NuvaRing is a vaginal ring and combination birth control method used to prevent pregnancy in sexually-active individuals with uteruses.
The active ingredients in NuvaRing birth control are etonogestrel and ethinyl estradiol.
The diameter of NuvaRing is 54mm. NuvaRing is in fact a pliable contraceptive ring. It looks clear, with a smooth, pliable texture that makes it easy to insert and remove.
To use NuvaRing, insert it into the vagina much like you would a tampon. This vaginal ring stays in for 3 weeks, then is removed for 1 week. Dispose the device after the 3-week period and repeat the cycle with a new contraceptive ring. Repeat this process for as long as you need coverage against pregnancy.
One pouch of NuvaRing birth control contains 3 rings for a 3-month supply of birth control coverage.
NuvaRing Birth Control 101
If swallowing a birth control pill each day doesn’t appeal to you, we’d like to meet another major player in the world of sexual health: NuvaRing.
NuvaRing birth control is just as effective as most oral contraceptives, but it’s administered differently. Rather than swallowing a pill every day like clockwork, NuvaRing is inserted manually into the vagina every 4 weeks with one ring-free week to close out the month.
If you’ve ever used a tampon or a menstrual cup, you’re already on the fast track to use NuvaRing like a pro. In this guide, we’ll take a closer look at how NuvaRing birth control works, who can use it, and help you decide whether it’s the right birth control method for you.
What is NuvaRing birth control?
NuvaRing is a birth control method that can be used by people with uteruses to prevent pregnancy.
NuvaRing is a type of combination birth control, which means it uses a blend of more than one type of hormone to prevent you from getting pregnant.
The two hormones that NuvaRing releases are:
Etonogestrel – Etonogestrel is a type of progestin. Progestin is a form of progesterone, a hormone your ovaries secrete after an egg is released. Each NuvaRing contains 11.7 mg of etonogestrel. Every day, the NuvaRing administers approximately 0.120 mg of this hormone to your body.
Ethinyl estradiol – Ethinyl estradiol is a form of estrogen. Estrogen is a hormone that supports the development and maintenance of uterus-based reproductive systems. Each NuvaRing contains 2.7 mg of ethinyl estradiol. Around 0.015 mg of ethinyl estradiol are released per day.
NuvaRing birth control is unique because it’s a low-dose form of birth control. This means it administers a smaller amount of its active ingredients in extended-release cycles.
When paired together, etonogestrel and ethinyl estradiol work to prevent pregnancy in a few key ways:
They interact with your body’s reproductive hormones to stall the development and release of an egg (ovulation).
They thicken the cervical mucus, making it more difficult for sperm to enter your uterus.
They change the thickness of your uterine lining (the endometrium) to make implantation more difficult in the unlikely event an egg is fertilized.
Another important thing to note about this birth control method? Rather than being taken orally, a contraceptive vaginal ring is inserted manually by the user similar to how you would insert a tampon.
To be effective, it must be worn for 3 weeks, then removed for 7 days. After your week without it, you’ll insert a brand new ring and start the cycle over again.
What are the pros and cons of using NuvaRing?
Every birth control method has its strengths and potential drawbacks, which usually pertain to the individual users’ preferences.
Here are some of the main benefits of using NuvaRing birth control:
High efficacy – In terms of pregnancy prevention, NuvaRing birth control is up there with the greats. It has a near-perfect (almost 100%) success rate when used properly.
Low-effort – Oral contraceptives work for some, but others may find it difficult (or inconvenient) to manage the strict daily schedule “the pill” requires. With NuvaRing, you’ll only have to think about your birth control method two times each month: when you put it in, and when you take it out.
Low-interference – Although it stays put in your vagina for a few weeks, NuvaRing won’t hinder your ability to have sex. If you’ve inserted it properly, you shouldn’t be able to feel anything—and it’s unlikely your partner will either.
