How do I use the birth control ring?

How do I put in and take out the vaginal ring?

It’s easy to put in the ring:

• Check the expiration date on the package. If the expiration date has already passed, don’t use that ring.  

• Wash your hands with soap and water

• Take the ring out of the wrapper or case

• If you’re using Annovera, wash your ring with mild soap and lukewarm water, then pat it dry with a clean cloth towel or paper towel. Do this every time you put in your Annovera ring. 

• Squeeze the sides of the ring together with your fingers and gently push it deep into your vagina.

Don’t worry about the exact placement of the ring in your vagina — if you can’t feel it when you’re walking around, it’s in correctly. If the ring feels uncomfortable, try pushing it in deeper or moving it around in your vagina with your finger. The ring can't get lost in your vagina or be in too deep. You can leave your ring in during sex or any other kind of physical activity.

When it’s time to take your ring out, just hook your finger through the ring and gently pull it out of your vagina. 

If you’re using Annovera, wash your ring with mild soap and lukewarm water, pat it dry with a clean cloth towel or paper towel, and store it in its case at room temperature, away from kids and pets.

Once you’re done with your ring, put it in its case or foil wrapper and throw it in the trash. You can also wrap it in toilet paper, but using the case or foil wrapper is better for the environment because it helps keep any hormones that are left in the ring from getting into the soil and water. Don’t flush the ring down the toilet.

How do I use Annovera? 

One Annovera ring has enough hormones in it to last for 13 cycles (1 year).

Using Annovera is simple: keep the ring in your vagina for 3 weeks (21 days), and then take it out for 1 week (7 days) — this ring-free week is usually when you’ll get your period. After 7 ring-free days, put your Annovera ring back in your vagina for the next 21 days.

Take out your ring and put it back in on the same day of the week every time. For example, if you put your ring in on a Sunday, take it out 3 weeks later on a Sunday. Then put it back in 7 days later on the following Sunday. So your “insertion day” and “removal day” will always be a Sunday.

It’s okay if you’re still bleeding or spotting when it’s time to put your ring back in — that’s normal. You can safely use tampons, menstrual cups, and pads with your Annovera ring in. Just be careful not to pull the ring out when you remove a tampon or menstrual cup.

Wash your Annovera ring with mild soap and lukewarm water anytime you take it out of your vagina and before you put it back in. Annovera comes with a case you can keep it in whenever it’s not in your body. Store Annovera away from extreme temperatures, pets, and kids. Don’t keep your Annovera ring in the refrigerator. 

As long as you start using Annovera on or before the expiration date on the package, it will last for 1 year after you put it in your vagina.

How do I use NuvaRing?

One NuvaRing has enough hormones in it to last for up to 5 weeks. You have a few different options for ring schedules, and you can choose to get a period or choose to skip it. All of these schedules work just as well to prevent pregnancy.

If you want to get your period:

Wear a ring for 3 weeks (21 days), 4 weeks (28 days), or 5 weeks (35 days). Then take it out for the next week (7 days) — that’s when you’ll get your period. After 7 ring-free days, put in a new ring.

Take out your old ring and put a new one in on the same day of the week every time. For example, if you put a new ring in on a Sunday, take it out 3, 4, or 5 weeks later on a Sunday. Then put a new ring in 7 days later on the following Sunday. So your “removal day” and “new ring day” will always be a Sunday.

It’s okay if you’re still bleeding or spotting when it's time to put in a new ring — that’s normal. You can safely use tampons, menstrual cups, and pads with your NuvaRing in (just be careful not to pull the ring out when you remove a tampon or menstrual cup).

If you want to skip your period:

Skipping your period with NuvaRing is safe and super easy. Just keep the ring in your vagina at all times, and swap it out for a new one every 3-5 weeks. You can do this 2 ways:

• Pick a date and always change your ring on that date. So if you put your first ring in on the 15th of the month, you always change your ring on the 15th of every month. (It’s ok that some months are longer than others.)

