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Dear Dr. Kate: Can You Tell Me All About the NuvaRing?

Thu, Feb 5, 2009

Advice, What's Up Doc?


Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City who’ll be answering your medical questions here regularly. After her recent post on the NuvaRing, a lot of you asked for more information on this birth control device, so here goes:

The NuvaRing is one of my favorite forms of hormonal contraception — all of the benefits of the Pill, without the daily hassle of remembering to use it. But since the Ring hasn’t been around as long as the Pill, many women have a lot of questions about using it. So I thought I’d address the most common Ring issues that come up in my office. When using the Ring….

What’s okay to put in your vagina:

  • A penis. Intercourse will not push the ring up into your pelvis, or to any place where you can’t retrieve it. And semen/sperm will not diminish the ring’s effectiveness.
  • A vibrator or other toys. Same as above.
  • Tampons. Ditto.
  • Medication. It’s fine to treat a yeast infection with over-the-counter creams like Monistat, or to treat vaginosis with prescription MetroGel. You don’t need to rinse the ring off afterward, either — the medication will all absorb eventually.

What’s okay to come out of your vagina:

  • The ring before sex. If sex is uncomfortable with the ring in place, just take it out. It sounds counter-intuitive, to take out your birth control before having sex. But the ring works its magic by turning off your ovaries — and the hormones will remain in your system after the ring comes out. You can remove the ring for up to three hours without losing effectiveness (and if anyone is having sex longer than three hours, please share your good fortune with the rest of us!). Just be sure to put it back in before you roll over and go to sleep.
  • Increased discharge. It doesn’t mean you have an infection — it’s just your vagina’s way of reducing friction with the ring in place. Think of it as more lubrication for sex.

Do any of you have questions about using the NuvaRing? [[Editors' note: Dr. Kate compiled all the most common questions she gets about the Nuva Ring and answered them in a post called "Everything You Need to Know About the Nuva Ring," so she will no longer be answering any Nuva Ring questions in this or other comments sections. The lady only has so much time.]]

– Dr. Kate

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City. She also lectures nationally on women’s health issues and conducts research on reproductive health. Check out more of her advice and ask her a question at Gynotalk.com.

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268 Responses to “Dear Dr. Kate: Can You Tell Me All About the NuvaRing?”

  1. Abby Says:

    I want to add that after I have a yeast infection (I’ve had a few lately from antibiotics) I find that rinsing my ring off after the infection is mostly gone (I use diflucan to make it go away) helps, because the yeast seems to stick to the ring. Helps a lot.

  2. Jean-ga Says:

    I’ve been using the Nuvaring for 3.5 years and I love it. 3 weeks in, 1 week out. No pill everyday and I can time my period starting down to the hour! Easy to put in and take out and very comfortable. Try it!

  3. bigmomma Says:

    about washing the ring — wont that wash away the medicine off the ring or something?

    also just to confirm – he can come in me during the 3 weeks that the ring is on, right? how about during the week i have it off? can he come in me then?

    sorry one more – i have not been on birth control for a year. i will be using nuvaring this weekend for the first time. how long do we have to wait before he can start to come in me?

  4. Jen Says:

    Thanks for the info… I hate the pill and will certainly be trying this nuva ring!


  5. Shaun Says:

    wow. that is alot of information. I dont even know if I could do all that. And thank you so much for lettming me in on all the info.

  6. John Says:

    I really enjoy blogs like this, since I am a blog addict I will visit again soon.

  7. fatima Says:

    Dr. Kate,
    ive been using the nuva ring since feb. 09 and i had to tried to remove the ring today and i couldnt feel it at all. what could have happened to it? can it dessolve? ot go anywhere else??


  8. Dr. Kate Says:

    Fatima, the ring may either be higher up in your vagina than you’re used to feeling for it (it can shift over time)…or it may have fallen out since you placed it. It definitely didn’t dissolve, and it’s definitely not “inside” your body (in a place other than your vagina, that is). Try using a bit of lubricant on your fingers, and reach up as high as you can. If you still can’t feel it, it’s likely fallen out.

  9. edwine Says:

    Can you pls tell me when do i insert nuvaring, is it the first day of my period of after my period??

