Monthly birth control ring (NuvaRing)

Effectiveness at preventing pregnancy is a top priority for you.

NuvaRing is over 99% effective at preventing pregnancy when used perfectly (exactly as directed). That means fewer than one out of every 100 people using NuvaRing perfectly for a year will get pregnant.

However, the effectiveness of NuvaRing with perfect use is based on the experiences of people involved in clinical trials who are using NuvaRing perfectly for an entire year. The effectiveness of NuvaRing with typical use, which means how real people use it in real life, is going to be more relevant for most people. In the case of NuvaRing, when it’s used as people typically use it, it is 93% effective at preventing pregnancy. That means that on average, seven out of every 100 people using NuvaRing for a year will get pregnant.

The combination pill, the monthly ring, and the patch are all equally effective.

You’re looking for a lower dose of hormones.

The ring uses a lower dose of hormones than other hormonal methods, so there may be fewer side effects. And because you aren’t taking the hormones by mouth, they don’t pass through your gastrointestinal system, so you can expect fewer side effects that affect that system, like nausea.

You want to put in relatively little effort each month.

If remembering to take a pill every day is not for you, the ring might be a good option. You only have to remember to take action twice a month: once to take the ring out and then once, a week later, to put a new ring in.

You want the option to skip periods.

If you’re using NuvaRing and want to skip periods, you can leave it in for up to five weeks instead of three. You can skip a single period this way or multiple periods throughout the year. You can even skip all of your periods for a year by inserting a new ring as soon as you take the old one out instead of spending a week without the ring in. Just remember to replace your NuvaRing with a new one at least every five weeks.

You’re comfortable touching your body.

Putting in NuvaRing involves putting your fingers inside your vagina. It’s a lot like putting in a menstrual cup or menstrual disc, so if you’re fine with doing those things, you should be good to go.

You aren’t looking for STI protection, or you’re okay with combining the ring with another method.

The ring doesn’t offer any STI protection. So if that’s something you’re looking for, you can use condoms or internal condoms along with the ring. Dental dams and/or gloves also offer STI protection, depending on what kind of sex you’re having. You may also want to consider PrEP (pre-exposure prophylaxis), which is a daily pill or an injection you can get every two months to decrease your risk of getting HIV.

You want a method that won’t permanently affect your fertility.

The only birth control method that permanently affects your future fertility is sterilization. NuvaRing does not affect your ability to get pregnant after you stop using it. In fact, you’ll return to whatever level of fertility is normal for you (which just means that you may be able to get pregnant) quickly after you go off the ring. So if you’re planning to stop using the ring, but you don’t want to get pregnant, protect yourself with another method right away.

You want a method that you can stop without help from a provider.

You can stop using NuvaRing without having to see a provider. Just keep in mind that you will quickly return to whatever level of fertility was normal for you before using NuvaRing, which means you may be able to get pregnant right away. If you don’t want to get pregnant, make sure to use another form of birth control as soon as you stop using NuvaRing.

You don’t need to hide your method.

NuvaRing is not one of the birth control methods that is easy to completely hide. If you’re storing NuvaRing (without opening it) for more than 4 months, it needs to be stored in the refrigerator. So if you share a refrigerator with people, and you don’t want them to know you’re using the ring, that could be a problem.

Also, some people with penises say they can feel the ring during penis-in-vagina sex. (Yes, it’s designed for you to leave in during sex!) So if you’re trying to hide that you’re using birth control from a sexual partner, the ring may not be the best choice.

You don’t have these risk factors.

For most people, the risk of blood clots while using the ring is very low. However, there are some things that greatly increase your risk, like:

• Previously having had a blood clot or having certain inherited conditions that increase your risk for a blood clot.
• Smoking cigarettes if you’re 35 years old or older.
• Having uncontrolled high blood pressure.
• Having heart disease or having had a heart attack or a stroke.
• Having recently had major surgery, if you won’t be able to get out of bed for a while.
• Having migraine with aura.
• Having had a baby less than three weeks ago.
• Having tested positive for antiphospholipid antibodies.

If you have any of these risk factors for blood clots or if you’ve had breast cancer or serious liver disease, it’s not recommended that you use either type of ring, the patch, or any of the combined hormonal birth control pills (the most commonly used kind of birth control pill). Check with your medical provider about other options.