do, the change in weight is likely small (10). In people using progestin-only contraceptives, most studies do not show an increase in weight or body fat, but some do show a small increase (11). Some people will gain weight on birth control, and some people may be more prone to weight gain than others.

Hormonal contraceptives have a number of uses in addition to protection from unwanted pregnancy. They are also used to treat or reduce symptoms of PCOS, endometriosis, heavy, irregular, or painful periods, and anemia. Fear of gaining weight may keep someone from starting birth control, or could lead to them using it incorrectly or inconsistently, or could cause them to stop using it altogether. This could leave someone without effective protection from unwanted pregnancy or without treatment for a condition. Talking to a healthcare provider can help you consider the possible risks and benefits of taking hormonal birth control.

Here’s why it’s tricky

Even though many people believe birth control causes weight gain, the research is not so clear cut. People generally tend to gain weight over time and weight fluctuates depending on when it’s measured. Most people gain weight from young adulthood to middle age, with an average weight gain of 0.52 kg (1.15 lbs) each year (12). There are daily, weekly, monthly, and seasonal patterns to weight. Two very small studies have shown that people weigh less in the morning than the evening (13,14). One study showed that weight had a pattern of increasing from Friday to Monday and decreasing from Monday to Friday (15). And adults in the U.S. tend to gain weight around the fall and winter holidays (16).

A study of people using birth control pills who were weighed every day for four months, showed that pill users gained about 0.2 kg (0.44 lbs) over the first 3 weeks of a pill pack and then lost the same amount during the placebo (withdrawal bleeding) week (17). Their weight did not change from the beginning to the end of the four-month study.

The copper IUD (e.g. Paragard, Mona Lisa, T-safe) does not contain any hormones, so there is no direct way that it would affect weight. Copper IUD users still gain weight in long-term studies though, just like people who aren’t using any contraception will gain weight with time and age. One study showed that long-term copper IUD users steadily gained weight—on average 4.0 kg (8.8 lbs) over 7 years (18). Copper IUD users are often used as the comparison group in studies looking at weight gain with various hormonal birth control methods. One group will use a hormonal birth control and one group will have the copper IUD, and typically both groups gain weight over time.

So while it may appear as though someone using a hormonal birth control has gained weight at the end of a study, it may not be any different than what they would have gained if they were using a non-hormonal method (such as a the copper IUD), or nothing at all.

Most adults are gaining weight and have normal patterns of weight gain and loss, but concern about gaining weight keeps people from starting birth control and makes people stop taking it. The issue of weight gain and birth control is not straightforward, and study results can often be unclear or contradictory. It’s possible that longer studies with more people are needed to fully understand the impact of hormonal birth control on weight.

Here’s what the research says about each birth control type

Progestin-only contraceptives and weight gain

The implant and the shot may contribute to weight gain in some people, but the hormonal IUD likely doesn’t cause weight gain.

Implant (e.g. Nexplanon):
It’s unclear whether the implant contributes to weight gain. One study showed that after using the implant for a year, users had gained 0.1 kg (0.22 lbs), which was similar to the weight gained by people using the copper IUD (19). The same study showed that there was no difference in the amount of body fat of implant users compared to copper IUD users after one year (19). Another study showed that implant users gained 2.1 kg (4.6 lbs) after a year of use, which was more than the people using the copper IUD in the study, but this difference in weight was only seen when users of all races were looked at together (20). When the researchers separated participants into two groups based on race (implant users who were black and implant users who were white or any other race), there was no difference in weight gain between implant and copper IUD users (20).

More research is needed to determine whether weight gain is associated with using the implant.

Hormonal IUD (e.g. Mirena, Liletta):
The hormonal IUD appears to not cause weight gain, but could possibly result in an increase in body fat. Several studies show that people who used the hormonal IUD for one year gained between 0.5 kg (1.1 lbs) and 2.9 kg (6.4 lbs), which was the same as the weight gained by copper IUD users (19-22).

One of these studies measured the change in weight of people who had been using the hormonal IUD for 10 years. After 10 years of continuous use, hormonal IUD users had gained an average of 4.0 kg (8.8 lbs), which was no different than the amount of weight gained by people who had been using the copper IUD for 10 years (21).

Looking at changes in body composition with hormonal IUD use is tricky. One study showed that there was no increase in the amount of body fat after a year of hormonal IUD use (19), while another study did find an increase in body fat percentage (22).

There are other hormonal IUDs, such as Kyleena, Jaydess, or Skyla, which have lower doses of progestin than Mirena or Liletta, but changes in weight on these particular types of IUD have not been well studied.

The shot (e.g. Depo-Provera):
Some studies have shown that people using the shot gain weight and others show no change in weight attributed to the shot. After using the shot for a year, users gained between 1.3 kg (2.9 lbs) and 2.2 kg (4.9 lbs), which was more than the weight gained by people using the copper IUD in some studies (20,21), but similar to the weight gained by copper IUD users in other studies (23,24).

