title: The combined vaginal contraceptive ring, nuvaring, and cerebral venous sinus thrombosis: a case report and review of the literature.
abstract: BACKGROUND
  Combined oral contraceptives are known to confer a risk of venous thromboembolism, including cerebral venous sinus thrombosis (CVST), to otherwise healthy women. NuvaRing (Organon USA, Inc., Roseland, NJ) is a contraceptive vaginal ring that delivers 120 μg of etonogestrel and 15 μg of ethinyl estradiol per day. Its use has been associated with rare venous thromboembolic events, but few cases of CVST associated with NuvaRing have been reported.
  
  
  OBJECTIVE
  To describe a case that illustrates the increased risk of CVST associated with use of NuvaRing. We describe the case of a NuvaRing user who presented to our emergency department with a headache, who was diagnosed with CVST.
  
  
  CONCLUSIONS
  Evidence suggests that NuvaRing has at least as much prothrombotic potential as combined oral contraceptives. Thus, emergency physicians should suspect serious venous thromboembolic events, including CVST, deep venous thrombosis, and pulmonary embolism, in NuvaRing users in the proper clinical setting.
authors.affiliation: William Beaumont Hospital, Royal Oak, MI, USA.
authors.forename: Christian
authors.initials: C
authors.lastname: Kolacki
authors.forename: Vito
authors.initials: V
authors.lastname: Rocco
mesh_terms: D000328:Adult; D003271:Contraceptive Agents, Female / Q000009:adverse effects*; D003274:Contraceptive Devices, Female / Q000009:adverse effects*; D017135:Desogestrel; D004967:Estrogens / Q000009:adverse effects*; D004997:Ethinyl Estradiol; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects; D012851:Sinus Thrombosis, Intracranial / Q000139:chemically induced*; D014057:Tomography, X-Ray Computed
chemical_list: D003271:Contraceptive Agents, Female; D004967:Estrogens; C044815:etonogestrel; D004997:Ethinyl Estradiol; D017135:Desogestrel