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Everything You Need to Know About the Nuva Ring

Fri, Oct 23, 2009

Advice, What's Up Doc?


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‚Äôre good to go. It doesn‚Äôt 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

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

  1. Alexis Says:

    Am I protected the first week after I insert the new ring, the week after my period?

  2. candy baby Says:

    after the period on the forth week… how many days do i need to wait to have sex that way im still protetced

  3. valerie Says:

    what if i am 3 days late having a period i started the nuva ring way before my period should of started the doctor said it was okay but now i havent had a period . Is this normal?

  4. valerie Says:

    I also have cramping but no period.

  5. Mila Says:

    I put the ring on oct.23 and took it off on nov. 4th. I had unprotected sex with my partner on oct. 24th, 25th, 26th, also, on nov. 3th & nov. 7th. I never replaced the ring I removed on the 4th. However, my period came down on nov.10th and it lasted for about 4 days. Is there a possibility that I can be pregnant?

  6. Jen Says:

    I was on the Nuvaring for 1 year and apparently gained 10 lbs the year I was on it. I didn’t know it until the doctor weighed me at my recent physical. Now that I am off of it, I have really noticed weight gain. The kind that makes my clothes not fit anymore. :( Will this stop? I don’t want to go back on the Nuvaring because my husband and I want to start a family. I also was on various birth control pills for 12 years before going on the Nuvaring. I know I will have baby weight to lose after the baby arrives, but I don’t want to have to lose extra weight on top of that. I am not pregnant yet (we wanted to wait a few months before trying to reduce the chance of a miscarriage). I just worry about having to lose a lot of weight after the whole process.

  7. keke Says:

    this is my first month using the NUva ring.. this is suppose to be my free week from the Nuva ring its almost time for me to insert nother Ring and my period has not came on.. is that normal… i know i am not pregnant i just went to the doctor in the 1st and had a pregnancy test and i ws already in week one of using the Nuva ring.

  8. jess Says:

    I have had the ring to actually come out on its own while using the bathroom and also comes out multiple times while pulling out a tampons! Is there something I’m doing wrong?

  9. Jessica Says:

    I just realized that I did not take out my Nuvaring on time. I haven’t had it in more than 4 weeks, so I know I’m protected. But what’s odd is that I got my period while the Nuvaring was still in and have it now. I’m going to proceed as normal and put in my new Nuvaring a few days early so I can start my cycle when I want. Is there anything wrong with this situation? Also, it has come out multiple times now during intercourse…is there something I can do to prevent this besides taking it out before sex??

  10. brittany Says:

    I just had a baby boy 6wks ago and I decided 2 get the nuvaring 2day at my 6wk checkup. I’m nt sure when my period is because I bleed 4 about 3 wks aftr giving birth but I need 2 start a method of birth control nooooow and not condoms. Can I start the nuvaring at anytime? And if I were 2 start 2day at a random time having nothing to do with my period when can I begin having unprotected sex?

  11. Irma Murillo Says:

    I had unprotected sex after my period (period last 3 days) so on day 4th I had unprotected sex, on the fifth day I took the day after pill and inserted the ring, this is my first time using it. I then again had unprotected sex on day 7th and 8th day this means that my ring was only in 3 and 4 days before i had unprotected sex, should I take another plan B, what are the chances that I will get pregnant?

  12. lakeitha Says:

    3mos since I been on the ring and I like it… I gain 2lbs all in the right places, but I can say the first month was crazy for me, I was craving donuts, had bad headache, tiredness, waking up out my sleep at night, going to the bathroom a lot and had gas… not cool at all. But after all that my body adjust to it all… you can’t feel it at all… and you don’t have to worry about what time you have to take it unlike the pill…the hormone goes straight to the cervix with the ring.. and you’ll never knows its there.

  13. Ale Says:

    Am I protected the week after my period , once I’ve placed the new ring …like on day two of my replacement ring?? I’ve been on it for four months…

  14. danielle Says:

    okay i just delivered a baby boy 4 weeks ago. havent yet gotten my period. not sure if i can take the nuva ring without having my period….

  15. Macey Says:

    How do I know if the ring is in all the way? I’ve pushed it in as far as I can. But I don’t think its far enough?