Even studies that measured changes in weight for people using the shot for longer periods of time give conflicting results. In one study, shot users gained 6.5 kg (14.3 lbs) after 10 years, which was more than the weight gained by copper IUD users (21), but in another study, shot users gained 9.5 kg (20.9 lbs) over the 10-year period, which was the same as the weight gained by copper IUD users (25).

After 12 months of using the shot, one study showed an increase in overall body fat—particularly around the abdomen (23), but another small study showed no difference in body fat compared to copper IUD users (24).

But averages don’t tell the whole story. In one study that showed that the users of the shot did gain more weight on average than copper IUD users, this difference went away when researchers separated the research participants into two groups based on race (users of the shot who were black and users of the shot who were white or any other race) (20). In this study, black study participants were more likely to gain weight regardless of the birth control method (20). In another study, even though the average weight gains didn’t differ between groups, 4 out of 10 users of the shot had a large weight gain (an average of 4.6 kg or 10 lbs) and had an increase in abdominal fat, which didn’t happen in the copper IUD users (24).

Combined hormonal contraceptives

Research shows that the combined pill, patch, and ring do not appear to cause weight gain.

The pill (various brands):
After using the pill for six months, research participants in two studies did not gain any more weight than the people who weren’t using any kind of birth control (26,27), gaining 0.88 kg (1.94 lbs) on average (26). Pill users also did not have changes in body fat after six months (27) or a year (28). Among pill users, 10 out of 100 gained more than 7% of their body weight in one year of use, and 5 out of 100 lost more than 7% of their body weight (29).

The ring (e.g. Nuvaring):
After a year, people using the ring gained 0.4 kg (0.88 lbs), which was the same as the amount of weight gained by people using the pill (28). There was also no difference in body fat among Nuvaring users after a year (28). For ring users, 8 out of 100 people gained more than 7% of their body weight after a year, and 7 out of 100 people lost more than 7% of their body weight (29).

It’s important to remember that these numbers are just averages. Some people in these studies gain weight and some lose weight, and the amount of weight differs from person-to-person. Some people may be more prone to gaining weight on birth control than others.

More research is needed to fully understand how and why different types of birth control may contribute to weight gain in some people, but not others.

Using Clue to track a new birth control method, along with weight and other symptoms (like whether you feel bloated), can help you figure out if things are changing and whether they are related to your birth control.

Although homework is usually best left for school, it’s key if you’re trying to decide on which contraception is best for you. When you’re mulling over your birth control options, there’s a lot to consider: hormones or no hormones? Are you on top of your sh*t enough to take something every day, or is a “set it and forget it” method like an IUD more up your alley? And, of course, there are the potential side effects, like mood shifts, irregular periods, and…weight gain?

You may have heard the rumor that hormonal birth control can affect the number on the scale. It’s a popular one, ob/gyns say. “I have a lot of patients who come in and say the Pill made them gain weight,” Idries Abdur-Rahman, M.D., a board-certified ob/gyn, tells SELF. But the truth is, it probably didn’t.

The confusion around birth control and weight gain is largely rooted in the first Pill’s effects.

“The short answer is that usually doesn’t cause weight gain, but it can,” says Abdur-Rahman. “It’s kind of old wives’ tale, because when birth control pills first came out, there was a lot of trial and error with pharmaceutical companies,” he explains.

In 1960, the first birth control pill, Enovid, made its debut. ” had a lot more hormones in it than needed to prevent pregnancy,” says Planned Parenthood. “It contained 10,000 micrograms of progestin and 150 micrograms of estrogen. In comparison, today’s lower-dose pills are more likely to contain 50–150 micrograms of progestin and 20–50 micrograms of estrogen.”

But those new lower-dose pills weren’t introduced until the 1980s, according to PBS. Before that, there was plenty of time for Enovid to make a name for itself. “Early critics of the Pill were right that a lot could be done to improve it. Among the millions of women using the Pill worldwide, there were disturbing reports of nausea, breast tenderness, water retention, and weight gain,” says Planned Parenthood.

But things are different now.

“The Pill gets a bad rap,” Alyssa Dweck, M.D., assistant clinical professor of obstetrics at Mount Sinai School of Medicine and co-author of V is For Vagina, tells SELF. In reality, you shouldn’t experience significant weight gain on hormonal methods like the Pill and similar forms like NuvaRing, she says.

Also, although a 2015 report of published in Cochrane Database of Systematic Reviews found that “the evidence was not strong enough to be sure that these methods did not cause some weight change,” they still “found no major effect on weight.”

Hormonal IUDs and the Nexplanon implant also shouldn’t cause actual weight gain.

