Using the Ring

The NuvaRing is a method of birth control that works by releasing the hormones progestin and estrogen directly into the vagina. This method is an alternative to other methods made especially for those who do not prefer pills, skin patches, intrauterine devices, injections or implantable devices.

When the ring is inserted into the vagina, the body recognizes that estrogen and progesterone are coming from somewhere else (the ring), so the ovaries do not need to release those hormones. While using the ring, your hormones temporarily go to sleep. While they are "napping," they do not release hormones, and do not cause the release of an egg, which is how the ring works to prevent pregnancy.

Forgetting to use the ring as directed can cause the ovaries to "wake up." When that happens, the ovaries release hormones and may release an egg, which can result in pregnancy.

  • Insert the ring into the vagina.  If you can feel it, you need to push it in further. It can’t get lost.
  • Leave it in for three weeks.
  • If you decide to have sex, your partner probably won’t feel the ring; however, you may take the ring out for three hours, but then you will need to reinsert it. 
  • At the end of three weeks, you should take it out to have a ring-free week.  Most women will get their period on the second or third day. 
  • At the end of the week, you will put in a new ring even if you are still having your period. 
  • Throw the old ring away. 
  • Some women do extended cycling on the ring, so when they take it out after three weeks, they immediately insert a new one and avoid the ring-free week.  

Most people don't have any side effects with the NuvaRing. However, during the first three months you may experience:

  • Bleeding or spotting during the time when the ring is in. This is called breakthrough bleeding and is usually worst during month one, less during month two, and by month three most people have regular periods during the week the ring is out. If breakthrough bleeding continues after month three, you may need a different method. Write down the dates of any bleeding that you have on a calendar. Bring the calendar to each visit with your clinician.
  • Other problems are not common, but you may have nausea, breast tenderness, headaches, or mood changes. If they occur, they are usually mild and don't last long. These symptoms usually occur with ring insertion and may be avoided if inserted at night.

If you are having problems with this method of birth control, do not stop using the ring, but call the triage nurse, 513-636-4681, option 2.  

The ring does not cause weight gain. 

Call the office immediately if you have:

  • Severe headaches (the worst headache you've ever had)
  • Dizziness
  • Vision changes
  • Chest pain
  • Pain in the calf of one leg
  • Severe abdominal pain
  • Shortness of breath
  • The ring does not protect against sexually transmitted diseases. Use condoms every time you have sex.
  • Never run out of rings. Call your pharmacy to request a refill on the ring once you remove it. If your pharmacy tells you that you have no more refills, call the triage nurse and ask for a refill.
  • If you are having a problem, don't just stop using the ring. Call the triage nurse.
  • The NuvaRing is currently the only vaginal ring available for birth control. If you are unhappy with it, you will need to discuss another method with your doctor or nurse practitioner. 

If you have questions, contact the Teen Health Center at Cincinnati Children's, 513-636-4681.


Last Updated 11/2013