NuvaRing is a contraceptive vaginal ring. NuvaRing is one of the most effective and user-friendly female birth control methods on the market.
This article answers common questions about NuvaRing. It provides key information to consider if you’re thinking about using this birth control method.
Below is all you need to know about NuvaRing, including how it works, how to wear it, and more.
NuvaRing is a lightweight and flexible vaginal ring containing 0.015 milligrams (mg) ethinyl estradiol and 0.12 mg etonogestrel per 24 hours. These are derived from progestin and estrogen respectively.
Unlike the contraceptive pill, which you have to take daily at the same time for optimal effectiveness, you only need to insert a vaginal ring into your vagina once a month.
When used exactly as directed, NuvaRing is 99 percent effective in preventing pregnancy. However, it’s about 91 percent effective with typical use. The more closely you follow the instructions on the package, the more effective NuvaRing should be.
Research shows that supplying contraceptive hormones directly to the uterus
This is due to a slow release of the hormone over time and the higher hormonal absorption that comes with topical application. This also means that the administered dose can be lower.
For people who have irregular menstrual cycles or conditions such as endometriosis, a vaginal ring like NuvaRing may be a good fit because it can allow the doctor to customize the right hormone combination for them.
In addition, there may be a lower risk of bleeding disorders compared with progestin-only methods.
Using NuvaRing may also help prevent or reduce the risk of a variety of hormonal-related conditions such as:
- brittle bones
- breast or ovarian cysts
- anemia (iron deficiency)
- premenstrual syndrome (PMS)
- infections in the ovaries, fallopian tubes, or the uterus
- ectopic pregnancy
Other benefits include:
- applied once monthly instead of daily
- comfortable to wear
- does not interfere during sexual activity
NuvaRing contains synthetic (artificial) forms of the hormones estrogen and progesterone. These are the same types of hormones that birth control pills contain. These hormones help prevent pregnancy by:
- Preventing ovulation. Ovulation is when one of your ovaries releases an egg. If you don’t ovulate, sperm will not be able to fertilize an egg.
- Thickening your cervical mucus. Cervical mucus is a substance your body secretes near your cervix. Thick mucus makes it harder for sperm cells to swim through the vaginal canal. This means it would be difficult for sperm to reach an egg if your body released one.
- Changing your endometrium. The endometrium is the lining of your uterus. Changes to this lining make it harder for a fertilized egg to implant in it.
It’s important to note that NuvaRing only works to prevent pregnancy. It does not protect against sexually transmitted infections (STIs).
It’s very simple to insert and remove NuvaRing. Before you insert the ring, talk with your doctor about the best time in your monthly cycle to start using NuvaRing.
After you insert the NuvaRing, you keep it in for 3 weeks and then remove it for 1 week, which is when you’ll likely get your period. A week after you remove the ring, you insert a new ring and start the cycle again.
- Wash and dry your hands. Open the resealable NuvaRing pouch and remove the ring. Keep the pouch to dispose of your ring later.
- Fold the ring in half so that two sides of the ring are touching.
- Insert the ring as far as you can into your vagina. You may need to use your index finger to push it deeper into your vagina. Don’t worry, there’s no risk of losing the ring or pushing it in too far. It doesn’t have to be in a certain position to work, either.
- Relax. You’re done!
Some people can feel it, but most don’t feel NuvaRing if it’s inserted correctly. The ring will stay comfortably in your body and will not dissolve. You’ll remove it after 3 weeks and reinsert it again after another week.
- Find the resealable foil pouch that came with your NuvaRing.
- Wash and dry your hands.
- Gently insert your index finger into your vagina and hook it into the ring.
- Slowly pull the ring out of your vagina.
Caring for your NuvaRing
When you’re not using it, follow rules from NuvaRing to keep it effective when you’ll need it:
- Store your NuvaRing box at room temperature between 68°F and 77°F (20°C and 25°C) for up to 4 months.
- Keep the box away from direct sunlight.
- Discard if the expiration date has passed or if you have just removed it. Put the used NuvaRing in the resealable foul pouch and throw it away. Never flush it down the toilet. Keep it away from pets and children.
Although NuvaRing is convenient in many ways, there are a few things to know to make sure that it is effective once you start.
Consider if you are switching from another hormonal birth control or you’re not currently taking another hormonal birth control. Follow these guidelines to start your NuvaRing:
|Previous birth control or pregnancy||When to start||Backup birth control|
|none||Option 1: Start on the first day of your period. Option 2: Start on days 2–5 of your period.||For option 2, use a barrier method of birth control for 7 days from start.|
|injection||Start on the date you would have gotten your next injection.||none|
|implant or IUD||Start on the day of removal.||none|
|combination pill, minipill, or patch||Start any day, but no later than the day you would have started your new pill pack or applied a new patch.||none|
|after childbirth||Start 4 weeks (28 days) after giving birth if not breastfeeding. Do not use if breastfeeding. Do a pregnancy test before starting if your period has not returned.||Use a barrier method of birth control for 7 days from start.|
|after miscarriage or abortion||Option 1: Start within 5 days of a complete abortion or miscarriage.|
Option 2: Start on the first day of your period.