IUD options like Mirena, Skyla, and Liletta release progestin, which can make your jeans feel a little tighter. “All of these can create a little bloating because progestin can make you you retain some water,” says Abdur-Rahman. (The same goes for the Pill and the implant.) But it shouldn’t be a huge amount—more like the type of bloating you would otherwise potentially experience during your period anyway.

The only major exception to this rule is the Depo-Provera shot.

Depo-Provera involves getting a shot of progestin every three months. “It’s a relatively high dose of the hormone” because it needs to protect you for a few months at a time, says Abdur-Rahman, who explains that the thinking is that Depo makes you hungrier, which can lead to weight gain.

A landmark 2009 study on the subject backs up the Depo-weight gain link. Published in the American Journal of Obstetrics and Gynecology, the research found that “bodyweight and fat significantly increase with the use of .”

Can Birth Control Cause Weight Gain?

According to the CDC, 99.1% of women in the U.S. between the ages of 15 and 44 have used any method of birth control. Many women rely on hormonal contraception – such as birth control pills, intrauterine devices (IUDs), the Xulane birth control patch, the Nexplanon implant, the NuvaRing, and the Depo-Provera shot – to help prevent unwanted pregnancy. However, women are often dissuaded from using birth control due to rumors or stories from friends that birth control causes weight gain.

For more information on all your contraceptive options, see our complete birth control guide. If you’re looking to save on your birth control, whether it be the combination pill, minipill, Depo-Provera shot, Xulane patch, NuvaRing or Nexplanon implant, consider SingleCare.

Can Birth Control Make You Gain Weight?

For the vast majority of contraceptive options, most research doesn’t show a direct relationship between weight gain and birth control use. This is the case for most hormonal forms of birth control, as well as non-hormonal methods. The one exception to this rule is the Depo-Provera contraceptive shot. Women who opt for Depo-Provera could experience some weight gain while using this form of birth control. More information on this research is available below.

Aside from users of Depo-Provera, weight gain while using birth control is a more complicated issue that may involve extenuating lifestyle factors. For many women, the choice to start or change methods of birth control may coincide with lifestyle changes, such as entering into a new relationship. Some women may also make modifications to their diet and exercise routines around the same time that they change up their birth control.

If your birth control method is not directly the cause of your weight gain, what is?

Water Retention

Water retention, also known as fluid retention or edema, could be one source of (real or perceived) weight gain. Symptoms of water retention include weight fluctuations, swelling of body parts such as feet, ankles, and hands, body aches and stiff joints.

The hormones progesterone and estrogen, used in many popular forms of hormonal birth control, play major roles in water retention. When your estrogen levels are elevated, you are likely to retain more water. This is why bloating is a common symptom in the days leading up to your period. High estrogen levels are also associated with increased appetite, which can contribute to weight gain fueled by overeating. Progesterone, on the other hand, is a natural diuretic, which means that it rids the body of excess fluids. When your progesterone levels are low, you can also experience bloating and water retention.

Water retention is usually temporary and should subside over the course of a few days. If you are experiencing water retention or bloating for an extended period of time, talk to your healthcare provider. Birth control that contains progestin, which is a diuretic, can help eliminate water retention.

  • Contraceptive options that contain estrogen include: combination birth control pills, the Xulane patch and the NuvaRing
  • Progestin-only birth control options include: the minipill, the Nexplanon implant, hormonal IUDs, the Depo-Provera shot and some forms of emergency contraception

For discounts on these contraceptive options, use SingleCare.

Adjusting to a New Pill

Common side effects of starting a new birth control pill, such as breast swelling and tenderness, can be interpreted as signs of weight gain. Everyone reacts to new medications differently. Give yourself time to adjust to your new pill, but talk to your doctor if you have significant concerns.

Lifestyle Factors

Changes in your lifestyle can coincide with beginning or changing birth control methods. Such lifestyle factors may include diet, exercise, stress, or beginning a new romantic relationship. Check in with yourself to see if you have made changes in any of these areas of your life. You may find it useful to keep a journal of your diet and exercise to identify behavioral patterns and tendencies. If you have gained weight on birth control despite maintaining your normal exercise and diet routine, talk to your doctor.

Normal Weight Fluctuations

Many women gain or lose a few pounds here and there. It is also normal for your weight to fluctuate by a few pounds throughout the week. Eating food, drinking fluids, exercising, urinating and excreting can all impact your body’s water composition, and consequently, affect your weight. Eating foods high in salt or sugar can lead to water retention and temporary weight gain. However, the weight should go away a few days after consumption. Water retention occurs during your menstrual cycle as well, which can cause some minor weight fluctuations. These fluctuations are all normal and should not be cause for concern. However, if you notice excessive or long-term weight fluctuations, consult your healthcare provider.

