Er ... should it be in, or out?
April 24, 2014 9:59 AM   Subscribe

Got off-cycle with my birth control (NuvaRing) & now period weirdness has ensued, and I'm not sure whether to call the month a loss and just "start fresh" next month or ... what. More (kinda grody, sorry) details inside, because I don't want to be TMI on the front page.

I use the NuvaRing for birth control. Due to travel & some poor planning on my part, I was about 3 days late putting my last new ring in and thus had to "restart" my protection cycle (you can only have the ring out for 1 week before losing continuous protection). 4 days into the 7-day starting window with the new ring, my husband and I had sex. I took the ring out for comfort during sex, but we used a condom since we were still in the unprotected period, and all was well.

Shortly thereafter, I noticed some spotting during urination. This isn't unusual mid-month so I figured it would resolve itself, but it continued ... until *2 days later* when I noticed the ring *sitting in the shower* where I'd put it to clean off, augh. I'd completely forgotten to put it back in after sex! OK, so I figured I'd just have to restart (again) and put it back in.

However, in the 4 days since I reinserted, the "spotting" hasn't cleared up -- instead, it's basically become a full-flung period, even with the ring in. And the thing is that the discharge and blood is like ... really dark and brownish-black and gloppy. It looks like "old" period blood and clotting/uterine lining bits, not "fresh" period blood (sorry). (Usually it comes out kinda deep, dark red and isn't brown unless it's like the stuff that's dried on the pad (REALLY sorry, you guys).) And there's quite a lot of it, despite having just *had* a "regular" period on my non-BC week, about 1 week ago.

So I guess I'm sort of wondering: Why am I having a second period/why is there so much still in there to come out? Is this like ... old period discharge and lining that wasn't "allowed" to slough off previously because I normally would have the ring in and the hormones prevented it? (My period usually doesn't start until 3-4 days into my week "off", is a light-ish 2-3 days, and ends when I put a fresh ring in).

Also, uh ... what should I do now? Should I keep the ring in and just take it out when I would originally have done so (3 wks from first insertion) so that I'm matching my overall cycle routine?

Or should I take it out, let whatever's going on down there clear up, and reinsert (for the 3rd friggin' time)? If so ... when would I take it out? (Also I'm a little leery of doing this since AFAIK the rings are hormone-impregnated silicone and it's now been degrading/dispensing its batch for a week already. I wouldn't want it to have, like, run out of hormones to dispense by the time I finish. Whenever that is.)

Or ... take it out, toss it for the whole month, and then start fresh next month, like a clean slate? But even then, I'm still a little confused since my cycle seems off. You're supposed to start BC in the few days after a natural period ends. Do I need to wait until this, uh, encore period ends, and then wait until ANOTHER one comes & goes to restart?

Your thoughts & advice are appreciated...

Sorry, again, for that description of period blood.
posted by alleycat01 to Health & Fitness (10 answers total)
According to the info distributed with Nuvaring, it can only be out of the body for a maximum of three hours before it is no longer effective (first FAQ on that page). put the one that had been sitting in the shower for two days back in? After it had been out for two days? If I'm reading that right, then you wouldn't be protected, and honestly, if I were you, I would go to Planned Parenthood or your OB/Gyn and have them check things out just to be on the safe side re: unplanned pregnancy. I use Nuvaring too and this seems like a lot to sort out on your own especially when the stakes are high!
posted by stellaluna at 10:14 AM on April 24, 2014 [2 favorites]

You should call your GYN doc.
Also assume you have vetted nuvaring before using it. I read a disturbing article on it in vanity fair.
posted by kmr at 10:14 AM on April 24, 2014 [1 favorite]

I'd recommend checking in with your doctor's office (I am betting they have a nurse line you could call to talk to someone right away?) or your pharmacist. I've found my pharmacist to be really knowledgeable about birth control issues when I've had insurance problems that messed with getting my pill on time. Definitely ask someone medical - I think I'd have the same concern as you that it was just kinda sitting out in the air for days.

