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Everything You Need to Know About the Nuva Ring

Fri, Oct 23, 2009

Advice, What's Up Doc?

nuvaring

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City and she answers your medical questions here once every two weeks. To ask her your own question (not about the Nuva Ring, please), click here.

When it comes to hormonal birth control, I get more questions about the NuvaRing than any other method — for proof, just check out the comments sections of my posts “Tell Me About the Nuva Ring” and “Does the Nuva Ring Deserve Its Bad Press.” The ring just doesn’t seem to be as intuitive as the once-a-day-every-day tyranny of the birth control pill. Most women’s questions focus on the timing of the ring, and what happens if their schedule gets thrown off. So, since Em & Lo have put a moratorium on Nuva Ring questions for the time being, here are the 14 points about the Nuva Ring that should hopefully answer any and all questions.

1. When to start it: You can start the ring any time you want…

  • If you’re starting it with your period, put in the ring during the first 5 days of bleeding.
  • If you’re starting it later than that, or totally off your period, take a pregnancy test first. If negative, begin the ring that day.
  • If you’re switching to the ring from the pill or patch (and you completed your pack of pills/box of patches), you can place the ring on the day you would have started your new pack of pills or box of patches.

2. How soon you’re protected: It depends on when you started the ring…

  • If you place the ring on the first day of your period, you’re protected immediately.
  • If you started the ring at any other time, you need to use condoms for 7 days for maximum contraception protection.
  • If you directly switched from the pill or patch to the ring (and you completed your pack of pills/box of patches), you’re protected immediately.

3. The minimum you must leave it in: The ring needs to be in your body for 3 straight weeks. Don’t take it out early if you start bleeding earlier than you expect — the ring needs its three weeks to work. If you remove the ring before the three weeks are up, you’re at risk of pregnancy that cycle.

4. The maximum it can stay in: The ring has enough hormones so that it may be left inside for up to 5 weeks and still be effective. So you’ve got lots of flexibility in how long the ring is in. And you don’t need to use the ring for the same amount of time each cycle — some months you may leave it in 3 weeks, some up to 5 weeks — your body will adjust. But if it’s left in longer than five weeks, you’re now at risk of pregnancy.

5. How long you can leave the old ring out before you put a new one in: When switching between old and new rings, the device cannot be out of your body for more than 7 days — in other words, you need to put a new ring back in by the same day of the week that you removed the old one. This rule holds even if you’re still bleeding — the new ring must be reinserted within a week. (If you want to shorten your ring-free week and, say, put a new one in after 3 or 4 days, that’s fine — you’ll still be protected.)

6. When it’s out for that one week, you’re protected: If you’ve used the ring following these guidelines, you’re still protected against pregnancy during the ring-free week. The ring has suppressed ovulation for that cycle, so you don’t need a back-up method of birth control during the ring-free week (though condoms are always a good idea for infection prevention, whether the ring is in or out).

7. Temporarily taking the ring out for three hours or less:
The exception to rule #3: you can remove the ring for up to 3 hours at a time and still be protected against pregnancy. For instance, you can take it out for a gyno visit, sex, or masturbation (some people don’t like the idea of playing ring toss in their vagina), but in each of those cases it isn’t necessary to do so.  There are no studies that tell us how often you can take a ring holiday; I counsel my patients that they can remove the ring once a day for 3 hours and are likely still safe.

8. Taking the ring out for more than three hours:
If it’s out for more than 3 hours, it’s possible that your ovaries will respond with a quickie ovulation. So put the ring back in and use condoms for a week.

9. If you’re late putting a new ring in:
If the old ring has been out for more than 7 days, put the new ring in anyway. Don’t wait for your period to start (so many women become pregnant while they’re waiting!). Then use condoms for 7 days.

10. Using rings back-to-back. You can use a new ring directly after taking out the old one — you don’t need to leave a ring out for any length of time, you don’t need a back-up method, and you can do this indefinitely (no need to ever bleed).

11. Bleeding patterns: It’s normal to have irregular spotting or bleeding during your first few months on a new birth control method. Don’t pull the ring out if you begin to bleed early — it doesn’t mean the ring is “finished,” it’s just breakthrough bleeding while your body is adjusting.