• Wear the ring for 3 weeks (21 days), 4 weeks (28 days), or 5 weeks (35 days). Then take out your old ring and put in a new ring. Change your ring on the same day of the week every time — so if you put your ring in on a Monday, change it every 3, 4, or 5 weeks on a Monday.

You may have some bleeding or spotting when you use the ring to skip your period — that’s totally normal. If you skip your period week every month, the spotting should go away after several months.

There’s nothing dangerous or harmful about using NuvaRing to skip your period. And it comes in really handy if you want a special occasion (like a vacation or a hot date) to be period-free.

When can I start using the birth control ring?

You can start using the birth control ring as soon as you get it — any day of the week, and anytime during your menstrual cycle. But depending on when you start the ring, you may need to use backup birth control (like condoms) for the first 7 days.

If you put your first ring in within 5 days after your period starts, it will start working right away. For example, if you get your period Monday morning, you can start using the ring anytime until Saturday morning and be protected from pregnancy right away.

If you start using the ring at any other time in your cycle, it needs to be in your vagina for 7 days before it will start protecting you from pregnancy. Use another method of birth control — like a condom — if you have vaginal sex during your first week on the ring.

Starting the ring after taking emergency contraception:

If you took a levonorgestrel emergency contraception pill (like Plan B or other over-the-counter brands), you can start using the ring right away.

If you recently took the ella emergency contraception pill, don’t start using the ring until it’s been 6 days or more since you had unprotected sex.

If you start using the ring after taking any emergency contraception pill — like Plan B or ella — use a backup birth control method (like condoms) for 7 days.

Starting the ring after pregnancy:

You can get pregnant again shortly after being pregnant, so talk with your nurse or doctor about starting your birth control as soon as you can.  

You can start using the ring right after an abortion or miscarriage. In general, you can start using the ring 3 weeks after giving birth (but wait 3 weeks whether you're breastfeeding or not). Read more about breastfeeding and the ring.

Do I have to take the ring out during sex?

Nope. In fact, it’s best to leave the ring in your vagina as much as possible. NuvaRing and Annovera are made to be worn all the time, including during sex. If it bothers you or your partner, try moving the ring around until it feels comfortable.

If you do take the ring out during sex, rinse it in lukewarm (not hot) water and put it back in when you’re done. Just make sure you remember to put it back in as soon as you can. 

If you leave an Annovera ring out of your vagina for more than 2 hours at a time, or at different times that add up to more than 2 hours total during the 21 days you’re supposed to have it in, you won’t be protected from pregnancy.

If you leave a NuvaRing out of your vagina for more than 2 days during the weeks you’re supposed to wear it, you won’t be protected from pregnancy.

If your ring has been out of your vagina for too long, use a backup birth control method (like condoms) until the ring has been in your vagina for 7 days in a row.

Don’t use lube that has oil or silicone in it while the ring is in your vagina. Water-based lubes are safe to use. Don’t use the birth control gel Phexxi with the birth control ring. 

How should I store my rings?

You can store NuvaRings at room temperature away from direct sunlight for up to 4 months. After 4 months, keep your NuvaRings in the refrigerator. Read the storage instructions on the package, and always check the expiration date before putting in a new NuvaRing.

The Annovera ring comes with a small case you can keep it in when it’s not in your vagina. Store Annovera at room temperature and away from kids and pets. Don’t put Annovera in the refrigerator. If you start using Annovera on or before the expiration date on the package, it will last for 1 year (13 cycles) after you put it in your vagina.

What do I do if I want to get pregnant?

If you decide you want to get pregnant, just take your ring out and throw it away.

It’s possible to get pregnant right after you stop using the ring. It can take a few months for your period to go back to the cycle you had before you started using it. But it’s still possible to get pregnant during that time, even if your period isn’t regular or you haven’t gotten your period yet since you stopped using the ring.

More questions from patients: