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THE RING /

The ring (brand names: Annovera and NuvaRing) is a small, bendable ring that you insert into your vagina. (It kind of looks like one of those jelly bracelets from the 80s, but it feels a tiny bit stiffer.) You leave it in place for three weeks at a time, then take it out for the fourth week. The ring works by giving off hormones that prevent your ovaries from releasing eggs. The hormones also thicken your cervical mucus, which helps to block sperm from getting to the egg in the first place.

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types of rings

  • Yearly (Annovera)

    Annovera is a white, squishy birth control ring that you can use for up to a year. You insert it into your vagina where you keep it for three weeks. At the end of the third week, you take it out for a week, wash it with mild soap and water, pat dry, and store in its case at room temperature. That’s usually when you get your period. At the end of the fourth week, you pop it back in and start the whole cycle again. After 13 cycles, it’s time for a new Annovera.

  • Monthly (NuvaRing)

    The NuvaRing is a clear, bendable ring that you insert into your vagina. (It kind of looks like one of those jelly bracelets from the 80s, but it feels a tiny bit stiffer.) You leave the NuvaRing in place for three weeks at a time, then take it out for the fourth week. That’s when you’ll usually get your period. At the end of the fourth week, you insert a new ring. There is also a generic version of NuvaRing that contains the same hormones.

It’s very effective

Annovera is 97.3% effective at preventing pregnancy when used perfectly (exactly as directed). That means about three out of every hundred people using Annovera perfectly for a year will get pregnant.

NuvaRing is 99.7% effective at preventing pregnancy when used perfectly. That means fewer than one out of every hundred people using NuvaRing perfectly for a year will get pregnant.

Relatively little effort each month

If you’re the kind of person who would have trouble remembering to take a pill every day, the ring might be a good option. You only need to remember to do something twice a month (take the ring out and then a week later put the ring in). And we can help you with that.

You’re comfortable with your body

If you’re not okay with putting your fingers inside yourself, the ring probably isn’t for you. It’s a lot like putting in a tampon, though: If you can do that, you’re good to go.

Skipping periods

If you want, you can use either type of ring to skip your period. If you’re using Annovera, instead of taking it out after three weeks, you can just leave it in. 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 leaving it in continuously. It’s good for up to 13 cycles (a cycle is 28 days), which is a calendar year.

If you’re using the NuvaRing and want to skip periods, just leave it in for four weeks instead of three, and at the end of the 4 weeks (28 days), put in a new one.

Storage and privacy

If you’re storing NuvaRing (without opening it) for more than 4 months, it needs to be stored in the refrigerator. So if you don’t want anyone to know you’re using it, this could be a problem. Annovera doesn’t need to go in the fridge, but you still need a safe place to keep it stored in its case between cycles.

Also, some partners say they can feel the ring during sex. If that’s a problem, check out our tips for dealing with it.

A lower dose of hormones

The ring uses a lower dose of hormones than other methods, so there may be fewer negative side effects.

Blood clots: should I be worried?

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 smoking cigarettes if you’re over 35 years old, as well as genetic and medical conditions, like uncontrolled high blood pressure, heart attack or stroke, and migraine headaches with aura. If you have any of these risk factors, 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), so check with your medical provider about other options.

When you’re ready to get pregnant

You’ll return to fertility (that’s just another way of saying you’ll go back to being able to get pregnant) pretty darn quickly after you go off the ring. So don’t take any chances. If you’re not ready for a baby, protect yourself with another method.

Don’t take our word for it. Check out the videos above to hear people talk about their experiences with the ring. And be sure to ask your health care provider which method is best for you.

Thanks to the Affordable Care Act, if you have health insurance, chances are good that you’ll be able to get this method with no out-of-pocket cost. If you don’t have insurance and you’re not on Medicaid, the NuvaRing averages costs up to @200 a month, but the generic version is less expensive. Annovera may cost up to $2,400 out of pocket for a year of birth control, but coupons and other discounts can lower the cost big time.

Prices for NuvaRing:

Prices for Annovera:

  • This method may be free or low-cost for you
  • With Medicaid: Free
  • With insurance: Free under most plans
  • Without insurance: Annovera can cost up to $2400, which would come out to about $200 a month—the same as the NuvaRing. However, with coupons from www.annovera.com the cost can be as low as $60. Also, depending on your income, you may be able to go to a low-cost clinic to get the ring at a reduced cost.
  • Payment assistance: Check with your local family planning clinics to find out if they offer free or low-cost Annovera. Also, ask your provider for extra samples, or check out the Annovera website for coupons.

Both types of rings are pretty easy to use. All you really need to remember is the schedule for inserting and removing the ring—and we can help you with that.

ring insertion using the twist method

Annovera

Once you insert the ring (see instructions below), leave it in for three weeks (21 days). Take it out for the fourth week (that means that you’ll leave it out for seven days). After taking it out, wash it with mild soap and water, pat it dry, and store it in its case at room temperature. When the ring is out, you’ll probably get a withdrawal bleed, which is like a period. After seven days, even if you’re still bleeding, put the Annovera back in again.

