“Why do I feel like my lower abdomen is swollen or my bladder is?”

You may need to follow up make sure uti not back

What you’re not being told by your Gynecologist is that despite being on a Nuvaring, your body still makes a small amount of its own baseline levels of female hormone that your Nuvaring will override. In addition, the longer you are on Nuvaring, the longer your body only makes a small and thin amount of lining inside the uterus that you may not completely bleed out with each cycle. Old brown blood is internal bleeding that takes a little time for your uterus to pass, that’s why it’s brown. That may be coming from bleeding from a very thin surface of lining inside the uterus and that lining doesn’t protect the muscle of the uterus well, so it’s like bleeding after a rug burn, or bleeding from the purely muscular inside surface of the uterus, sometimes assoc with cramps but many times no cramping is involved. The job of the artificial progesterone or progestin is to NOT build a thick lining so that you don’t bleed a lot; that has good and not so good implications over time. Sometimes what I recommend is to switch from the Nuvaring to a birth control pill for a month or so to give your uterus a different exposure from both the artificial estrogen and progesterone that are in the Nuvaring to the artificial estrogen and progesterone that in a birth control pill. I usually choose an Ortho Novum birth control pill or a 35mcg dose due to both of their artificial hormones seem to be the best tolerated by the largest number of women. This shows your uterus a little higher amount of hormone to build a little more lining that yes, you will have to bleed out. However, that little more lining will then act to stabilize the inside of your uterus and after a 1month, 2month or even 3month ‘vacation’, then switch back to your Nuvaring. You don’t lose any contraception as you are continuing a birth control pill but you have to remember to take it every day. The alternative is to stop the Nuvaring and let your body come back with its own natural hormones but then you are not covered by any contraception and you cannot trust the 1st month that you are back on the Nuvaring.

You may have interstitial cystitis and/or colitis. See a provider and check it out!

Sincerely,

Dr. Janice Alexander, RN, MD

She could have endometriosis. Need to be evaluated by a gynecologist.

Naheed Akhter