And just to commiserate, I've definitely had spotting that was basically a full-on period while on birth control - both during times I got off-schedule with the pills, and times I was just on something that was the wrong dose for me. From what I understand, it's not truly a period, but withdrawal bleeding because of the missing hormones. I wouldn't be worried about it, but again, good to check with a medical person to see what their recommendation is for starting up a new ring.
posted by augustimagination at 10:26 AM on April 24, 2014

The ring has to be stored refrigerated in order to remain effective. Sitting in the shower where it gets hot? It's out of hormones. You'll need a fresh ring, and it's probably a good idea to at least chat with your doctor or pharmacist.
posted by stoneweaver at 10:31 AM on April 24, 2014 [1 favorite]

First off, get that used old ring out of there. Not only is it not going to be effective (it needs to be refrigerated or inside you to work) it's really potentially dangerous to put it back in after it had been sitting in a damp, warm environment for that long.

Secondly, this month is definitely a loss, BC wise. Use condoms, call your pharmacist/gyn and ask what you should do next month. The answer will probably be start a new nuvaring cycle and proceed as usual.

Thirdly, if you have any (ANY) inkling that you might have an infection call your doctor. The bleeding you're experiencing sounds like hormonal withdrawal bleeding but better safe than sorry.
posted by lydhre at 10:38 AM on April 24, 2014

I would also be leery of the ring that was left in the shower for two days being fully effective for the whole cycle as you mention, and definitely would assume it would only be effective until the regular four week after you ORIGINALLY inserted it (prior to the two-day shower stall vacation)...and I wouldn't even really be confident about that. NuvaRings degrade faster with higher temps (like a hot shower), so it might be useless at this point.

I have also had the dark thicker spotting with the NuvaRing. It usually happens if I get off schedule or use it to skip my period for 2-3 months in a row (this is Dr. approved but the spotting is more common when I skip.)

As far as when to insert the new ring: I would mostly be concerned with causing my body the least amount of hormone rollercoastering possible, so I would give a medical professional a call for their opinion concerning insert a new ring now or go ring-free until you get a period and then do a new ring.

Definitely continue using condoms until you've been on a new ring for 7 days.
posted by dahliachewswell at 10:43 AM on April 24, 2014

Secondly, this month is definitely a loss, BC wise. Use condoms, call your pharmacist/gyn and ask what you should do next month.

There's no need to wait until next month to start a fresh ring. Your monthly cycle on hormonal birth control is completely artificial and there's no need to align yourself to it.

As far as interpreting the color/thickness of your vaginal discharge, that way lies madness. It's about as useful as reading tea leaves.

I know that Nuvaring is billed as the "set it and forget it" birth control option for the more forgetful among us, but I think you might benefit from a birth control method with even sturdier training wheels, ie an IUD. Talk to your gynecologist.
posted by telegraph at 10:46 AM on April 24, 2014

Just to qualify my above comment about the tea leaves, I only mean in this particular case. Obviously fertility awareness and charting and all of that good stuff is useful. But in this case, don't drive yourself crazy worrying about why your blood is darker/thicker/whateverer.
posted by telegraph at 10:48 AM on April 24, 2014

Thanks, you guys. Your advice & experience was very useful & clarifying.

I'm a little ashamed I didn't recheck my knowledge about the NR -- FWIW I've been on it for almost 5 years and this is the first time such a timing F-up has happened. My gyn told me when I first started that I had to reinsert the ring w/in 3 hours of removing it (during the "on" time) for pregnancy protection to continue uninterrupted, not that after 3 hours the ring became useless, so I should have checked the NR site to see if that was still the most up to date info.

Fortunately we haven't had condomless sex since then so pregnancy is not a issue but I'll definitely get rid of this one stat, consider the month a wash, and check with my gyn about when to start afresh. I too am concerned with minimizing hormonal rollercoastering so I suspect I'll just want to wait for my next natural period in any case.

Thanks also for the reality check about the, uh, color and texture of the discharge. The green is always helpful.
posted by alleycat01 at 11:01 AM on April 24, 2014

I suspect I'll just want to wait for my next natural period in any case.

Just to clarify: you won't get a "natural" period unless you've ovulated, which you may not do any time soon, regardless of how long the ring was out. You could have withdrawal bleeding/spotting for a few days or for several weeks - it's kind of a crapshoot. As others have said, your artificial, hormonally-induced period has nothing to do with a natural/normal period. You don't need to wait until next month to insert a new ring. Call your GP for clarification, but you can likely insert a new ring right away.
posted by pecanpies at 11:54 AM on April 24, 2014

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