If you leave it out for more than seven days, you’ll need to use a backup method of birth control, like condoms, for seven days after putting it back in.

During the three weeks (21 days) that you have the ring in, it’s important not to take it out. And it’s designed to keep it in during sex. But if it ever comes out, make sure to put it back in right away. If the ring is out of your vagina for more than two hours total during those 21 days, you will need to use a backup method of birth control for seven days after putting it back in.

Here’s how to put Annovera in:
Step one: wash your hands.
Step two: squish the ring between your thumb and index finger.
Step three: insert it into your vagina as far up as you can get it with your finger. It’ll sit tucked up against the side of your vaginal wall. The exact position doesn’t affect how well it works to prevent pregnancy, as long as the entire ring is inside your vagina. So you just want to make sure you’re comfortable and no part of it is coming out of your vagina. If you need to, you can take it out and try again or try just pushing it further into your vagina.

Here’s how to take the Annovera out:
Step one: wash your hands.
Step two: insert your finger into your vagina until you feel the edge of the ring.
Step three: Hook your finger on edge of the ring and pull down.

During the time that the ring is out, you’ll probably get a withdrawal bleed, which is like a period. If you’re still bleeding when it’s time to put the ring back in, don’t worry. That’s totally normal.

Here’s a video showing how to put in and take out the Annovera.

NuvaRing

Just like with Annovera, once you insert the ring (see instructions below), leave it in for three weeks (21 days). Take it out for the fourth week (that means that you’ll leave it out for seven days). After taking it out, put it back in the re-sealable pouch it came in and toss it in the trash. Disposing of it in its pouch will help prevent the hormones in the ring from leaching into the environment. When the ring is out, you’ll probably get a withdrawal bleed, which is like a period. After seven days, even if you’re still bleeding, insert a new ring and start the cycle again.

If you take the NuvaRing out during the three weeks (21 days) that you have the ring in, make sure to put it back in as soon as possible. If it’s out for more than 48 hours, you’re at risk for getting pregnant, and you’ll need to use a backup form of birth control for 7 days after putting the ring back in.

If you leave the NuvaRing out for more than 48 hours during the third week of a cycle, put it back in right away. On the day when you would normally have taken the ring out (day 22 of the cycle, where day 1 is the day you put it in), take it out and put a new one in, skipping your ring-free week. If you don’t put a new one in on that day, you’ll need to use a backup form of birth control until you’ve had a ring in for 7 days in a row.

Here’s how to put the NuvaRing in:
Step one: wash your hands.
Step two: squish the ring between your thumb and index finger.
Step three: insert it into your vagina as far up as you can get it with your finger. It’ll sit tucked up against the side of your vaginal wall. The exact position doesn’t affect how well it works to prevent pregnancy, as long as the entire ring is inside your vagina. So you just want to make sure you’re comfortable and no part of it is coming out of your vagina. If you need to, you can take it out and try again or try just pushing it further into your vagina.

Here’s how to take the NuvaRing out:
Step one: wash your hands.
Step two: insert your finger into your vagina until you feel the edge of the ring.
Step three: Hook your finger on the edge of the ring and pull down.

There are positive and negative things to say about each and every method. And everyone’s different—so what you experience may not be the same as what your friend experiences.

The Positive

Positive “side effects”? You bet. There are actually lots of things about birth control that are good for your body as well as your sex life.

The Negative

Everyone worries about negative side effects, but for most people who use the ring, they’re not a problem. Remember, you’re introducing hormones into your body, so it can take a few months to adjust. Give it time.

  • Easy to use—it’s just like putting in a tampon
  • Doesn’t interrupt the heat of the moment
  • Might give you shorter, lighter periods
  • May clear up acne
  • Can reduce menstrual cramps and PMS
  • Offers protection against some nasty health problems, like endometrial and ovarian cancer, iron deficiency anemia, ovarian cysts, and pelvic inflammatory disease
  • Annovera lasts a whole year—longer than monthly methods like the pill, patch, and the NuvaRing—which means you don’t have to worry about refills for a whole year
Things that will probably go away after two or three months:
  • Bleeding in between periods
  • Breast tenderness
  • Nausea and vomiting
Things that may last longer:
  • Increased vaginal discharge, irritation, or infection
  • A change in your sex drive

If you still feel uncomfortable after three months, switch methods and stay protected. You’re worth it.

*For a very small number of people there are risks of serious side effects.

Yearly (Annovera)

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Monthly (NuvaRing)

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We’re here to get this method working better for you. And if it still doesn’t feel right, we’ve got ideas for other methods. Just remember: If you change methods, make sure you’re protected while you switch.

