What is it?

It is a soft plastic flexible vaginal contraceptive ring. It contains both estrogen and progestin hormones like the birth control pill which are slowly released from the ring over 21 days to prevent pregnancy. When you remove it, after 21 days, you will have a period, or a “hormone withdrawal bleed”.

How does it work?

The hormones in the Nuva Ring are slowly released and absorbed through the lining of the vagina (vaginal mucosa) into the blood stream. This prevents ovulation so that no egg is released from the ovaries. It also helps to thicken the cervical mucus making it harder for sperm to travel into the uterus. It also helps thin the lining of the uterus to prevent a fertilized egg from implanting inside the uterus.

How do I start using it?

Insert one ring into the vagina using any position that is comfortable (e.g. squatting or lying down). Press the edges of the ring together and place one end into the opening of the vagina. Push the ring high into the vagina. There is no exact position that is crucial for placement of the ring. As long as you are comfortable, the ring is placed correctly. The hormones will be absorbed into the bloodstream regardless of where the ring is placed inside the vagina. Leave the ring in place for 3 weeks (21 days). DO NOT remove for intercourse. After 21 days, remove the ring for 7 days. Hook you index finger over the edge of the ring and gently pull out. Discard the ring in the foil package provided and throw into garbage. Do not flush down the toilet.

When does it start working?

If you start on the last day of your period, or on the day after an abortion, it will start working right away. If you start in between your periods, then it takes 7-10 days to be effective. Use condoms or abstain from sex until it is working.

Can I use tampons with a ring inserted?

Yes, you can. Usually you bleed only when the ring is removed, but if you have break-through bleeding, you can use a tampon.

Can I use the ring if I have yeast or a vaginal infection?

Yes, there is no infection that will get worse if a ring is left in place. There is no infection that is caused by the ring. You can use yeast treatment at the same time the ring is inside.

What if I am late putting in the next ring after a period?

That’s a concern. Take the morning after pill, or a copper IUD, and put it in right away. Don’t rely on it for 7-10 days.

Can I use 2 rings back to back a week off to skip my period?

Yes, but only use 2 rings back to back, for 3 weeks each. Don’t use more than that, ie. not 3 or more rings without a break.

What are danger signs that something is wrong?

There is a small but serious risk of blood clotting with using the ring, though these risks are less than the health risks of pregnancy. If there is a clot forming, you may have severe pain in your calf or thigh, chest pain, severe headaches or vision problems. Seek help at the emergency department right away.

Many women like the ring for the following reasons:

  • You don’t have to remember a pill each day,

  • You can remove and insert it yourself, and it’s private

  • It regulates your period, so you know when you expect it

  • It can reduce the amount of bleeding and/or cramps

  • It is 92-99.7% effective (depends on your perfect use)

  • It allows for more spontaneous sex as you are protected

There are some health benefits to being on the ring:

  • It may help reduce acne, moodiness or other PMS symptoms that you have when you are not on hormones

  • It may reduce the risk of ovarian cysts

  • It is believed to reduce endometrial and ovarian cancer

  • It is reversible- once you stop, you can get pregnant

  • It will help you avoid pregnancy till you are ready

Some women don’t like the ring for the following reasons:

  • You may not be comfortable touching your genital area

  • A few notice vaginal discomfort, with or without sex

  • It may cause spotting or irregular bleeding

  • It may cause hormonal side effects like breast tenderness, bloating, nausea or mood changes

  • It doesn’t protect against STIs

Some women SHOULD NOT use the ring:

  • Women who are over 35 and smoke

  • Women who cannot take estrogen

  • Women who might be pregnant

  • Women who have undiagnosed vaginal bleeding

  • Women who have liver problems (e.g. hepatitis)

  • Women who have diabetes

  • Women who have migraines

  • Women who have had a stroke or heart attack

  • Women who have a risk of blood clots, or ever had one

  • Women who are breastfeeding (first 2 months)

It can fall out!

If this happens, rinse it and re-insert. But, if it has been out for over 3 hours, and you have had sex, you will need the morning after pill or a copper IUD right away. Don’t rely on it for 7 days.