  16. J. F. Says:

    I have been on the nuva ring for a few years and get my leriod every 3 months, i just put a new ring in and started bleeding a couple days later, i would normally get my period after this ring, should i take it out and have my period? But will it still be ok to use after? Or should i just leave it in?

  17. Michelle Says:

    I recently took my ring out and started bleeding just two days later…I have a hectic work schedule and the fatigue I’m feeling is worse than the cramps, but they potentate eachother…but after I saw blood, I put the ring back in and it’s been about 24 hours since then. I’m still bleeding, and taking ibuprofen and muscle relaxers generously, but when will the fatigue and bleeding start receding? Does anyone know exactly how long it takes for the hormones to start working when the ring has only been out for a few days? PLEASE this is very important, I’m already on thin ice at my job for this very problem and I’m just damn sick of it. Any answer would be much appreciated, thanks!!!

  18. sonia Says:

    ive been on nuvaring for 2 months…i didnt like it so i took it out last week before the 4th week came around. i have brownish like spotting,does this mean i will get my period around this date, or will my cycle continue normally on the date i used to get it (when the ring was supposed to be removed)?

  19. Maria Says:

    When you insert a new NuvaRing does it have to be inserted at the same time you put in your previous one or does the time not matter? It’s my first month using the ring and it’s my “free-ring” week. I inserted my first ring on a Friday at 12:30 a.m. But I took it out at 2:00 a.m. on the 3rd week. Does that matter? Am I still protected?

  20. Maureen Says:

    This is my first month on the ring. I was supposed to take it out on Monday, march 26. I forgot and just remembered today. Once I take it out, is it okay to put the new one in on Monday?

  21. S Says:

    I am suppose to take out the nuvaring today. I had protected sex today as well. Is there a possibility I could get pregnant if I take out the nuvaring today or am I still protected?

  22. E Says:

    Thank you for this! Straightforward, comprehensive, and ultra-helpful. Every nuvaring should come with a link to this page :)

    Also to anyone on here who is considering the ring: I highly recommend it. I had serious breakthrough bleeding the first month but it has stopped completely this second month and I am experiencing virtually no other side effects! If you have had bad experiences with the pill like I have, I urge you to try the ring!

  23. AJ Says:

    I want to start using NuvaRing for the first time but I want to know if it is safe, as I just recently had unprotected sex. Is there a period of time I should wait to find out if I may have become pregnant or can I start taking it right away?

  24. sheila Says:

    i was late putting my nuva ring in by 1 day i put it in on a Monday should I keep it in for the 3 weeks and take it out on that monday or go back to my old schedule and take it out on sunday? I’ve been taking it correctly I just want to know because I am the 3 weeks and I want to know if I should takee it out today or tomorrow? (Sunday or Monday)?

  25. TT Says:

    I was on the IUD for 5 years and when it was due to be taken out my Dr put me on the nuvaring. So I have no idea when my last period was since I never got one with the IUD. My spouse and I decided we want to go ahead and have a child so I took the nuvaring and was awaiting one period to get back to normal. It has been 4 days and no period….is that normal? could my period still come or could I possibly be prego already?

  26. Melissa Says:

    I took out my ring after 3weeks. But didny get my period ? Should I be worried?

  27. Stacy Says:

    If I take the ring out is it common to get cramps a couple days later?

  28. Michelle Says:

    This is my first time using a contraceptive, and my perioded just ended two days ago. I just had the nuvaring inserted today and need to know how long it will be before I am protected?????

  29. Maria Says:

    I stopped using the ring for 4 months, and then starte it again on the 3rd day of my period. I had unprotected sex 5 days after putting in the ring. Should I be worried?

  30. Amber Says:

    I took out my ring after 3weeks. But didn’t get my period ? Should I be worried?