  10. Thalia Says:

    How soon can you have unprotected sex after starting the NuvaRing?

  11. Dr. Kate Says:

    Edwine, you should insert it on the first day of your period.

    Thalia, if you start the NuvaRing within 5 days of the start of your period, you’re protected right away. But if you start at any other time in your cycle, you should use condoms for a week for maximum protection.

  12. caitlin Says:

    I started nuvaring 11 days ago. Since it was my first month using it, I inserted the ring on day 1 of my period as directed. I had a shorter period than usual, and typically when my period is ending it will be a little bit brown. However, after 3-4ish days of period, this brown discharge that usually means “okay, it’s over” has been going on right to day 11 of having the ring in!! This is SO annoying and almost defeats the purpose of birth control since having sex with this brown discharge would be rather messy. I have read on some websites it takes up to 3 months for this to stop, 3 months? seriously? I just don’t know what to do.

  13. Dr. Kate Says:

    It’s not three months for everyone – have you used hormonal contraception before? If you have, and the prolonged periods didn’t last long on the pill, they likely won’t on the ring either. But yes, 3 months of irregular periods (longer or spotting in-between) isn’t unusual. Tuck a towel under your bum during sex until the discharge clears, and try to think of it as extra lubrication!

  14. Lisa Says:

    I wear the ring 4 weeks in and 1 out (my gyno says that’s ok). Sometimes I immediately put a new ring in and skip my period. I forgot to do that this time and I was wondering if I put in a new ring during the “break week” (before my period started) if I would be protected or if I would have to wait seven days.Thanks!

  15. cathy Says:

    Can you start the nuvaring for the first time, after the initial 5 days of a period….say 6 or 7 days post first day of period? If so, how does that work, won’t my ovaries already be in there cycle and increase risk of pregnancy?

  16. Jessica Says:

    Hello Kate,

    I just stopped using the ring I thought it was great but my body is way to sensitive to the hormones and even after over year if usage I was still vomitting and feeling ill when inserting and taking out the ring. I took the ring out as normal on the 1st and a week passed in which I got my cycle however I still have bleeding. My cycle should have ended last Monday the 8th. Yet, I am still having bleeding and spotting but only when I urinate and it is the 16th. Should I be concerned?

  17. Dr. Kate Says:

    Lisa, as long as you put in a new ring before 7 days have gone by, you’re protected…when you put the ring in doesn’t really matter in that time period.

    Cathy, you can put your first ring in at ANY time during your cycle. You use condoms for a week (if it’s not your period) in case you ovulate in the first few days. If you already ovulated but didn’t have sex, you’re fine. And if you ovulated and had sex – and may have an early pregnancy – the ring won’t cause a miscarriage or birth defects.

  18. Dr. Kate Says:

    Jessica, it’s not uncommon to have irregular bleeding upon stopping hormonal contraception – your body sometimes needs a few weeks (or even months) to normalize the natural ebb and flow of hormones. If the bleeding becomes wicked heavy, call your gyno. Otherwise, have plenty of pantiliners around and ride it out.

  19. Nikki Says:

    I just started using the Nuvaring, I put it in, and it doesnt feel high enough.. i can feel it with my finger and it is only like an inch in my vagina. I cant feel it otherwise..  but does it have to be a certain amount in the vagina?

  20. Dr. Kate Says:

    As long as the ring is all the way in the vagina, and it feels comfortable, you’re good to go. It doesn’t need to be in a particular place.

  21. Kay Says:

    Im 46 and using the nuvaring strictly for making my periods better or non existent…my husband has had a vasectomy. Is it really necessary for me to have a period at all? Can I just put a new ring in every 4 weeks and have NO period?

  22. Em Says:

    Hi Dr.Kate, i havn’t started the nuva ring yet because i was waiting for my period. Should i insert the ring the first day of my period or 5 days later?… or when it stops

  23. Jaki Says:

    Hello Dr. Kate,

    So I am just starting out on the ring, this is my 9th day or so with it in and I had sex for the first time (while on it) yesterday and I had a few complications.