  • ...I heard that taking hormonal birth control is bad for the environment because of hormone-filled pee getting in the water.

    Any form of birth control is better than no birth control when it comes to the environment. But let’s look a little closer at the claim that hormones in birth control are getting into the environment through pee. The simple answer is: yes, it is. But—and this is a big but—it is small compared to other sources of estrogen.

    Current research finds that the contribution of EE2 (the primary active ingredient in the pill, the ring, and the patch) to the total amount of estrogen in of our waterways is small. Bigger—much bigger—sources of estrogen in the environment come from industrial and manufacturing processes; agricultural fertilizers and pesticides; the drugs we give livestock; and the waste and runoff produced by these sources.

    Simply removing hormones from contraceptives will not eliminate the environmental impacts of estrogenic compounds. It’s much better to buy organic food if you can and even better to tell Congress to do its job and regulate chemicals, than to forego birth control. From Mother Earth’s standpoint, any form of birth control is better than no birth control. For purists who don’t want to add any hormones to the environment or to their body, no matter how small, there are options for you. Natural latex condoms and the copper IUD are two frequently cited examples of ultra-green contraceptives.

    Still not working?

    If you’d like to use a super effective method without any hormones, try the Paragard IUD.

    Try a different method

  • ...My partner feels the ring when we have sex.

    Both the Annovera and the NuvaRing are designed to keep in during sex. During the three weeks (21 days) that you have the Annovera in, it’s important not to take it out. But if it ever comes out, make sure to put it back in right away. If Annovera is out of your vagina for more than two hours total during those 21 days, you will need to use a backup method of birth control for seven days after putting it back in.

    If you are using the NuvaRing and decide to take it out during sex during the three weeks (21 days) that you have the ring in, make sure to put it back in as soon as possible. If it’s out for more than 48 hours, you’re at risk for getting pregnant, and you’ll need to use a backup form of birth control for 7 days after putting the ring back in.

    If you leave the NuvaRing out for more than 48 hours during the third week of a cycle, put it back in right away. On the day when you would normally have taken the ring out (day 22 of the cycle, where day 1 is the day you put it in), take it out and put a new one in, skipping your ring-free week. If you don’t put a new one in on that day, you’ll need to use a backup form of birth control until you’ve had a ring in for 7 days in a row.

    Still not working?

    If you want a method that you don’t have to remember daily, you won’t have to remove in the moment, and that your partner won’t feel during sex, you might want to go with the implant, shot, or patch.

    Try a different method

  • ...It's too expensive.

    Since we don’t exactly know what you’re paying now, we’ll cover a few scenarios to see if we can help you out:

    If you’re on Medicaid, the ring might be free for you. If you have private insurance, it’s probably covered for no more than your copay.

    If those aren’t options for you, check with the family planning clinics around you and find out if they offer free or low-cost birth control. Most do.

    Another solution might be to ask your partner to help pay for the expense.

    You could also check the NuvaRing or Annovera websites for discounts and coupons.

    Still not working?

    If you find it’s still just too expensive, you have other options. Some varieties of the pill (generics, in particular) may be cheaper than the ring (no generic ring yet!), but don’t forget that you need to take the pill every single day.

    Try a different method

  • ...I'm tired of inserting it.

    A once-a-month method like the ring requires less effort than many other options out there, but there are certainly other effective methods that require even less work.

    Still not working?

    If inserting something once a month is too much for you, perhaps you want to think about something you can forget about for years, like the implant or IUD.

    Try a different method

  • ...I'm getting vaginal discharge.

    The extra discharge you are experiencing from using the ring is probably normal. After a couple of cycles, this discharge may go back to normal.

    Also, the ring may protect you from a bacterial infection that can occur in the vagina called bacterial vaginosis (BV).

    If you’re concerned that the vaginal discharge that you’re experiencing may be caused by an infection, visit your health care provider.

    Still not working?

    If it sticks around and really bothers you, think about something you don’t insert in your vagina. You could try the pill or patch (if you like regular periods), or the shot (if you don’t mind irregular or nonexistent periods).

    Try a different method

  • ... It's always slipping out.

    There’s a chance you’re not inserting the ring correctly.

    Try this: Use an empty tampon inserter to push it in all the way.

    Still not working?

    If you tried the ol’ tampon trick and it’s still an issue, look into a form of birth control you won’t need to insert yourself. Think about the shot, implant, or an IUD.

    Try a different method

  • ...I heard there's a risk in using tampons or a menstrual cup with the ring.

effectiveness

Perfect use
99.7 %
Typical use
93 %
read more »

quick facts /

  • Easy to insert, works like the pill. Choose from Annovera or NuvaRing.

  • The ring’s pretty effective the way most people use it.

  • Most common—yet temporary—effects are irregular bleeding, sore boobs, nausea.

  • Ring in. Wait 3 weeks. Ring out. Wait 1 week. Repeat.