Using the NuvaRing

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What is the NuvaRing?

The NuvaRing is a clear, flexible, and thin plastic polymer ring that is 54mm in diameter and 4 mm thick. It provides a continuous low dose of progestin (etonogestrel) and estrogen (ethinyl estradiol) to prevent pregnancy.

How do I use the NuvaRing?

The NuvaRing is inserted into your vagina, where it remains in place for three weeks. At the beginning of the fourth week, remove the ring from your vagina (use your index finger to hook the NuvaRing and pull it until it pops out). Your period should start in the week when the ring is not inside your vagina. Seven days after the removal of the NuvaRing, insert a new ring—even if you are still bleeding.

When do I start the NuvaRing?

Beginning to use the NuvaRing depends on whether or not you have been using a hormonal type of birth control (such as pills or the patch) during the previous month. It will also depend on the birth control method you were using, if any.

For women who have not used hormonal birth control in the past month:

Insert the NuvaRing into your vagina at any point during your cycle. Use backup contraception for next 7 days.

For women who are switching from a combined oral contraceptive (birth control pills that have estrogen and progestin):

After taking your last active hormone pill in the package, insert the NuvaRing within the next 7 days. It is effective in preventing pregnancy right away.

For women who are switching from the Patch:

After removing your last patch at the end of your cycle, insert the NuvaRing within the next 7 days. It is effective in preventing pregnancy right away.

For women who are switching from a progestin-only contraceptive (The NuvaRing is effective at preventing pregnancy right away if you follow the directions below:

  • If you are using a progestin only pill (such as Micronor) insert the NuvaRing on the same day you take your last pill. Use backup for 7 days.

  • If you are using a progestin-containing IUD (intrauterine device), insert the NuvaRing on the same day that the implant or IUD is removed.

  • If you are using an injectable contraceptive (such as Depo-Provera), insert the NuvaRing on the day that your next injection would be due. Use backup for the next 7 days.

Use the stickers that come in the NuvaRing booklet to remember when you put the ring in and when you need to take it out.

How do I insert the NuvaRing?

  • Wash and dry your hands. Remove the ring from the foil pouch.

  • Find a comfortable position (lying down, squatting, sitting on the toilet or standing with one foot resting on a higher surface, such as a stool, bed, chair, or bathtub).

  • Hold the NuvaRing between your thumb and index finger, pinching the ring so that it becomes long and narrow.

  • Gently insert the narrowed ring into your vagina. Release it when it is inside the vagina. If you can feel the ring, use your finger to re-position it until it is comfortable. The NuvaRing will not go in too deep or get lost inside your vagina. After the ring is in place, it stays in the vagina for three weeks and then it is removed for seven days.

How do I remove the NuvaRing?

  • After three weeks, remove your NuvaRing.

  • Insert your finger into your vagina and hook your finger under the rim or grasp it between the index and middle finger. Then pull it out gently.

  • Place the used ring in the original foil pouch (if you kept it) and throw out in the trash. Do not flush it down the toilet.

  • Your period will usually start during the week the NuvaRing is not in your vagina. To continue to prevent pregnancy a new ring must be inserted one week from the time the last one was removed, on the same day of the week, even if you are still bleeding.

What if the NuvaRing was not inserted properly?

  • If the ring has not been inserted properly, it can slip out of the vagina. Sometimes this happens when exerting force, like during a bowel movement. If it does slip out, and it has been out of your vagina less than three hours, you are still protected from pregnancy. Rinse the ring with cool to lukewarm water and reinsert it as soon as possible within three hours. If your NuvaRing is lost, a new one should be inserted for a new 21-day cycle. It is not recommended to remove the ring for sexual intercourse.

  • If the NuvaRing has been out of your vagina for more than three hours, you will need to use back up contraception such as condoms for the next 7 days and follow the instructions below:

    • During the first or second week of your cycle, if the ring is out of the vagina for >3 hours, it may be reinserted.

    • During the third week of cycle, if the ring is out of the vagina for >3 hours, discard the ring and choose one of the following two options in combination with a 7-day back up method:

      1. Insert a new ring immediately to begin a new three week cycle

      2. Have a withdrawal bleed and insert a new ring no later than 7 days from the time when the last ring was removed/expelled. This is an option only if the ring was used continuously for the preceding 7 days

  • Do not remove the NuvaRing during intercourse.

Get immediate medical attention if you have:

A - abdominal pain, upper right side

C - chest or arm pain, shortness of breath, coughing up blood

H - headaches, severe and not relieved by aspirin or Tylenol

E - eye problems, blurred vision, flashing lights, double vision, blindness

S - swelling, redness, numbness, tingling or pain in the legs


Revised March 2009