Spotting on Nuvaring: Causes & What to Watch For

Question
I am a 26 yof who has been on birth control pills for approx 10 years now. Last year I switched to the Nuvaring and am currently still with that. My LMP start was May 19th and LMP end was May 24th. VERY regular with birth control. 28-29 day cycle. I had some spotting June 11th PM and June 12th AM. Spotting was less than 1/8 tspp probably. Only visible by wiping after I went to the bathroom. Once in the evening and then once in the morning. My nipples were VERY erect and very tender/painful for a few days. Concerned about pregnancy or my period was early so I took the ring out. Now, my period is one week late and two pregnancy tests show negative results. Took both tests with first morning urine. My breast soreness has gone away. Where is my period? Could I be pregnant? If I am, will the ring have any negative effects? Could this all be breakthrough bleeding? Implantation bleeding? Hormones? Please help; my Doc. not sufficiently answering my questions. And lastly, should I continue health habits as if I were pregnant?

Answer
If your last period started on May 19, then you were due for your next period on June 15. The spotting that you had on June 11, may have been your period. Remember, when you are hormonal contraception, you really do not get a regular period, but rather merely a "breakthrough bleeding" once a month. This spotting that you had on June 11 may have been the regular breakthrough bleeding (period). You were correct to take the pregnancy tests. If you took a pregnancy test a week after you should have gotten your period, and the test was negative, you are not pregnant. If you want a more accurate diagnosis, take two blood tests for pregnancy (Beta HCG) 48 hours apart. If there is a doubling of the results in 48 hours, it indicates a viable pregnancy. If there is a halving of the results in 48 hours, it indicates a miscarriage. If the value is less than 5 on both occasions, it means that you were never pregnant. You probably merely had some hormonal imbalance this month. By the way, if you did become pregnant, the Nuvaring would not harm the pregnancy or the fetus as long as you remove it prior to the second trimester of pregnancy. That also goes for people who use the pill or the patch.