    1)It went from not feeling it, to my partner not minding it-almost added sensation(and me not enjoying it), to neither of us like it at all, so I removed it.

    2)At first I was nice and wet and it slowly declined all the way til I took the ring out and then I couldn’t get wet at all.

    3)After putting it back in it feels weird, I notice its there and I keep trying to push it up further but it just seems to slowly slide down.

    So now that you know my issues my questions are, can I use a lubercant, I was thinking of the K-Y intenseify. Should I take the ring out if Im using lube (although I’ll be removing it anyways j

  24. Dr. Kate Says:

    Em, you should put the ring in on the first day of your period–you’ll have the quickest protection against pregnancy that way.

    Jaki, you can use lubricant during intercourse with the ring in place (and it may help to use lube to place the ring as well). Sometimes it takes awhile to get used to the sensation of the ring during sex….but it’s okay if you always take it out. You can have the ring out for up to 3 hours and still be protected against pregnancy.

  25. Ally Says:

    I went on the ring 7 days ago, right after my period. I had sex last night and I’m concerned it wasn’t in long enough to protect me. Do you think I was protected? Cause I’m panicking a little now

  26. Emily Says:

    I was reading Jaki’s post and was worried about what had happened to her, i havn’t started the ring yet but if the ring is uncomfortable for me or my partner when we have sex is it best to use a different method of birth control? I don’t want to be constantly taking the ring out during sex either, so i wonder if that is a problem

  27. Meg Says:

    I’ve been on the Nuvaring since about Nov-Dec ’08.

    About 3 cycles ago, we were on our honeymoon. I started spotting on Friday. Because we were in Jamaica and I had no way of contacting the doctor, I left the ring in for 2 more days, and then took it out on Sunday, like I normally would. I had my period that 4th week and then put a new ring in the following Sunday.

    I went 3 weeks and then took the ring out, had a regular period week, then put in a new ring. This brings us up to the present.

    I woke up this morning and went to the bathroom. After wiping I noticed I had bright pink on the tissue. I’m apparently spotting again (Friday). I tried to call my doctor this morning, but of course they are closed for the July 4th holiday. Do I wait 2 days and take it out Sunday as usual, have a week off, and start again?

    I was under a ton of stress back in May when I had the first early spotting incident. I’ve also been under quite a bit of stress this past month with work. Is spotting a few days early unusual? Could this be due to stress?

    PS-I am very unhappy with Nuvaring thus far. Then again, I’ve been unable to take every other form of birth control that I’ve tried (emotional issues, severe swelling of the calves, abnormal periods). My husband just had a vasectomy on June 1, so luckily in a few months I won’t have to worry about birth control anymore.

  28. Dr. Kate Says:

    Alli, 7 days is enough to protect you from ovulating for the rest of this cycle. But there’s always a tiny chance that you ovulated really early (at the end of your bleeding) and could have gotten pregnant before you put the ring in. So if your period is late this month, take a pregnancy test to be sure.

    Emily, most folks (both women and their partners) are comfortable with the ring in during sex. But it’s okay to take it out all the time (how many times a day are you having sex, anyway?) you have intercourse – it will still work as well.

    Meg, stress can be a cause of spotting with the ring – the hormone levels are fairly low, and it wouldn’t be unusual to have some breakthrough bleeding if you’ve had lots of stress lately. You don’t want to take the ring out before at least 3 weeks are up – so if it’s 3 weeks on Sunday, wait till then and remove it. But if it’s been in for more than 3 weeks, you could take it out now.

  29. Dr. Kate Says:

    Ally, to prevent that worry in the future, when you’re starting the ring for the first time in a while, put it in during the first 5 days of your period, for full protection that cycle.

  30. Toya Says:

    I had a abortion in April and put the ring in 2 days after(which was a Sunday). I was spotting in June (a very little bit for 3 days) and still no period and its now July, can i be pregnant. The spotting was 3 or 4 drops every 4 to 5 hours, should i be worried?

