The NuvaRing — another birth control option

Originally Published: November 1, 2002 - Last Updated / Reviewed On: May 22, 2014
Share this

Dear Alice,

What is the NuvaRing, and how does it work?

Dear Reader,

A true revolution in 1960, these days the pill is old news. Today, women have a variety of birth control methods to choose from — including the NuvaRing, a vaginal contraceptive approved by the U.S. Food and Drug Administration (FDA) in 2001. The NuvaRing is a clear plastic ring (slightly larger than a rubber band) that is placed in a woman's vagina for three weeks at a time. The ring provides a continuous low dose of progestin and estrogen hormones that are absorbed through the vaginal wall. Just like the pill or the patch, the ring prevents pregnancy by suppressing ovulation (meaning that the ovaries do not release the monthly egg) and thickening the cervical mucus, making it difficult for sperm to enter the uterus. The ring stays in the vagina for three weeks, then it's removed and a woman gets her period during the fourth, "ring-free" week.

To get NuvaRing in the U.S., women will need to visit a health care provider for a prescription. Your health care provider will let you know when to insert the ring and how many days it will take for the ring to provide effective pregnancy prevention. In any case, the ring doesn't completely protect against pregnancy during the very first week of use, so you will need to use a back-up method of contraception. After the first week, the ring provides continuous pregnancy protection, even during the fourth "ring-free" week when you get your period.

Inserting the ring may seem awkward at first, but practice makes perfect — similar to using a tampon or diaphragm.

  • First, wash your hands and take the ring out of the foil pouch.
  • Next, find a comfortable position — lie down or put one foot up on a chair or bathtub.
  • Pinch the ring between your thumb and index finger so that the circle shape bends into an oval. Slowly insert the ring into your vagina and use your pointer finger to push the ring in.
  • The ring is generally more comfortable and less likely to slip out if you position it at the back of the vaginal canal, past your pubic bone. Don't worry; the cervix keeps the ring from going in too deep or "getting lost" inside your vagina.
  • If the ring does slip out, just rinse it off and re-insert. If the ring has been out for more than three hours though, you should use a condom prevent getting pregnant.

After three weeks, take out the ring on the same day and at around the same time that it was inserted. For example, if you started using the ring at noon on a Sunday, then remove it three Sundays later around lunchtime. To take out the ring, insert your index finger into your vagina and hook your finger under the edge of the ring. Slowly tug, and the ring should slide out.

Your period will usually start two to three days after removing the ring. Just like starting a new birth control pill pack, you should insert a new ring one week from the time the last one was removed, even if menstruation continues, on the same day of the week and at or around the same time as it was inserted during the last cycle.

When used correctly and consistently, the ring is about 98 percent effective at preventing pregnancy, but there are some disadvantages. Women using the ring may experience side effects such as vaginal discharge and irritation, headaches, weight gain, mood changes, change in libido, and nausea.

NuvaRing is not recommended for women who:

  • smoke
  • are over the age of 35
  • are pregnant or may be pregnant
  • have uncontrolled high blood pressure
  • have diabetes with nerve damage
  • suffer from severe migraines
  • have liver disease or liver tumors
  • have breast or other cancers sensitive to reproductive hormones
  • have a blood clotting disorder
  • have a history of heart attack or stroke

The ring may also increase the risk of blood clots (particularly due to the type of progestin in the ring), heart attack, gallbladder and liver conditions, and stroke.

If you're interested in learning about different birth control methods or using the NuvaRing, talk with your health care provider. At Columbia, students can contact Medical Services (Morningside) or the Student Health Service (CUMC) to make an appointment. Whether or not you get hooked on the NuvaRing, it's nice to know there's another reliable form of birth control out there.

Alice