NuvaRing and Breast/Arm Pain: A Patient's Experience & Concerns

Question
So, i've been on birth control pills before & never had any side affects. Then a month ago [sept.12] i got put on the Nuvaring. Well the first week i was on it i expierienced some really bad chest and arm pain so i took it out. I had it out all night. [7 hours] then i put it back in the next morning just thinking that it may be the side effects. well now i have 2 days until i'm supposed to take the ring out & i have been having VERY MiLD cramps [ i usually have cramps before a period but they are usually pretty severe] My gyno told me that i may have breakthrough bleeding before i'm supposed to take the ring out. Well no bleeding. Then i also have been VERY sick everyday, it usually subsides when i eat but then gets bad again afterwards. I also have been having pretty bad breast tenderness. I was just wondering what the possibility is that i am pregnant. I have been having unpretected sex since about the 2nd or 3rd week of my nuvaring & everyday. My boyfriend & i are pretty conserned. Please help! Thanks, Kayla

Answer
Dear Kayla,

If the Nuvaring has been out of the vagina for more than three continuous hours during the 1st or 2nd week of use, contraceptive effectiveness may be reduced. In this situation, the ring should be reinserted as soon as possible and use an extra method of birth control, such as male condoms and/or spermicide, until the ring has been used continuously for seven days. If you did not use a back up method, you may have been susceptible to pregnancy.

The most common side effects with Nuvaring use are: vaginitis, headache, upper respiratory tract infection, vaginal secretion, sinusitis, weight gain, and nausea. Other side effects that are common to combination hormonal contraceptives in general are:
-Nausea
-Change in weight
-Vomiting (increase or decrease)
-Gastrointestinal symptoms (such as abdominal cramps and bloating)
-Change in cervical erosion and secretion
-Breakthrough bleeding
-Diminution in lactation when given
-Spotting immediately postpartum
-Change in menstrual flow
-Cholestatic jaundice
-Amenorrhea
-Migraine
-Temporary infertility after discontinuation of treatment
-Rash (allergic)
-Mental depression
-Edema
-Reduced tolerance to carbohydrates
-Melasma which may persist
-Vaginal candidiasis
-Breast changes: tenderness, enlargement, secretion
-Change in corneal curvature (steepening)
-Intolerance to contact lenses

So - the symptoms you describe may very well be related to the new use of the Nuvaring. You will need to wait and see if you get a regular period that is normal for you. If you do not get a regular period during the "off" week or if it is spotty or much lighter than normal, you should wait until the last day of that week and test for pregnancy. Make sure when you test that you use 1st morning urine to get a concentrated sample for the most accurate results.

I hope this information has helped you and answered your question. I wish you well.

Brenda