The Depo-Provera (DMPA) Shot and Weight Gain

Unlike most forms of birth control, the DMPA contraceptive injection is correlated with moderate weight gain. One study found that around 25% of Depo-Provera users experienced weight gain and increased appetite after six months of use. Most women who gained weight on the birth control shot experienced an over 5% increase in body weight.

Why Does Depo-Provera Cause Weight Gain?

Scientists aren’t sure, but the DMPA shot does deliver a much higher dose of progesterone than other forms of hormonal birth control. It’s possible that the extra hormones slow the body’s metabolism, promoting fat storage. The excess hormones could also increase appetite. Researchers have found that women tend to lose weight after they go off the birth control shot – an average of three pounds over two years, according to US News and World Report.

If you do find that you gain weight on your birth control, you can choose to stop your birth control altogether, while being safe about pregnancy prevention. Depo-Provera takes a while to lose effectiveness, but you will need to use a secondary form of birth control, such as condoms, to be safe. Another option is to remain on this form of birth control, but alter your diet and exercise regimen. Consider finding the right diet plan for you or trying some easy home workouts. It may also be a good idea to address underlying lifestyle factors that could contribute to your weight gain, such as increased stress or a new relationship. Talk to your doctor before stopping your birth control or drastically altering your diet and exercise regimen.

The Bottom Line

Many young women have been discouraged from using hormonal birth control due to rumors that it can cause weight gain. However, the majority of contraceptive options have no established correlation with weight gain. The exception to this statement is the Depo-Provera birth control injection, which has shown to cause moderate weight gain in some women. For most women, any weight gained on Depo-Provera is lost after going off of the injection.

Unless you use the contraceptive shot, your weight gain is likely not directly caused by your birth control. Weight gain that many women attribute to their birth control may be caused by other factors, such as changes in lifestyle or diet and exercise routines. However, everyone is different. Talk to your doctor if you experience unexplained weight gain on any form of birth control. He or she can help you identify the source of the problem and help you learn more about different birth control options.

For more information on all your contraceptive options, consider our complete guide to birth control in 2018. If you’re looking to save on your preferred method of birth control, whether it be the combination birth control pill, the minipill, the Xulane patch, the NuvaRing, the Nexplanon implant or the Depo-Provera shot, try SingleCare.

  • Toxic Shock Syndrome (TSS). Some of the symptoms are much the same as the flu, but they can become serious very quickly. Call your health care provider or get emergency treatment right away if you have the following symptoms:
  • Sudden high fever
  • Vomiting
  • Diarrhea
  • A sunburn-like rash
  • Muscle aches
  • Dizziness
  • Fainting or feeling faint when standing up
  • Allergic reaction, including hives, swelling of the face, lips, tongue, and/or throat causing difficulty in breathing or swallowing (anaphylaxis and/or angioedema)
  • Liver problems, including liver tumors
  • High blood pressure
  • Gallbladder problems
  • Accidental insertion into bladder
  • Symptoms of a problem called angioedema if you already have a family history of angioedema

The most common side effects of NuvaRing (etonogestrel/ethinyl estradiol vaginal ring) are:

  • Tissue irritation inside your vagina or on your cervix
  • Headache (including migraine)
  • Mood changes (including depression, especially if you had depression in the past). Call your health care provider immediately if you have any thoughts of harming yourself
  • NuvaRing problems, including the ring slipping out or causing discomfort
  • Nausea and vomiting
  • Vaginal discharge
  • Weight gain
  • Vaginal discomfort
  • Breast pain, discomfort, or tenderness
  • Painful menstrual periods
  • Abdominal pain
  • Acne
  • Less sexual desire

Some women have spotting or light bleeding during NuvaRing use. If these symptoms occur, do not stop using NuvaRing. The problem will usually go away. If it doesn’t go away, check with your health care provider.

Other side effects seen with NuvaRing include breast discharge; vaginal injury (including pain, discomfort, and bleeding) associated with broken rings; and penis discomfort of the partner (such as irritation, rash, itching).

Less common side effects seen with combination hormonal birth control include:

  • Blotchy darkening of your skin, especially on your face
  • High blood sugar, especially in women who already have diabetes
  • High fat (cholesterol, triglycerides) levels in the blood

There have been reports of the ring becoming stuck to the vaginal tissue and having to be removed by a healthcare provider. Call your healthcare provider if you are unable to remove your NuvaRing.

Tell your health care provider about any side effect that bothers you or that does not go away. These are not all the possible side effects of NuvaRing. For more information, ask your health care provider or pharmacist. Call your health care provider for medical advice about side effects. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Women Who Stand By Their NuvaRing

There’s the 24-year-old who stopped breathing, had two heart attacks, and died on life support. There’s the mother whose two-year-old son watched her go into a seizure. And there’s the college student who started spitting up blood while having lunch with her dad.