  31. Megan Says:

    I have been on the nuvaring for about a year (LOVED IT BTW)… but due to the fact our insurance doesn’t cover contraceptive…. the monthly cost was way to much so I decided to get an IUD put in just this past week on wednesday.. June was the last month of using Nuvaring so i put it in on the Sunday as usual, three Sundays later took it out and had my period. The dr wanted me to put a new ring in on the normal 4th Sunday which was last week (june 28th) because my appt wasn’t until July 1st so they didn’t want me to be w/out birth control. I did this and then wednesday the 1st of July, I took the nuva ring out and had the IUD put in. The dr told me the IUD could cause spotting, and at first it did… but starting on thursday night/friday morning, its definitely more than spotting, could taking the ring out have caused an early period? It is like a really heavy period

  32. Leslie M. S. Says:

    Dr. Kate,
    I’ve been happily using nuvaring for 2 years now. 4 weeks in, 1 week out. Today was the day I had to remove the ring (I haven’t yet) for the week break. I had unprotected sex today. Should I take plan b? Because I know sperm can live inside for 3 days. Is it safe to take out the ring?

  33. Tina K Says:

    this is the first time I am using nuvaring and today is the 7th day after the 1st day of my last period. Is it gonna make a difference if i insert the ring today? I plan on using a condom regardless i’m on the ring for extra protection…

  34. Dr. Kate Says:

    Toya, if you haven’t had a “real” period (several days of bleeding, not just spotting) since the abortion, I think you should take a pregnancy test. It’s possible that the ring has just drastically reduced your monthly bleeding (if so, yay!), but it’s better to know for sure.

    Megan, the heavy bleeding could be from the ring coming out early. It could also be the IUD itself – is it a Paragard (copper)? They’re known for sometimes causing heavy bleeding. If it’s the IUD, the bleeding will likely lessen with time (over the next few cycles)…but if you’ve got a lot of pain too, see your gyno to make sure the IUD isn’t being expelled.

  35. Dr. Kate Says:

    Leslie, you’re safe. There’s enough hormone in the ring for 5 weeks of use…so if you’re on that 5th week, you’re still protected. No need for plan B, and you can now take the ring out for a week to have a period if you want (or just put in a new one and skip the bleeding this month).

    Tina, I tell my patients that if you don’t put the ring in within 5 days of starting your period, it’s safest to use condoms for the first week of use. So go ahead and place the ring, and be sure to use condoms. Yay for dual protection!

  36. Alexis Says:

    my nuvaring fell out, so I didn’t have one for a couple days, and then I got a new one and wore it for 3 weeks, then took it out for one. During the 3 weeks in and 1 week out, I had a constant period and didn’t have sex, then at the end of the 4th week, I put a new one in at the same time. I called a gyno (not mine) and she said that I wasn’t protected for this whole month, but the gyno I went to, to get the new nuvaring from said I would be protected this month, so before I called to make sure, I had unprotected sex, but he pulled out before.

  37. Chelle Says:

    I’m sure this has been asked several times above me, but just to be sure: I started my period Friday night, and put the ring in on Sunday morning, when would I be considered safe? Now or should I wait the seven days? This is the first time using birth control and the rings I was given were samples, so, no real instructions.

  38. Brandi Says:

    Dr. Kate,
    I just started Nuvaring last month and took it out and immediatly got my period. I was suppose to reinsert it on that saturday and forgot. I had sex tuesday (day 11 lmp) and rember the next day to reinsert it. (I was on the patch for over a year before switching to nuvaring). Is there anyway that I cold be pregnant? Would you ovulate late or early if you were 4 days late on reinserting?

  39. Tina K Says:

    I inserted the ring, am I still supposed to feel it. I don’t feel it in my body but i can feel it if I put my finger inside. My question is if I can feel it with my finger won’t he be able to feel it when we have sex? and is it possible for his penis to get stuck in it move it or pull it out?

  40. katie Says:

    I have been using the NUVA ring for about one year and recently i stopped using it because i stopped having sex. Now i do not have a regular period anymore and i want to start using the nuva ring again. Can i just use the Nuva ring before my period starts? I am not planning on having sex and i just want to have a normal period. I also want to stop breaking out. So my questions is, if i can put the nuva ring in me if ive had my period about 2 weeks ago?


