Is it normal to spot with a NuvaRing?

Dear Reader, 

It seems like you’re in a spotty situation. Spotting brown discharge can be common when skipping your period or starting the vaginal ring. That said, it may be helpful to discuss your symptoms with a health care provider to understand why your spotting has gotten heavier. Ongoing spotting or heavy brown discharge might be a sign of an underlying health issue like an infection. Read on to learn more about vaginal rings, what spotting may indicate, and what to know about the potentially harmful effects of brown discharge.  

What is a vaginal ring and how does it work? 

The vaginal ring is a form of hormonal birth control that helps prevent pregnancy. It’s a flexible ring that you insert into the vagina. The ring works by slowly releasing two hormones—etonogestrel and ethinyl estradiol. These hormones work together to stop the ovaries from releasing an egg. Without an egg, sperm have nothing to fertilize, which means pregnancy likely won’t occur.  

You can wear a vaginal ring for between three and five weeks, followed by a seven-day break. During this break, people often experience bleeding given that the ring has been removed and the hormones are no longer present in the body. However, as you mentioned, you can also choose to skip your period altogether by simply popping in a new ring when you remove your old one. The way the ring works is essentially like pressing snooze on your menstrual cycle.  

Is spotting common when using a vaginal ring? 

Spotting is light, unexpected bleeding outside of your regular period; it can also be referred to as breakthrough bleeding. During the first three months of using a vaginal ring, spotting is especially common as it’s often your body’s way of adjusting to fluctuating hormones. Breakthrough bleeding can happen with any form of birth control, including the pill, patch, or ring. You might also notice some spotting if you choose to skip your period by using the vaginal ring continuously. This type of bleeding is known as withdrawal bleeding since it happens during the hormone-free week of birth control. It’s different from a menstrual period since birth control keeps the uterine lining thin, and withdrawal bleeding is usually lighter than a regular menstrual period. Withdrawal bleeding typically replaces your usual period. It may be helpful to note that spotting typically settles down over time and doesn’t happen often unless there are hormonal changes.  

Is brown discharge a harmful sign?  

Brown discharge is usually just old blood that’s had a little extra time to oxidize. This means that it’s been exposed to oxygen, which turns the blood from red to brown. Brown discharge is common and often appears at the beginning or end of your period when the flow is lighter. It can also happen when you’re starting a new form of birth control since hormonal changes can shift the way the uterine lining sheds.   

You also mentioned noticing more brown discharge when you run or stand up. This can happen because of gravity. When you’re sitting or lying down, blood can collect in the uterus. Then once you’re on the move again, your uterus might drop it like it’s clot. Gravity helps blood flow out more quickly, and sometimes all at once in a sudden gush. 

That said, while brown discharge can be normal, heavy brown discharge might be an indication of another health issue, such as infections, sexually transmitted infections (STIs), or other medical conditions. If you’re experiencing spotting over an extended period of time, consider speaking with a health care provider to figure out what your next steps are in understanding the cause and finding solutions, if necessary.  

Hope this puts a period at the end of your questions!