The accounts of women experiencing the negative side effects of the NuvaRing contraceptive are gruesome, and their stories are part of the evidence that led to the $100 million settlement last week with NuvaRing maker Merck & Co. The pharmaceutical company agreed to hand over $100 million for liability lawsuits claiming the ring caused blood clots that sometimes led to heart attacks and even death, although Merck denied fault. The women argued they were not adequately warned about these side effects, and about 3,800 of them are eligible to partake in the settlement.

Despite the well-publicized risks, some women are finding it difficult to ditch a contraceptive that has provided them with consistency and convenience. Oftentimes, finding the right birth control takes years of trial and error, and side effects range from weight gain to decreased libido. For this reason, when women find the right contraceptive, they tend to develop a certain loyalty to it.

Sarah, 26, a graduate student in New York City, struggled with finding the right birth control since she was 20 years old. During the year she was on the pill, she put on weight and was constantly having mood swings. She’d feel depressed one day and highly irritable the next. She switched to the NuvaRing five years ago after a friend suffering similar effects made the swap, and it has been smooth sailing ever since. “I hated the whole contraceptive experience, but with the NuvaRing I don’t experience any of that,” she says.

The NuvaRing ring is a flexible ring that women insert inside their vagina and remove for the week of their period. Like an oral contraceptive, it releases the hormones progestin and estrogen (though at lower levels), preventing ovulation and sperm from reaching the egg, but you don’t have to remember to take a pill every morning. Women prefer it for its convenience, the localized hormones, and the fact that there’s less accountability. In 2012, there were about 5.2 million prescriptions in the U.S. for the NuvaRing, according to IMS Health, a healthcare technology and information company.

According to the American College of Obstetricians and Gynecologists (ACOG)–the medical authority on all things related to baby-making–NuvaRing leads to a slight increased risk of deep vein thrombosis, heart attack, and stroke. And, as highlighted in a safety warning on NuvaRing’s website, the danger is higher for some women, like those over 35 who smoke more than 15 cigarettes a day or women who have multiple risk factors for heart disease. Its typical use failure rate is 9%, the equivalent of an oral contraceptive, according to the CDC.

Following the settlement Friday, Merck issued a statement saying, “We stand behind the research that supported the approval of NuvaRing, and our continued work to monitor the safety of the medicine.”

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Though the side effects of the NuvaRing are very real, for many women it bears no complications. “I am extremely busy with very irregular hours and travel for my job,” says Julie*, 27, who works for a film production company in Los Angeles, California, “so the NuvaRing is the ideal fit for my lifestyle. I have virtually no side effects, so I plan to remain on it for the foreseeable future.”

Other women simply shrug off the dangers. “Every drug you take comes with risks, from Asprin to birth control to allergy medicine,” says Ricci Ellis, 31, a respiratory therapist in Little Rock, Arkansas, who switched from the pill after consistently forgetting to take it. “For me, the benefits of NuvaRing far outweigh the risks.” Because she’s not not a smoker and leads an active and healthy lifestyle, Ellis considers herself relatively safe from the risks of blood clots, strokes, and sudden death.

“It is absolutely essential that people are aware of the risks associated with each method of contraception,” says Bill Albert, the chief program officer at The National Campaign to Prevent Teen and Unplanned Pregnancy. The American Heart Association (AHA) recently recommended that women considering birth control get screened for high blood pressure, which can put them at a greater risk for clots and stroke. “Equally important, however, is how such risks compare to those of other methods, and to pregnancy as well.”

According to Albert, the side effects need to be placed in a broader context so that they are neither dismissed nor viewed with disproportionate alarm. “One of the highest risk of blood clots comes with pregnancy. Consequently, if an individual is having sex and doesn’t want to get pregnant, skipping birth control altogether for fear of blood clots is not the best way to protect your health,” says Albert. “This is not meant to be cavalier, but the doubling of a rare risk is still rare.”

Medical experts are careful to not trivialize the risks, but Dr. Eve Espey, the chair of ACOG’s Committee on Health Care for Underserved Women and a professor in the Department of Ob-Gyn at the University of New Mexico’s School of Medicine, says the NuvaRing settlement hasn’t changed how she counsels her patients. “It’s always tragic and horrible when a woman has a bad outcome or dies from a blood clot. But to then label that method as dangerous often translates into more unintended pregnancies with a higher risk than using the method,” says Dr. Espey. Though popular for its convenience, the NuvaRing isn’t the most effective form of birth control out there. And neither is the pill. The intrauterine device (IUD) and the implant are considered the two safest and most effective forms of birth control available, with a typical use failure rate of 0.8% and 0.05% respectively.

When asked if women currently using NuvaRing should talk to their doctors about other options, Dr. Espey said, “How do you prepare for the event that’s so rare?”

But it’s making Sarah think twice. “I’m definitely concerned about the risks,” she says. “I am making an appointment with my gynecologist to discuss options.”

