Nuvaring And Missed Menstrual Period

Dear Ask The Doctor: I am currently on Nuvaring the vaginal birth control ring. I have been on it for almost a year now, and have loved it up until now. I usually leave the ring in for 3 weeks and then remove it for a week my period comes the next following two days after. Or even sooner. This time it has been four days since I took out the ring and still no period. Could I be pregnant or is this typical with this birth contr ?? I've been having cramps as if I was going to start but it hasn't come yet.

Dear Haylee: If you miss a menstrual period you must consider the possibility that you are pregnant, especially if:

• You miss a period and NuvaRing was out for more than 3 hours during the 3 weeks of ring use
• You miss a period and waited longer than 1 week to insert a new ring
• You have followed the instructions and you miss 2 periods in a row
• You have left NuvaRing in place for longer than 4 weeks