The Ring

Quick Facts

Moderately effective

Doesn’t reduce your chances of getting an STI

Small, flexible ring that goes in the vagina

Easy to use

You need to change it once a month

A hand holding a clear contraceptive ring

More About the Ring

  • The vaginal ring is a small, flexible combined hormonal contraceptive ring that you put in your vagina.
  • The hormones in the ring stop ovulation and thicken cervical mucus. This blocks sperm from getting to the egg. If sperm can’t get to an egg, you can’t get pregnant.
  • There are currently two kinds of rings available:
    • The NuvaRing and other generic brands are a monthly ring where you put it in for 21 days, take it out, and put a new one in 7 days later. It needs to be replaced every 28 days.
    • The Annovera ring is a yearly ring that works the same way. However, instead of replacing it every month, it lasts for 13 cycles (a full year).
  • The hormones in the ring are the same ones that are in the pill and the patch. Therefore, the benefits, limitations, and side effects are similar.

How to Use the Ring

NuvaRing: insert it into your vagina and leave it in for 21 days in a row. After 21 days, remove the ring for 7 days. That’s when you will usually have your period. Open a new packet and insert a new ring after 7 days.

Annovera ring: Remove it after 21 days of use. Wash it with mild soap and water, pat it dry, and store it in its case. After 7 ring-free days, gently wash the Annovera ring and put it back in.

How to put in and take out the ring:

  • Wash your hands with soap and water. Dry your hands.
  • If using the NuvaRing, open a new packet. If using the Annovera ring, remove it from your vagina, wash it with a mild soap and water and use a clean towel to pat it dry.
  • Choose an insertion position that feels comfortable to you. You can lie down, stand, or squat to insert the ring. If you use tampons, try the same position used to insert a tampon.
  • With clean hands, squeeze the sides of the ring using your thumb and pointer finger and push it into your vagina. It’s like inserting a tampon. You should not be able to feel it after inserting it. If you can feel it, you should reposition it.
  • When it’s time to take the ring out, wash your hands, hook your finger around the side and pull it out.
  • Wrap the used ring up and throw it in the trash. Don’t flush it down the toilet!

 

With clean hands, squeeze the sides of the ring together and push it into your vagina

With clean hands, squeeze the sides of the ring and push it into your vagina.

Green donut chart showing 99%. The title says "Over 99% effective with perfect use"
Yellow donut chart showing 91%. The title says "91% effective with typical use"

Effectiveness

  • The Annovera ring is 97% effective with perfect use. That is, if it is used correctly all the time, 3 out of 100 people will get pregnant in a year.
  • The NuvaRing is 98% effective with perfect use. That is, if it is used correctly all the time, 2 out of 100 people will get pregnant in a year.
  • You can improve effectiveness by remembering to change it on time. You can set a reminder on your phone to help you remember!
  • Some medications may make the ring less effective. Talk to your provider to see if this might affect you.

Benefits

When used correctly, the ring is moderately effective and easy to use. It can also have positive effects on your health and sex life.

  • It’s easy to use – you put it in like a tampon.
  • The ring only needs to be changed once a month.
  • It doesn’t interrupt the heat of the moment.
  • It may clear up acne.
  • It makes your periods regular.
  • It gives you shorter, lighter periods.
  • You can also choose to skip your periods with the ring.
  • Like the pill, it may reduce your chances of developing other health problems. These include endometrial and ovarian cancer, anemia, ovarian cysts, and pelvic infections.

 

Nine hands each holding a thumbs up
A young woman holds up her hands as if weighing options and looks thoughtful

Side Effects and Limitations

Most side effects go away after a few months. Many people have no side effects at all. Give it time and talk to your Family PACT provider if you are concerned about any symptoms you might have. If you decide to switch methods, start a new method right away.

  • You can remove either ring before sex. Just be sure to put it back in within 2 hours with the Annovera ring, and within 3 hours with the NuvaRing.
  • It’s possible for the ring to come out of your vagina by mistake. This could happen during sexual intercourse, bowel movements, or use of tampons. If your ring falls out, wash and dry it before placing it back in your vagina.
  • The ring should not be out of your vagina for longer than a few hours total (2 hours for the Annovera ring, 3 hours for the NuvaRing) during your 21-day cycle. If the ring has been out of you for more than 2 hours for the Annovera ring or 3 hours for the NuvaRing, use a back-up method of birth control (e.g., condoms). Continue using back-up birth control until the ring has been reinserted for 7 days in a row.
  • You should not use oil or silicone-based lubes, creams, gels, or suppositories in the vagina while you are using the ring. Water-based lubes are okay.
  • People over 35 who smoke should not use the ring. Cigarette smoking increases the risk of serious cardiovascular conditions like heart attack, blood clots, or stroke which can be fatal.
  • Side effects may include bleeding in between periods, breast tenderness, nausea, vomiting, change in sex drive, and more vaginal discharge. These usually go away in 2-3 months.
  • You need to remember to insert and remove the ring on the right days of the month.
  • You need a prescription.
  • It does not reduce your chances of getting sexually transmitted infections (STIs).

 

Family PACT Coverage

If you are eligible, Family PACT covers the cost of the ring. A provider can help you decide if the ring is the best option for you. Search for a nearby Family PACT provider: click “Find Providers” in the top right-hand corner of this page.​

California Department of Health Care Services Family PACT logo