  41. ashley Says:

    Hi Dr.Kate i started tthe nuvaring for the first time on sunday bvut i still had my period, and i just pretty much stopped my period today (tuesday) when i take the nuvaring out, what happens if i dont get my period that week?

  42. Dr. Kate Says:

    Chelle, you’re safe. As long as the ring goes in within the first 5 days of your period beginning, you’re safe for that cycle.

    Brandi, there’s a chance–though it’s small–that you became pregnant. If you’re late inserting a new ring, there’s a chance that you’ll ovulate before the ring has a chance to “turn off” your ovaries. So if you don’t get a period at the end of this cycle, take a pregnancy test.

    Tina K, it’s normal to not be aware of the ring when it’s in (that’s one of the nice things about it). Researchers have asked men whose partners are using the ring. Most men don’t feel the ring during intercourse, and of those men who can feel it, most don’t care. (Takes more than that for a fella to not enjoy sex!) He won’t get stuck, or pull it out (penile ring toss?)…though if it’s ever uncomfortable during intercourse, just take it out, for up to 3 hours.

  43. Dr. Kate Says:

    Katie, you can start the ring at any time – period or not. Just restart it when you want to, and you’ll likely see bleeding at the end of the cycle.

    Ashley, most women will still have a period (or some bleeding) when they take the ring out – even if it feels like a “second period” that month. If you don’t bleed at all, you can take a pregnancy test to be sure – but it’s still unlikely that you’d be pregnant.

  44. ashley Says:

    so basically the ring trains your body to have a period that week that you dont have the ring in?

  45. kel Says:

    Dr. Kate,
    I just switched from the pill to the nuva ring. I usually get my period in the evening on the third day of my placebo pills. I read that when switching from the pill to the nuvaring to put it in on the first day of your cycle. I put the ring in today, even though I hadn’t gotten my period just yet (I put it in this morning as opposed to the evening when I normally get my period). By putting the ring in today before I started menstruating, will I not get my period until the beginning 4th week when I am supposed to take this ring out?

  46. Alexis Says:

    … Why did you skip my question completely?

  47. emandlo Says:

    Alexis: Dr. Kate checks in when she can and dedicates a *lot* of time to answering follow-up questions here, but there’s no guarantee she can get to all of them. If you need an answer urgently, you should check in with your own doctor, who knows a lot more about your sexual health history than Dr. Kate. Also, Alexis, we’re not doctors, but common sense would indicate that if you had any doubt at all, then you shouldn’t have had unprotected sex. :-)

  48. Dr. Kate Says:

    Ashley, it’s actually what doctors call a “withdrawal bleed” – bleeding in response to the sudden lack of hormones from the ring. This is why if you use rings “back to back” (putting a new one in at the same time as taking out the old one), you generally won’t bleed at all.

    Kel, many things can happen when you switch from one method to another. It’s most likely that you won’t bleed till the fourth (ring-free) week, and you’ll skip your period this month. But it’s also possible that you’ll spot sooner, or even have two periods this month. Annoying, but not unhealthy, and the bleeding will likely regulate by the second cycle.

    Alexis, I couldn’t tell what your question was from your comment (which is why I emailed you yesterday). If the ring comes/falls out in the middle of the cycle, there’s a chance of ovulation, and then pregnancy if you have sex while it’s out or in the few days after. If you didn’t have sex when it was out, or for a month after, you likely didn’t get pregnant. When restarting the ring mid-month, you should always use condoms for a week to cover this pregnancy possibility. If you first had sex again after a “full cycle” of ring use (3 weeks in, one out), it’s not likely you got pregnant from sex that time.

  49. dale Says:

    Dr Kate, I used the Nuva Ring in 2003-04. I had extreme vaginal dryness and subsquentially stopped using the ring. Shortly after I became pregnant. During my pregnancy I developed a blood clot in my leg. My physcian at the time attributed this to “pregnancy hormones”, but I blamed it on the Nuva Ring. Please alert everyone to the risks involved with using hormonal birth control.

  50. Mandy Says:

    Is it bad to have unprotected sex after the 3 weeks of having the nuva ring and you remove it, but before you have started your period?


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