12. Other things in your vagina: Fingers, penises, tampons, sex toys, semen — all okay.

13. You can’t lose it in your body.
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 to work, and it won’t go in too far.

14. Risk of pregnancy: If you have sex without using the ring correctly, you are at risk of pregnancy. Take a pregnancy test if your period doesn’t come when you expect.

Dr. Kate
Gyotalk

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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61 Responses to “Everything You Need to Know About the Nuva Ring”

  1. Michelle Says:

    I had he ring in for no longer than 2 weeks because I had very bad side effects from it. Chronic nausea, weight gain and mood swings. I’ve now got my period 2 weeks early without any signs. Is this normal? Or should I see my GP. There is no way I could be pregnant because I did not have sex while having the ring in.!

  2. Jamie Says:

    I am using the nuvaring all month for no periods. This is my third month of doing this. I had my usual pms symptoms last week and started bleeding a few days ago. At first it was just a little brown but after sex w my bf, I’m actually bleeding now. It’s not time for a new ring yet and I havnt taken it out for longer than a cpl mins for cleaning in the shower. I’ve read some bleeding is normal but how long will this last? And how often will it happen? It kinda defeats the purpose of not having periods. I don’t get to see my bf often but when I do we’d like to have full access w no restrictions (fingers and mouths).

  3. Katy Says:

    If I’m already on the nuva ring, can I put the new one in a few days early? Will that put me at risk?

  4. Elsa Says:

    This was so helpful! The package just tells you the average 28 day cycle and doesn’t explain alternatives. Also it doesn’t really answer the major questions about how it translates compared to the pill. This answered my questions, thank you!

  5. Sara Says:

    Can I have sex with the ring in?

  6. Jen Says:

    I have a quick question about the nuvaring.

    I started the nuvaring at the end of my menstrual cycle. Because I had to start it again at the end of my cycle following the removal of the nuvaring in order to keep schedule, do I still wait a week before it’s safe to have sex without a condom?

  7. Trisha Steinburg Says:

    Ok my last day of my cycle was April 15th 2014 …I started the nuva ring on April 26th 2014 after I put the ring in we had sex 3X in which he ejaculated in me twice, I wasn’t on birth control before this! I thought I was covered immediately after inserting the ring! To make matters worse I took it out to soon, I had it in only 12 days.. I bled after taking it out, my period lasted for 3 days.. Kinda heavy one day and then light the other two days! The second day of bleeding I had sex and he ejaculated in me. That was on May 10th I didn’t put another ring in until May 19 and that was 30 minutes prior to sex and he also ejaculated in me, one hour after sex I took the nuva ring out and have not put it back in! What are my chances of being pregnant? Worried

  8. Trisha+Steinburg Says:

    I have been extremely crabby and very sleepy as well!

  9. Marlen Says:

    I put the nuvaring today
    Around 3. And couple
    Hours later I started
    To feel dizzy my head
    Started to Hurt little bit
    Then I felt sleepy
    I felt like I wanted to throw up
    You think I should take it off
    Or this is normal ?

  10. Tori Says:

    Thank you! Answered every question I’ve ever had and found no answers! :)

  11. Meghan Says:

    Thanks in advance for your help. I’ve been on the Nuva Ring for a little over a month. The first cycle I was on it, I took it out on Wednesday instead of the Sunday coming up because I was experiencing some health issues and the doctors in the ER told me to take it out just in case it was causing any problems, which it wasn’t. I got my period that Saturday and I put the ring in on Sunday, because I read somewhere that it is the most reliable when you put the ring in right when your cycle starts.
    I am a virgin, so I know it doesn’t matter when I put the ring in. However, my boyfriend and I were planning on having sex this weekend and I was wondering if I would still be covered because I didn’t go a whole week after taking it out? To be more clear, I took it out Wednesday the 11th of June and put it back in on Sunday the 15th without any break between. I called my nurse at my OBGYN but she wasn’t clear as to whether I would be covered. Do any of you guys know?
    Thanks!


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