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NuvaRing & OrthoEvra

14 October, 2003

Question:

I remember reading a question on this site about OrthoEvra (hormonal contraceptive patch) and NuvaRing (hormonal contraceptive vaginal ring), but I can't find it now.

1 – The ring must be in place for 7 days before it is effective; therefore, it must be inserted no later than nightfall after a hefsek, meaning it will be in place during shiva neki'em. I believe (though I'm not certain) that it is medically preferable to leave it in place, but it can be rinsed and put back in after being out of the body for a short time without losing effectiveness. I have no idea whether doing so repeatedly (once or twice a day for a week) has a worse effect. Should the ring be removed to perform each bedikah of that week, or should it be left in place?

2 – Is the ring a chatzitzah for the purposes of mikvah immersion? If the answer is generally "no," under what circumstances would it have to be considered a chatzitzah?

3 – Can either of these methods be used to establish a veset kavua as with oral contraceptives?


Answer:

The ring is technically easier to remove and replace than the patch. Once you remove the patch, the glue sometimes does not work to stick it on again (and the contraceptive is in the glue) so you would have to use a new patch, thus adding to the cost. The patch does not interfere with bedikot. It, and all the glue, need to be removed prior to mikveh use.

In order to be effective contraception, the ring is inserted seven days after the removal of the previous ring, regardless of where in the cycle you are.

The ring should be removed prior to mikveh immersion as a potential chatzitzah. (If it is inadvertently left in for immersion, a halachic question should be asked.) The ring should be removed for the hefsek taharah. Some authorities, including our halachic supervisor Rav Yehuda Henkin, also recommend removing the ring in order to perform one bedikah each on days one and seven of the shivah neki'im.  The ring is rather mobile, so for other bedikot it can be removed or pushed to the side as you go around it. According to the manufacturer, the ring can be out for up to three hours without affecting efficacy. Therefore, removing it for the above purposes should not impair its efficacy.

Establishing a veset after taking off the patch or taking out the ring is halachically similar to establishing one after stopping the active pills in a package of oral contraceptive pills. There is a difference of opinion as to how to proceed in this case (see Hormonally controlled vestot). If to date you have counted your veset based on the interval from cessation of the pill, you can do the same after taking out the ring or taking off the patch. Thus, if you start your period every month at a consistent interval after cessation, then you can establish a veset kavua similar to that established by the cessation of the active pills of oral contraception.


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