All in all, NuvaRing is both a powerful and nearly inconspicuous means of offsetting pregnancy. That said, there are some potential disadvantages:
Withdrawal bleeding – Most people experience breakthrough bleeding during the week they switch out their NuvaRing. This usually sets in on the 2nd or 3rd day during your “break” week, which means you may have to reinsert the vaginal ring even if you’re still bleeding. Withdrawal bleeding is perfectly normal and won’t do your body any harm, but it can be a nuisance (or a little messy) for some users.
Allergies – It’s possible for irritation to occur. Some users develop vaginitis, where the bacterial balance of the vagina is disturbed, resulting in inflammation, itching, or pain. Rarely, people develop an allergic reaction to a foreign body in their vagina, which can result in anaphylaxis, a life-threatening allergic reaction.
Spontaneous removal – It’s unlikely your NuvaRing will budge much during everyday wear, but it is possible for the NuvaRing to fall out. This usually occurs when removing a tampon, having a bowel movement, or during penetrative intercourse. To prevent any interference with your birth control protocol, make a habit of checking that your NuvaRing is still in your vagina before and after you have penetrative sex.
If your NuvaRing falls out, be sure to put it back within 3 hours after it was dislodged. Give it a rinse in lukewarm water to keep it sanitary, then reinsert it into your vagina. If your NuvaRing happens to fall into the toilet, you will want to use a mild soap to clean it before re-inserting it. So long as it’s back in place within 3 hours, you’ll still be protected against pregnancy.
Who should use NuvaRing?
NuvaRing birth control can be used by most sexually active people with a uterus.
That said, some people shouldn’t use a birth control ring, while others may need to wait until they can use it safely. Here’s the scoop:
Postpartum – If you’ve recently had a baby, you’ll need to wait until at least 4 weeks after you’ve given birth to use NuvaRing birth control. You’re at a higher risk of blood clotting in the early postpartum stages, so give your body time to heal and readjust before you use it. If you’ve chosen to breastfeed your new baby, wait to use NuvaRing until after you’ve weaned your child and use a progestin only birth control or a non-hormonal form of birth control in the meantime. Both postpartum individuals and people who breastfeed can use the progestin only pill safely.
Cigarette smokers – In general, hormonal birth control methods like NuvaRing are not safe if you smoke cigarettes and are over the age of 35. The combination of these two conditions puts you at higher risk for adverse events such as a heart attack or stroke. Instead of NuvaRing, you’re best off opting for an alternative form of contraception.
Migraine Prone - If you experience migraine with aura, also referred to as a classic migraine, it is best to avoid combined oral contraceptives that contain estrogen. People with migraine with aura are at an increased risk of stroke if they use contraception containing estrogen.
If you have any preexisting medical conditions—particularly a history of thrombotic diseases in your family—always speak to your health care provider before starting NuvaRing.
How to use NuvaRing
If you’ve ever inserted a tampon or a menstrual cup, inserting a vaginal ring will probably feel like second nature to you. You can try inserting it however is most comfortable: standing up, squatting, or even lying down.
There are 3 main phases involved in using your NuvaRing correctly:
Insertion – You can insert a NuvaRing manually or use the tampon-like applicator included in your box. If you go without the applicator, be sure to pinch the NuvaRing in the middle so that it forms a slender “8” shape and slides easily into the vaginal canal. Once inserted, the ring will sit like a disc just below your cervix. There’s no need to be too precise about its exact placement—unless your NuvaRing causes you discomfort, its precise positioning inside your vagina won’t impair its ability to prevent pregnancy.
Withdrawal – You’ll wear your NuvaRing in your vagina for 3 weeks. On your 4th week, you’ll remove it for a 7-day break. To remove, insert one or two fingers into your vagina until you can feel the rim of the ring. Hook your finger (or pinch two together) and slowly pull the ring down the vaginal canal. Don’t flush your NuvaRing down the toilet—either insert it into the foil sachet that comes with your package or toss it in the trash. Just make sure any pets or kiddoes you have around the house can’t get to it!
Insertion (Round 2) – After your 1-week break, it’s time for a new ring. Timing is key: you should always insert it on the same day of the week, and around the same time that you started your NuvaRing cycle a month ago.