*Name has been changed for privacy.

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At last, science has spoken—it’s not all in your head. A landmark study from the University of Copenhagen—the largest of its kind—has confirmed what women around the world have quietly accepted for years: using hormonal contraceptives can increase your risk of depression and the chance that you will be prescribed antidepressants.

And the risk is substantial. The study tracked one million Danish women, aged 15 to 34, and revealed that taking the combined birth control pill (with estrogen and progestin, a steroid hormone) meant women were 23% more likely to deal with depression.

That number rises to 34% for women using progestin-only pills. While an IUD (intrauterine device) ups the risk to 40% and the vaginal ring, 60%. Importantly, these percentages only represent the women who actually sought out medication options for depression—chances are, the true numbers could be higher since they don’t take into account women relying on non-pharmaceutical treatments for mood irregularities.

When the news first broke, FLARE watched as many women breathed a collective sigh of relief on social media and shared their personal battles. So we spoke to four women about their experiences with The Pill and other hormonal birth control methods.

Karolina’s experience with The Pill

Karolina Rembeisa’s adverse reaction to two types of birth control pills led to an increase in anxiety, depression and newfound panic attacks. “First came the tightening of the throat, followed by an all-consuming fear, often about nothing specific. Colours were dulled and everything seemed to vibrate at a low frequency,” she says.

“I was unable to get out of bed for anything other than work. At that point, I realized I was depressed.”

The 24-year-old talked to her doctor and switched from Alesse to Ortho Tri-Cyclen. After three weeks, the symptoms returned—worse this time. “I felt hopeless and irritable to the point of rage. I began to consider suicide.”

Rembeisa doesn’t believe birth control was the sole cause of her depression and anxiety, but found that the disturbance of hormonal levels it triggered seriously amplified any mood disorders she had.

Reilly’s experience with the Nuvaring

For Reilly Stephens, 25, her mood took a sharp turn after she went on the Nuvaring. She felt unusually tired and foggy—and extra irritable prior to her period. Two months in, she hit her lowest point. “I lay in bed with the lights off for two days. I remember calling my Mom and telling her something strange was happening,” Stephens recalls.

“I couldn’t remember what it felt like to be happy. I felt completely out of control.”

Since discontinuing the Nuvaring, Stephens is back to her normal self, but she admits the incident was scarring, and she’s apprehensive about other birth control options. “When I Googled ‘depression and Nuvaring,’ my heart sank. I had done research prior to starting and only saw some mixed reviews—nothing that would have prepared me for what I experienced.”

Jacyln’s experience with a hormonal IUD

Jaclyn (who asked us not to include her last name), 24, had never struggled with serious mood changes before using the hormonal IUD, which she had removed via hysteroscopy this year.

“My two years on the hormonal IUD were awful. It made me sluggish and anxious. I started feeling panicked, out of breath and had trouble sleeping,” she says. “As my symptoms worsened, it was apparent my IUD could be the cause. I was gaining weight and growing hair in weird areas, and my sex drive went down.”

Four months after the removal, Jaclyn feels much better both physically and mentally. She and her boyfriend agreed that condoms are the best option for now.

“I just want to give my body a break,” she says.

Victoria’s experience with the combined birth control pill

Victoria (who also asked us to withhold her last name), 25, had waited four months to see a gynaecologist for a hormone-free copper IUD prescription—only to be told she’d have to wait another two months to get the procedure to insert it. In immediate need of reliable contraception, she was prescribed her third brand of the combined pill: Diane-35.

During her two years on Diane-35, Victoria suffered extreme mood swings, anxiety and depression.

Now that she’s stopped taking hormonal contraceptives, Victoria’s energy has improved and her moods are consistent. She’s relieved that studies like this are gaining traction. “Before this, it was difficult to blame my mental health fluctuations on the pill—a form of birth control I was told was the ‘best’ for over 10 years,” she says.

Her frustrations with birth control echo the shared experiences of way too many women. “The biggest disappointment has been hearing the consensus that the pill was totally harmless. Why wouldn’t I take it? Shouldn’t I be responsible? But I’ve learned that hormones do have a huge impact on my body.”

So, how do you find the best option for you?

After reviewing the results, the study’s senior author, and gynaecologist at the University of Copenhagen, Professor Øjvind Lidegaard says he now encourages women to consider alternatives like condoms or the copper IUD if they are concerned about the effects of hormones, especially if they are predisposed to depression or have previously battled with it.

But accessibility to the copper IUD can be surprisingly difficult, so girls often settle for quicker, more readily available contraceptives. And many doctors still recommend using the combined birth control pill, since it has a much lower risk of depression than progestin-only products.

Dr. Simone Vigod, a psychiatrist and scientist at Women’s College Hospital who leads the Reproductive Life Stages Program, advises women to stay connected with their doctor and constantly monitor their symptoms.

