• Dr. Sally

The Ring

The ring is a method of hormonal birth control in the form of a flexible plastic ring that is inserted into the vagina, where it stays in place for three weeks and is out for one week. It is also known by the brand name "NuvaRing." Like the pill, the ring can be used for other benefits.

How does it work?

Hormones are slowly released from the ring and absorbed into the body through the lining of the vagina.

Estrogen and progestin hormones work together to prevent pregnancy by preventing the release of an egg.

How well does it work?

The ring is 99% effective in preventing pregnancy with perfect use and 91% effective with typical use.

The ring does not protect against sexually transmitted diseases (STDs).

How do I use it?

- First, check the expiration date on the original package. If it is not expired, you are good to go. Keep the

package so you can dispose of the ring in it later.

- Second, insert the ring in your vagina and leave it in for three weeks. To insert the ring, pinch the sides (or twist it into a figure-8) and insert into the vagina, using your finger to push it in. It does not need to be in a specific position as long as you are comfortable, it doesn’t feel like it will slip out, and you cannot feel it.

- Third, remove the ring for the fourth week. Hook a finger under the rim of the ring and pull it out. Place it into the resealable foil pouch that it came in before disposing of it. You will have seven ring-free days.

- Repeat with a new ring. Ring users typically get their period during the ring-free week. It is okay to insert a new ring if you are still bleeding. Feel free to use a tampon or pad or have sex with the ring.

You may notice the pharmacy keeps your ring in the refrigerator. You don’t have to though. It is okay for the ring to be kept at room temperature (15° to 25°C, or 59° to 77°F), out of direct sunlight, for up to four months.

What if the ring falls out?

If the ring falls out, gently rinse with water and reinsert it. If it is out for more than three hours, insert a new ring and use a backup method (like condoms) for seven days.

What if I forget to change it on time?

The ring has enough hormones to effectively prevent pregnancy for four weeks. If you have left it in for longer than four weeks, verify that you are not pregnant and insert a new ring, skipping the ring-free week.

Use a backup method of birth control for the next seven days. Consider using emergency contraception if you had sex during the time the ring was hormone-depleted.

What are some side effects I might experience?

Rarely, serious side effects can occur with the ring, such as blood clots and strokes. If you experience sudden and/or severe pain in your abdomen, chest, head, or legs that may be accompanied by dizziness, nausea, vomiting, difficulty catching your breath, or changes in vision or mental status, call your healthcare provider right away and/or get to an emergency room. When starting the ring, you may experience nausea, headache, breast tenderness, or changes in weight, mood, libido, or bleeding . Typically, these side effects resolve within three months. You may notice more vaginal discharge -- that is harmless. If you have vaginal irritation or discharge that is clumpy, foul-smelling, or has a color, see your doctor to make sure there's no infection.

What if I want to get pregnant soon?

You can get pregnant as soon as soon as you stop the ring.

Is it right for me?

The ring is an effective, convenient, pill-free option that is safe for most people. Some health conditions make it unsafe to use the ring but the minipill can be used instead (examples: history of blood clots, high blood pressure, and smoker over age 35). Another important factor is comfort with using a vaginal product.

Connect to learn more about our work to expand access to birth control. Or email us.

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