You’re advised to start using NuvaRing on either Day 1 of your period or a maximum of 5 days after your cycle has begun. If you opt for the latter, be sure to use supplementary birth control (like a condom) for at least 1 week following insertion if you have sex.
NuvaRing’s pregnancy-preventing effects will start to work its magic 1 week after you’ve first inserted it. If you start it within the first 5 days of your period, you’re good to go from Day 1.
How does NuvaRing feel?
Since the process of inserting a NuvaRing is a bit more involved than taking an oral contraceptive, many people have questions about how wearing a NuvaRing actually feels.
The majority of individuals who use NuvaRing can’t feel it once it’s been inserted. Think of it like using a slim tampon for light period days. After it’s fully inserted past the vaginal entrance, it’s easy to forget it’s there.
If you can feel it, it’s probably because it isn’t pushed far enough into your vaginal canal. Go ahead and make an adjustment if necessary. Just remember, the material of the ring is built to conform to your shape, so don’t be afraid to give it a nudge if you need to!
Let’s take a look at what NuvaRing birth control can—and can’t—do for your sexual health.
NuvaRing is one of the most effective methods of birth control available. It is more than 99% effective when it’s used properly.
Though NuvaRing is an excellent means of preventing pregnancy, it cannot be used to protect against STDs or HIV (AIDS). If you or your partner has one or more of these conditions, it’s critical you use a condom for coverage against infection.
Learn more about how effective birth control is for other contraceptive methods.
What are the side effects of NuvaRing?
There are some side effects associated with NuvaRing, both mild and, at times, more severe.
Some routine, mild side effects include:
Nausea or bloating
Though rare, NuvaRing also comes with a few other potentially serious side effects. These are:
Toxic shock syndrome (TSS) – There are some cases of TSS that have been reported with NuvaRing use. Tampons are another common cause of TSS. If you experience symptoms of TSS like a sudden high fever, rash, and vomiting with loose stool while using the NuvaRing, seek medical treatment immediately.
Liver disease – NuvaRing has been associated with the development of both benign and malignant tumors in the liver, and people with liver disease should not use NuvaRing. If you observe signs of jaundice—a discoloration and “yellowing” effect of the skin or eyes—you should immediately stop using NuvaRing.
Lastly, NuvaRing use may, in rare cases, result in an increased risk of developing a venous thromboembolic event (VTE)—a type of severe blood clot in the deepest veins of your body. Please seek immediate medical attention if any of the following potentially serious symptoms occur: Severe abdominal pain, chest pain or severe arm pain, shortness of breath, severe headaches, vision problems, severe leg pain, suicidal thoughts or thoughts to harm yourself or others.
Healthy users of NuvaRing are at extremely low risk of a VTE. However, if you have a history of thrombotic disorders, obesity, or smoking, do not use NuvaRing as a method of birth control. Consult a health care provider for other potential contraception methods.
Put A Ring On It With Favor
All in all, NuvaRing birth control is an excellent, effective, mostly hands-free way for sexually active people with uteruses to unwanted pregnancy.
If you like what you hear, you can put a ring on it with Favor. Check out our alternative to Nuvaring with our Annovera 101 guide. We’re a mission-driven company that provides people with the resources and science to help them make the right decisions for their reproductive health care.
Telemedicine consultations to help you settle on your ideal birth control method. From the birth control patch to emergency contraception (such as Plan B), we have what you need for your reproductive health.
Prescription fulfillment services are covered through insurance (including Medicaid) or one of our payment plans
Regular shipments of your birth control of choice, depending on how frequently you would like to receive it, plus self-care extras to help you pull through any discomforts that come with your monthly menstrual cycles
We serve 49 out of 50 U.S. states, including 99% of under-resourced reproductive health deserts across the country. To enroll, and learn more about the expertise and resources we can offer you, head on over to HeyFavor.com.
Reviewed By: Jessica Barra, FNP - Family Nurse Practitioner