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 of Gynotalk 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.
Hi Em & Lo, I have a question for you. So I had my period on Thursday (Nov. 10th) and then inserted a new nuvaring Sunday (Nov. 13th).
I’m always on time each month with inserting and removing (3 weeks in 1 week out).
I then had unprotected sex with my bf 2 days after inserting a new ring.
Am I protected? I’ve read several articles that say you need condoms as a back up method for the first week but no one has specified if: it’s only for the very first time you’re using nuvaring ever, or if it’s every time you start a new 3 week cycle having used the ring before? Should I take a plan B? If I could get an answer asap that’d be great!! I’m worried :0 thanks!
I just have a quick question so I started my Nuvaring the 7th of this month and the nurse at planned parenthood showed me when too put it in and when too take it out so I put it in the 7th and I just took it out today and I doing it right or wrong cause everybody is saying keep ring in for 3 weeks and the next week take it out for my free ring week is that correct
Than that will make it 4 weeks you have had it in. Take it out on the 3rd week from day you inserted.
And the day you took it out give it exactly one week to put in another and follow the 3 week guildelines until you take it out again. it was hard for me to understand but i have been using these bad boys for so long now and been perfectly fine.
I had sex with my boyfriend the day I had to take my ring out on the 25th and took it out the next day 26th. I’ve been on the ring for quite awhile now and I use it how I’m suppose to. I put in a new ring every 1st and take it out every 25th. Should I be concerned ??
I’ve tried just about every birth-control on the market and this is hands down my favorite!! I would recommend this to any woman searching for a hormonal and spotting friendly BC. Thanks to this BC I no longer have breakouts or spotting..it’s just perfect! There are a lot of useful Nuvaring apps that you can download also to help you keep track of your ring days also.
I had my ring in for 4 weeks my boyfriend and i want a baby so i took the ring out and we had unprotected sex. Can i still get pregnant if i keep it out?
Thank you! This is the most informative piece on nuvaring in the whole Internet!
Exactly! She answered every question I had.
Hi Doctor, the exp. date on nuva ring packet is Sept 24, 2016, I expect to insert it for the next 3 week cycle on Sept 15. Is it still going to be cosidedred an effective birth control? Thank you.
I have heard horrible stories about women using the nuvaring should I worry? I’ve already gone through 3 different Birth Controls and changed die to pain or cramping, not from blood clots.
I just started my NuvaRing July 19. My period usually lasts 4-5 days so i started my period on July 16 and decided to put on the NuvaRing 3 days after my really bad bleeding so i put it on when I know that my period is almost done. Is that Fine? Also when I first inserted the NuvaRing I felt like i didn’t place it in right so I decided to pull it back out. I washed it with warm water then I placed it back in. I waited for 8-9 hours then while I was taking a shower, I decided to put my finger in to check if i can still feel it so I pulled it our one more time put it back in and still felt the same….? Then I did multiple researchers and I found out that the ring itself is suppose to feel bent when placing my finger inside my vagina right?. So was it OK for me to pull it out twice for my first time trying on this birth control? I only pulled it out then pushed it back in right away.
This has hands down been the most useful, insightful read on NuvaRing! All those other forums/discussions/articles will have a girl all sorts of mixed up and confused! All my questions and concerns answered in a short and thorough list. Thank You!
I am in my 2nd month of Nuvaring….I just took it out. Started brown spotting/break through bleeding after intercourse 4 days ago. happened last month also….but only lasted a day. I have had trouble in the past w/bc pills etc….and fibroids/cysts… so I just got a little spooked. Maybe i shouldn’t have taken it out ?? I am 46 and My gyno put me on it to help w/hormones. Not sure it’s the right thing….although it did help w/breast tenderness. 1st month felt great…but not so much after that.
Thoughts ?
From what I understand, you need to keep the ring in even despite the bleeding. As you said, it’s simply breakthrough bleeding as your body adjusts to the new form of birth control. It’ll take 2-4 months for you to regulate. I’m going through the same thing now and I was spooked too! I also was placed on NuvaRing for cysts. Other than this breakthrough bleeding, it has worked well and I believe it will continue to once our bodies have adjusted. Good luck!
My husband and I decided to TTC and I took my last nuvaring out May 19th. I had my period the next week, as normal, then began ovulating just as I had before. Now 13 days aftermy period ended, I’ve just started my period again. Do I need to be concerned? I’ve never been pregnant before and this didn’t happen the last time I got off BC.
I just recently had an abortion, I was told to put my Nuvaring in on that Sunday but my bleeding was still pretty heavy so I was uncomfortable with doing so. It will be 2 weeks tomorrow since I had it. But I’m still spotting. Was I right for waiting or should I have put it in on that Sunday? I haven’t been having sex of course. But once I’m completely healed I do wanna be able to have sex with my husband. But the thought of bleeding in anyway while trying to insert this grosses me out.
My wife took the ring out a day early from her three weeks, is she still protected or should i use protection?
I started NuvaRing for the first time on day 2 of my period. I have now been bleeding for over 2 weeks and it is very heavy (using a pad and super plus tampon). Why am I bleeding for so long, and will I stop bleeding if I remove it? I had 2 miscarriages back to back before starting the NR, so I feel as if I have been bleeding for months and months! I am totally over it! Help!