Annovera (segesterone acetate/ethinyl estradiol) is a brand-name vaginal ring that’s prescribed as birth control in adults and adolescents. As with other drugs, Annovera can cause side effects, such as headache, nausea, and high blood pressure.

Annovera has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “Side effect specifics” section.

Annovera can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Annovera in clinical trials:

* For more information about this side effect, see “Side effect specifics.”

Mild side effects can occur with Annovera use. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Annovera’s prescribing information.

Mild side effects that have been reported with Annovera include:

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the FDA approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking Annovera and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Side effect specifics.”

Annovera may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Annovera’s prescribing information.

If you develop serious side effects while taking Annovera, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

  • toxic shock syndrome (TSS), which may include symptoms such as:
    • muscle aches
    • high fever
    • feeling dizzy or faint
    • vomiting
    • skin rash that looks like a sunburn
  • liver problems, including liver tumors, which may have symptoms such as:
    • jaundice (yellowing of the skin or whites of the eyes)
    • dark-colored urine
    • weakness or tiredness
  • increased levels of sugar in your blood, which may include symptoms such as:
    • urinating more often than usual
    • feeling unusually tired
    • excessive thirst
    • blurred vision
  • increase level of fats (cholesterol and triglycerides) in your blood
  • high blood pressure
  • risk of serious cardiovascular problems*

* For more information about this side effect, see “Side effect specifics.”

ALLERGIC REACTION

For some people, Annovera vaginal ring can cause an allergic reaction.

In general, symptoms of allergic reactions can be mild or serious.

Ways to manage

For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.

For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Annovera, your doctor may recommend taking a different medication instead.

Annovera may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Does Annovera cause weight gain?

It’s unlikely. Weight gain was not reported as a side effect of Annovera in the drug’s clinical trials.

Most hormonal birth control methods have not been shown to cause weight gain. However, some people may experience bloating in the first few months of using birth control, which can make it feel like you’ve gained weight. This typically will go away as your body gets used to the drug.

Talk with your doctor or pharmacist if you have concerns about weight management while using Annovera or any other form of birth control.

How long do the side effects of Annovera last?

Most side effects of Annovera are mild and go away within a few days to weeks as your body gets used to the medication. Examples of these include nausea, headaches, or abdominal pain.

Sometimes, side effects can last for months or not go away. You may experience changes in your period, such as spotting between periods, especially during the first month of use. Annovera can also cause serious side effects, such as a heart attack or stroke, that could lead to long-term treatment or recovery times. (To learn more, see “Side effect specifics” below.)

If you have side effects that are bothersome or don’t go away, talk with your doctor or pharmacist. You should contact your doctor right away if you develop symptoms of a severe side effect while using Annovera.

How do the side effects of Annovera compare to NuvaRing?

Both Annovera and NuvaRing are combined hormonal contraceptives and have similar side effects. Common side effects of both drugs may include headache, nausea, breast tenderness, and irregular bleeding.

Annovera and NuvaRing also have the same boxed warning about the risk of serious cardiovascular disease and cigarette smoking. (See “Side effect specifics” for more information.)

Talk with your doctor or pharmacist if you have questions about the side effects of Annovera or NuvaRing and how they compare.

Learn more about some of the side effects that Annovera may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Annovera.

Risk of serious cardiovascular problems

This drug has a boxed warning for the risk of cigarette smoking and serious cardiovascular events. This is a serious warning from the FDA. A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Studies have shown that people who smoke cigarettes while using a combined hormonal contraceptive, including Annovera, may have an increased risk of serious cardiovascular events. However, these cardiovascular events, such as blood clots, heart attacks, and stroke, were rare.

Symptoms of a blood clot may include:

  • sudden shortness of breath
  • chest pain, which may be more severe while breathing deeply
  • swelling, pain, or a feeling of warmth in the affected limb
  • skin redness or discoloration

Symptoms of a heart attack may include:

  • chest pain that may spread to the neck, arms, or back
  • the feeling of pressure, squeezing, or tightness in the chest
  • shortness of breath
  • feeling dizzy or lightheaded

Symptoms of a stroke may include:

  • sudden severe headache
  • weakness or numbness in an arm or leg
  • vision problems in one or both eyes
  • difficulty walking, including lack of coordination or dizziness

What you can do

This risk of serious cardiovascular events is higher in people over 35 years of age, smokers, or those who have high blood pressure, diabetes, lipid disorders, or obesity. This risk increases with age and the number of cigarettes smoked.

Talk with your doctor about your risk factors before deciding if Annovera is right for you. Due to these risks, if you’re older than 35 years of age and smoke cigarettes, your doctor will likely recommend other birth control options for you.

Irregular periods

Some people may experience spotting or breakthrough bleeding (bleeding at a time other than their usual period) while using Annovera. This was a common side effect reported in Annovera’s clinical trials. It’s also possible that you experience heavier bleeding than usual, have a period less frequently than usual, or have no period at all. While breakthrough bleeding can occur at any time while using Annovera, it’s most likely to occur during the first month of use.

What you can do

Typically, these changes in your periods are not harmful. Any irregular bleeding you experience will usually resolve within a few months as you continue using Annovera. If you’re concerned about bleeding or are still experiencing breakthrough bleeding or other irregularities after a few months of using Annovera, talk with your doctor. They may recommend switching to a different birth control medication.

Below is important information you should consider before taking Annovera.

Annovera has a boxed warning. A boxed warning is the most serious warning from the FDA. For details, see the “Side effect specifics” section.

Other precautions

Before taking Annovera, discuss your health history with your doctor. Annovera may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

  • depression
  • high blood pressure
  • history of heart problems, such as a heart attack or stroke
  • history of blood clots
  • lipid disorder (high cholesterol or triglycerides)
  • chloasma (hyperpigmentation of the skin)
  • gallbladder disease
  • abnormal vaginal bleeding
  • history of a hormone sensitive cancer, such as breast cancer
  • liver problems, including liver tumors
  • migraine headaches
  • smoking cigarettes
  • an upcoming surgery
  • previous allergic reaction to this or a similar drug
  • pregnancy
  • breastfeeding

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.