When asked about when women should consider switching birth control methods, Vigod say it ultimately depends on the severity of your symptoms. Uncharacteristic irritability is another sign to watch out for—it appears in most hormonally-related mood disorders.

“If you’re having serious symptoms after two weeks, you should just stop and tell your doctor,” says Vigod. “If you go through one cycle and have mild signs, try waiting for another . If after two or three cycles you’re still having difficulty, that’s a red flag.”

And when it comes to telling the difference between “the blues” and capital-d depression, Vigod suggests monitoring the persistence and degree of your moods, and checking in with a two-question screening tool:

  • “Have you felt down or sad more days than not for the past couple weeks?
  • Have you been less interested in the things that normally interest you?”

If the answer is yes to both, you should consider seeking help.

Vigod also stresses that it’s possible to have a negative reaction literally any time you put medication in your body. For most people, hormonal birth control offers huge success rates. But not all contraceptives are one-size-fits-all options.

The key to finding the best option is doing your research, following up with your doctor and regularly checking in with yourself on your mental health. It helps to talk about it, too. The study got the conversation started—it’s our job to keep it going. The more women open up and share, the more we can learn.

Related:
Should You Get the HPV Vaccine Even If You’re “Old”?
Are You Playing Sexual Roulette?
When Should My Guy and I Talk “Numbers”?

In This Section

  • Birth Control Ring
  • How effective is the ring?
  • How safe is the ring?
  • How do I use the ring?
  • How do I get the ring?
  • What are the benefits of the ring?
  • What are the disadvantages of the ring?

Remembering to put a new ring in on time might be hard. And some people get side effects that bother them (but they usually go away in a few months).

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Want the ring?

Find a Health Center A right arrow in a circle

You have to change NuvaRing on time.

It’s really important to always put your new rings in on time, or you might not be protected from pregnancy. Using our birth control app, setting a reminder, or marking your calendar can help you stay on schedule.

If you have a really busy life and think you won’t stay on top of your ring schedule, check out other birth control methods like IUDs or the implant that are super low-maintenance and almost impossible to mess up. Take our quiz to help you find the birth control method that’s best for you.

There can be negative side effects.

Like with all medicines, there can be NuvaRing side effects. But most usually go away after 2 or 3 months. Many people use the ring with no problems at all. You can keep track of any side effects with our app.

The hormones in the ring can change your level of sexual desire. You may also notice spotting or bleeding between periods, sore breasts, nausea, or headaches. These side effects usually go away after 2 or 3 months, and they don’t happen to everyone who uses the ring. You may also have a little extra vaginal wetness when using the ring.

Birth control shouldn’t make you feel sick or uncomfortable. Luckily, there are many different types of birth control, so you’ve got options. If you keep having side effects that bother you after using NuvaRing for 3 months, talk with your nurse or doctor about trying another birth control method. But don’t stop using the ring without starting a new method if you can, or you won’t be protected from pregnancy.

Some NuvaRing side effects are serious.

Serious problems from using the ring are very rare. People using birth control that has estrogen, like the NuvaRing, have a slightly higher chance of having a few rare but dangerous problems than people who don’t use birth control with hormones.

For more information about side effects, talk with your nurse or doctor or read the package insert that came with your NuvaRing.

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More Women Are Seeking Side-Effect Free Forms of Family Planning

If you follow women’s health, you may have noticed a trend in the past few years when it comes to the most highly-prescribed contraceptives. Some women are starting to ditch pharmaceutical birth control due to undesirable side effects. In a 2018 Cosmo survey, 70% of young women said they’d either stopped taking the Pill or had considered doing so in the past three years.

The Cut published this headline, “Yes, Your Birth-Control Pills Really Might Be Making You Feel Awful, Study Says.” For years, studies have been documenting a connection between birth control and increased depression, lowered libido, and migraines. But for a long time, these studies haven’t been heard over the din of the latest birth-control advertisements. Perhaps as a result, we are finally starting to hear women sharing their own experiences publicly.

As a woman named Gena Steffens shared at Huffington Post last year, “Going Off Birth Control Cured My Depression And Gave Me Back My Sex Drive.” Steffens explained, “like a lot of women, I was put on birth control pills shortly after starting my period. If you had asked me at any point in the past, I would have told you I had never experienced an adverse side effect from my birth control.” But only after stopping the drug did Steffens realize how long she put up with the undesirable side effects, which, at the time, she didn’t know were due to the Pill. “I struggled with depression, mood swings, and a truly lackluster sex drive for years,” she said. “The notion that these conditions are ‘normal’ for women is reinforced so constantly in our society that I simply accepted that I was naturally a slightly sad, sexless lady.”