Option 3: Start on days 2–5 of your period.
Option 4: For a miscarriage or abortion after 12 weeks, wait 4 weeks (28 days) before starting.
|For best protection, use a barrier method for 7 days from start for any of these options.|
NuvaRing can cause certain side effects. Some of these effects are temporary and only occur as your body adjusts to the ring’s hormones. However, if your side effects are severe or don’t go away after a few months, call your doctor.
More common side effects
Side effects can include the following:
- irritation of your vagina or cervix
- increased vaginal discharge
- weight gain
- breast tenderness
- decreased sex drive
- vaginal spotting (light bleeding)
Serious side effects
Rarely, people can have serious side effects from using NuvaRing. In some cases, these problems can be fatal. Serious side effects from NuvaRing can include:
- blood clots
- high blood pressure
- liver problems
- reproductive or breast cancer
- gallbladder disease
- high cholesterol
- inflammation of the pancreas
- toxic shock syndrome
When to call a doctor
Call your doctor right away if you have any of these symptoms:
- leg pain that doesn’t go away
- shortness of breath
- pain or pressure in your chest
- sudden and severe headache
- yellowing of your skin and the whites of your eyes
- sudden high fever with vomiting, diarrhea, sunburn-like rash, and muscle aches
If your symptoms are severe, call 911 or go to the nearest emergency room.
Risk factors for problems with NuvaRing
NuvaRing may not be the best choice for all people, especially if they have certain risk factors. One of the more serious possible side effects of NuvaRing is blood clots. These are rare, but if they occur, they can be serious and even fatal. Risk factors for blood clots from NuvaRing include:
- being over age 35
- smoking cigarettes
- having a history of:
- blood clots, stroke, or heart attack
- migraine headaches with aura
- blood clotting problems
To learn about other risk factors or to find out if NuvaRing is a safe option for you, talk with your doctor. Be sure to discuss your full health history, especially if you have any of the risk factors listed above.
Who should not use NuvaRing?
People who have a history of, or currently have, the following conditions should not use NuvaRing:
- inflammation in the veins
- deep vein thrombosis (DVT)
- vascular or coronary artery disease
- heart disease
- very high blood pressure
- diabetes with impact on the veins
- headaches with neurological symptoms
- immobilization from recent surgery
- breast cancer or reproductive cancer, such as of the uterus, cervix, or vagina
- abnormal genital bleeding
- liver tumors or disease
- hypersensitivity to any of the components of NuvaRing
Test and drug interactions
Medications and herbal supplements that can make the NuvaRing less effective include:
- St. John’s wort
- certain protease inhibitors used to treat HIV
- atorvastatin (Lipitor)
- antifungal drugs
- certain hepatitis C medications
- anticonvulsant drugs
Standard dosage antibiotics do not appear to impact the effectiveness of NuvaRing.
Using NuvaRing, however, can also make some medical tests less accurate. Consult with your doctor about using NuvaRing if you are on any medications or need to undergo medical tests.
You’ll need to purchase one NuvaRing for every 5 weeks of use. According to Planned Parenthood, the cost can be up to $200 out of pocket.
Some health insurance plans may cover the entire cost. Contraceptives may also be covered under Medicare part D depending on your plan. You may also be able to purchase it for less from Planned Parenthood or through government assistance programs.
In order to get a prescription, you may need an appointment with a physician first. This may have a cost but will likely be covered by most insurance plans.
NuvaRing is a simple, easy-to-use, and effective form of birth control. To learn more about it, talk with your doctor.
Discuss your health history, any medications or supplements you take, and your birth control preferences. Your doctor can help determine if NuvaRing is a good choice for you.
What should I do if my NuvaRing comes out?
That depends on how long the ring has been outside of your body. If the ring has been out of your vagina for less than 3 hours, rinse the ring in lukewarm water and reinsert it right away.
If the ring has been out of your vagina for more than 3 hours, use a backup method of birth control and follow the instructions on the NuvaRing instruction label. Call your doctor for further advice to make sure you are protected.
NuvaRing may not protect you against pregnancy if you stop wearing it for more than 3 hours. Your doctor will tell you when you should insert a new ring.
Can I take out NuvaRing during sex?
If you prefer, you can remove the ring for up to 3 hours during sex. Be sure to do this no more than one time in a 24-hour period. Also, be sure to rinse the ring with lukewarm water before putting it back in.
Can NuvaRing get lost inside of me?
No, this is not possible as long as you insert it into your vagina. There have been some cases of accidental insertion into the bladder.
Will my partner or I be able to feel NuvaRing during sex?
If you inserted NuvaRing properly, you probably won’t be able to feel it during intercourse. Your partner may be able to feel it, but most people report that it doesn’t bother them.