NuvaRing vs. Depo-Provera
See how NuvaRing and Depo-Provera compare on approved uses, dosing, side effects, and cost.
Key Takeaways
NuvaRing is a monthly vaginal ring containing estrogen and progestin, while Depo-Provera is a progestin-only injection given every three months.
NuvaRing carries cardiovascular and clotting warnings tied to its estrogen content, while Depo-Provera carries a boxed warning for bone density loss with long-term use.
NuvaRing requires monthly insertion and removal, while Depo-Provera only needs a clinic visit every three months but can delay the return of fertility after stopping.
NuvaRing vs. Depo-Provera Drug Summary
NuvaRing
NuvaRing is a combination hormonal contraceptive containing both estrogen and progestin, delivered through a flexible vaginal ring. It stays in place for three weeks, is removed for a week to allow a period, and is replaced with a new ring the next month. It is FDA-approved solely to prevent pregnancy.
Depo-Provera
Depo-Provera is a progestin-only contraceptive given as an intramuscular injection every three months. It contains no estrogen, which makes it an option for people who cannot take estrogen-based birth control. Like NuvaRing, it is FDA-approved only for pregnancy prevention.
NuvaRing vs. Depo-Provera Side Effects
NuvaRing
Depo-Provera
NuvaRing vs. Depo-Provera Dosage
NuvaRing
Depo-Provera
| STAGE | DOSE | WHEN |
| Starting dose | 1 ring vaginally | Weeks 1-3 |
| Maximum dose | ring-free interval | Week 4 |
| Dose changes | 1 increase | Every 3 weeks |
| STAGE | DOSE | WHEN |
| Starting dose | 150 mg every 3 months | At the start |
| Maximum dose | 150 mg every 3 months | Same as starting |
| Dose changes | None | Fixed dose |
NuvaRing
| STAGE | DOSE | WHEN |
| Starting dose | 1 ring vaginally | Weeks 1-3 |
| Maximum dose | ring-free interval | Week 4 |
| Dose changes | 1 increase | Every 3 weeks |
Depo-Provera
| STAGE | DOSE | WHEN |
| Starting dose | 150 mg every 3 months | At the start |
| Maximum dose | 150 mg every 3 months | Same as starting |
| Dose changes | None | Fixed dose |
NuvaRing vs. Depo-Provera Indications
NuvaRing
NuvaRing is approved only for preventing pregnancy in women who choose it as their birth control method. It is not approved for emergency contraception and carries added cardiovascular risk warnings for women over 35 who smoke. Because it contains estrogen, it is not appropriate for everyone.
Prevents pregnancy as a combined hormonal contraceptive
Inserted vaginally once a month
Not approved for emergency contraception
Not recommended for women over 35 who smoke
Depo-Provera
Depo-Provera is approved only for preventing pregnancy through a progestin-only injection given every three months. It is not recommended as a long-term method beyond two years unless other options are inadequate, due to bone density loss risk. Because it lacks estrogen, it can be used by many people who cannot take combined hormonal contraceptives.
Prevents pregnancy as a progestin-only contraceptive
Given as an injection every three months
Not approved for use as emergency contraception
Not recommended for continuous use beyond two years
NuvaRing vs. Depo-Provera Pros and Cons
NuvaRing
NuvaRing combines estrogen and progestin in a monthly vaginal ring, which tends to give more predictable bleeding patterns for many users. Its estrogen content brings added cardiovascular and clotting risks, particularly for smokers over 35. List prices for NuvaRing also tend to run higher than Depo-Provera on a monthly basis.
Pros
No injection needed, self-inserted vaginal ring
Monthly dosing gives more control over timing than an injection
Often produces more predictable bleeding patterns
Fertility typically returns quickly after stopping
Cons
Contains estrogen, carries VTE and cardiovascular risk warnings
Not for women over 35 who smoke
Requires monthly insertion and removal, with risk of user error
Roughly $200 to $584 per month before insurance, higher than Depo-Provera
Depo-Provera
Depo-Provera is a progestin-only injection given every three months, which avoids estrogen-related cardiovascular risks entirely. Its main tradeoff is a boxed warning for bone density loss with prolonged use, along with very common menstrual irregularities. At list price, it is generally less expensive per month than NuvaRing.
Pros
Contains no estrogen, an option for those who can't take it
Only requires dosing every three months
Long track record, contraceptive approval since 1992
Roughly $20 to $45 per month equivalent, lower than NuvaRing
Cons
Boxed warning for bone density loss with prolonged use
Not recommended for use longer than two years unless necessary
Menstrual irregularities are very common, over half of users at 12 months
Fertility return can be delayed for months after stopping
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