As another woman shared at Huffington Post, “I started taking birth control pills in January 2011. By May of that year, my doctor discovered that a blood clot had developed in my right leg and spread to my lungs.” In 2014, Vanity Fair covered the story of athlete Megan Henry who almost died of blood clots due to the NuvaRing.

In 2017, journalist Sabrina Debusquat published the results of a survey of 3,616 French women who chose to stop taking the Pill. She found that the majority of women had stopped at least one time due to “minor but problematic side-effects,” including loss of libido, weight gain, and mood disorders. What’s telling is that after dropping the Pill, 71.5% of the respondents said they experienced positive effects, including improved libido, feeling reconnected to herself and her body, fewer mood swings, depression or unexplained anxiety, weight loss, and more energy.

The side effects of birth control can be devastating. This year, a systematic review of research revealed that as many as 300 to 400 U.S. women die of blood clots due to their birth control choice. And there are new studies linking birth control use to depression and suicide, and autoimmune diseases, such as Lupus, Crohn’s Disease, and Multiple Sclerosis (MS). For 16 years, the permanent birth-control device Essure caused side effects ranging from headaches and back pain to perforated fallopian tubes for many women before the FDA announced new informed-consent requirements for the drug, and Bayer took it off the market just this past year. And this isn’t the first time women weren’t fully informed of the risks of hormonal birth control.

Pharmaceutical companies have tried to create different birth control methods that minimize symptoms and side effects, such as the hormone-free copper IUD (ParaGard). But the side effects women report about the IUD can be just as bad and less subtle than those of oral contraceptives. As one woman shared at The Everygirl, “I handle pain extremely well, but it was the worst pain I’ve ever felt in my life… I returned to work still trembling from the pain. The next 12 months were awful.” That’s a long time to endure painful side effects.

It’s Not Just Women’s Health

Hormonal birth control may also affect women’s relationships. Some research has shown that the artificial hormones in the Pill may influence mutual attraction, altering the qualities that a woman uses in picking a mate, as well as how men perceive their partner’s attractiveness.

Additionally, when formerly birth-control-using women seek to start a family, many encounter challenges to getting pregnant that can be emotionally straining, both personally and for the relationship. Unfortunately, since hormonal birth control depletes women of many nutrients and natural hormones that facilitate pregnancy, many women have a hard time trying to conceive later in life or carrying a pregnancy to term. Another study found an increased risk of miscarriage among some women due to reduced levels of progesterone—an essential hormone for conception that the Pill suppresses.

Another reason some women have trouble conceiving after getting off hormonal contraceptives is due to undetected fertility issues beforehand, the symptoms of which can be covered up by the artificial hormones and simulated monthly period that comes like clockwork with the Pill.

Serving Women’s Family Planning and Health Needs Without the Risks

One reason some women suffer years of side effects from artificial birth control is because they have “not felt heard” when they mention the problems they are experiencing to their doctors. Others may not have been informed about the side effects at all.

As a result, many women who are fed up with hormonal birth control’s side effects are researching more natural methods of pregnancy prevention on their own. Some rely on charting apps that predict when they are fertile, but there are more medically-supported, natural options available, specifically Fertility Awareness-Based Methods (FABM). These methods include the Sympto-Thermal Method, for example, which boasts an effectiveness rate of pregnancy prevention that exceeds the effectiveness of the Pill. (To ensure the greatest efficacy, users of FABM should be taught by a certified FABM instructor.)

In addition to pregnancy prevention, FABM, also known as evidence-based forms of Natural Family Planning (NFP), equip couples to seek pregnancy with greater effectiveness than without. Not only does knowledge about her fertility during her monthly cycle equip a woman to seek pregnancy with greater likelihood, but charting can also help a woman identify health conditions that could be inhibiting her fertility.

This is another reason some OBGYNs are turning to natural family planning methods as a safer form of birth control to offer their patients. As one OBGYN, Dr. Summer Holmes Mason, recently shared at Natural Womanhood, “Prescribing contraception was bread and butter gynecology for me. It was probably one of the largest tools I had in my arsenal as an OBGYN to treat medical issues.” But after a couple of years, Dr. Holmes Mason noticed a disturbing trend. “I realized people were coming back to me with more side effects than I thought was acceptable,” she explained.

Now, she offers natural family planning options in addition to other forms of birth control, and she feels better equipped to serve her patients’ health. “I really try to utilize the informed consent process,” she said. “I feel like my patients will know what they are getting into if they are getting hormonal contraceptives, and I let them make that choice for themselves . . . for those people who don’t want to, after having that discussion, I have so much more to offer.”

It’s about time more in the medical community followed suit. Now that we are beginning to hear from more women who are fed up with artificial birth control, there’s more than enough demand.

Mary Rose Somarriba is the editor of Natural Womanhood and an associate editor of Verily magazine.

Editor’s note: This article was updated on 5/4/19.

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