  31. Lou Says:

    Totally by mistake I took my ring out a week to early to early as I was meant to take out instead I took it out this Wednesday instead of next Wednesday, so should I put it in next week which gives me my 7 day break or do I wait till the following week. I have a feeling next week but no harm to be on the safe side and double check . Please respond thanks

  32. kimi Says:

    Thank you for this! I’ve been on NuvaRing for almost a year and after getting pregnant on the pill, having horrible side effects from the depo shot and getting horrid UTI’s from Merina. I have found this to be the most positive form of birth control for me. Zero weight gain or surprise pregnancy (love my baby, he is my world!) I am delighted to know that I don’t have to wait the full seven days to put in a new ring. My crazy work schedule makes this difficult. So thank you again. This was good information for me too! :-)

  33. Courtney Says:

    I had my period kind of a lite one but had one.. I put the ring in and I was getting very sick off of it. I took it out after a week and I never got my period.. Is that normal?

  34. Sasha Says:

    I kept my ring out possibly over three hours but I put it back in immediatley after I realized it and kept having unprotected sex for a few days after, is that okay?

  35. kris Says:

    i have been using the ring for years. This is the first time i have taken it out late. Im two days late taking it out. When do I put it back in

  36. amanda Says:

    I put my nuvaring in on the day I was suppose to start it and I guess when taking out my tampon it fell out and I didn’t realize it till a couple days later. I have been bleeding non stop(really heavy) since. Is that normal??

  37. Cimary Says:

    Would i get my period again as in twice a month like you do when you use the depo and you don’t take it again. I used the nuva ring for the first time and then i took it out so i can get my period and i had intercourse after my period went away, and i haven’t gotten my second one because i have no way to get to my doctor and i have to go in for a second prescription. Can you help me ?

  38. Crystal Says:

    I took my nuvaring out 4 days early so that I wouldn’t be on my period when I went to see my bf I’m 3 days away from putting
    It back in and still have not started yet is that normal?
    I’m putting it back in on the 3rd and will be seeing him on the 8th will I still be protected or do I need to put it back in right away?Plz help

  39. sara Says:

    I been on the nuva ring for a couple of days now . I started noticing I haven’t been sleeping good since I started the nuva ring .. is this normal.?

  40. SR Says:

    I have a question. I forgot to take my ring out on time, and left it in for an extra day. I then put a new one in after six days. Am I still protected? (I believe that I should be, but I am paranoid)

  41. April Says:

    Someone tell me when exactly do I take it out cause today is the day I do but what time and when I get my period after how long till I put it back in I’m so confused and don’t want to mess up.

  42. vanna Says:

    I put the nuvaring in a day after my period, I was taking antibiotics and wasn’t aware it makes it not work as well. Now I think I’m pregnant I’m having all symptoms. I started my period march 7th ended march 11th got the ring that day. Should igo by my normal period starting time or the nuvaring starting time?

  43. NikkiStephenson1127 Says:

    How long after having sex can you remove the nuva ring? The same day I was due to take it out, we had sex, so is it okay to still take it out and not get pregnant?

  44. Chaela Says:

    I’ve been on the nuva ring for 4 months almost . The last 2 mints my periods come late . Should I be worried ? I’ve been using it right, leaving it in the 3 weeks and normally my period comes on the 20th but its late again

  45. Carmen Says:

    I had unprotected sex…got my period…then started the nuvaring for only 5 days…got my period 2 days after the removal…had more unprotected sex…could I be pregnant?

  46. Angie Says:

    I removed nuvaring a week earlie got my period and insert new ring after 7 days without the previous ring (that was thrusday) and had sex today (sunday). Should I be worrie to be pregnant ( I’ve been using nuvaring for 3 years)

  47. Rose Says:

    I inserted my nuvaring yesterday. (first time ever using it) I had unprotected sex last night. Should I be worried about being pregnant? If I should be worried will the nuvaring hurt the fetus at all?

  48. Fiama Says:

    So this is my first month of having the nuvaring in and I haven’t had my period since January. I am irregular but I still chdcked I wasn’t pregnant. The questions and answers say that we aren’t going to ovulate but this is my last week and I’m cramping to the point of goose bumps and ovulating to the point I have to where I soak my underwear. Is that a possibility?

  49. marcela Says:

    I started my period 4 days before taking the ring off so I figure I started earlier but when I go and reach to take it out the ring was no in me so it must of fall out when I was having sex so now im concern because I don’t know when it fell out n if I should wait untill my period is over to put a new one in. I been using the ring for about 3 years.

  50. Jessica Says:

    I been on the ring for 2 months and I’m spoting is it normal to spot for almost 2 weeks

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