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

Most common
Vaginitis (up to 13.8%)
Headache/migraine (up to 11.2%)
Mood changes (up to 6.4%)
Device-related (up to 6.3%)

Depo-Provera

Most common
Menstrual irregularities (up to 57%)
Weight gain >10 lb (up to 38%)
Headache (up to 17%)
Abdominal pain (up to 11%)

NuvaRing vs. Depo-Provera Dosage

NuvaRing

Dosage
Dosage Table
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

Dosage
Dosage Table
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

Common Symptoms and Related Diseases You Can Explore

Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.