The ring (brand names: Annovera and NuvaRing) is a small, bendable ring inserted into the vagina. It is left in place for three weeks at a time, then take it out for the fourth week. The ring works by giving off hormones that prevent the ovaries from releasing eggs. The hormones also thicken cervical mucus, which helps to block sperm from getting to the egg in the first place.
Types of Rings
Annovera is a white, squishy birth control ring that can be used for up to a year. Inserted into the vagina it stays for three weeks. At the end of the third week, it's taken out for a week, washed with mild soap and water, patted dry, and stored in its case at room temperature. People will usually get their period during the fourth week, at the end of which, the ring is put back in and the whole cycle starts again. After 13 cycles, it’s time for a new Annovera.
The NuvaRing is a clear, bendable ring inserted into the vagina. Left in place for three weeks at a time, the NuvaRing is taken out for the fourth week, which is when people usually get their period. At the end of the fourth week, a new ring is inserted. There is also a generic version of NuvaRing that contains the same hormones.
Relatively little effort each month
For those who have trouble remembering to take a pill every day, the ring might be a good option as it only requires people to do something twice a month.
You’re comfortable with your body
For those uncomfortable with putting their fingers inside themselves, the ring probably isn't the right choice. It's a lot like putting in a tampon, though.
Skipping Aunt Flo
The ring also allows people to skip their period altogether.
Storage and privacy
For those storing the ring for more than 4 months, it needs to be in the refrigerator, which may be a problem for those for whom privacy is important. Also, some partners say they can feel the ring during sex. If that’s a problem, the ring can be taken out during sex—but most be put back in within 3 hours, and this can only be done once within 24 hours.
A lower dose of hormones
The ring uses a lower dose of hormones than other methods, so there may be fewer negative side effects.
Smokers over 35, beware
For those over age 35, smoking while using the ring increases the risk of certain side effects.
Blood clots: should I be worried?
There has been lot of discussion about the ring and blood clots. The truth is that for most people, the risk of blood clots while using the ring is still very low. There are some genetic and medical conditions that increase risk, so check with a medical provider if you’re worried.
The pregnancy question
A person's return to fertility should occur very quickly after stopping this method, which is great for those looking to conceive. But for those who aren't ready or interested in getting pregnant, an alternative method will be required right away.
Thanks to the Affordable Care Act, for those with health insurance, chances are good that IUDs are available without out-of-pocket costs. Explore all insurance options at HealthCare.gov or at a state-based marketplace. For those who don’t have insurance and aren't on Medicaid, the ring averages around $55 a month.
- This method may be free or low-cost.
- With Medicaid: free.
- With insurance: free under most plans.
- Without insurance: the full price of the ring can range from $30 - $75. Depending on a person's income, they may be able to go to a low-cost clinic to get the ring at reduced cost.
- Payment assistance: check with a local family planning clinics to find out if they offer free or low-cost rings. Also, ask a provider for extra samples, or check out www.nuvaring.com and www.annovera.com for coupons.
How to Use It
The ring is really pretty easy to use. All that needs to be remembered is the schedule for inserting and removing the ring.
How to put it in
First, wash your hands. To put in the ring, just squish it between your thumb and index finger, and insert it like a tampon. It’ll sit tucked up against the side of your vaginal wall. The exact position doesn’t really matter, as long as you’re comfortable. You don’t even need to take it out when you’re having sex. But if you want to take it out during sex, that’s alright so long as it's put it back in within three hours, and is only done once every 24 hours.
How to take it out
To take the ring out, hook your finger on the lower edge and pull. Once you insert the ring, leave it in for three weeks. Take it out for the fourth week, then insert a new ring and start the cycle again. When the ring is out, you’ll probably get your period. If you’re still bleeding when it’s time to put the ring back in that's normal, but don't wait .
Every method has its own positives and negatives, and because everyone's birth control is different what one person experiences may not be the same as another's experiences.
- Easy to use—it's just like putting in a tampon.
- Doesn't interrupt the heat of the moment.
- Might make periods shorter and lighter.
- May clear up acne.
- Can reduce menstrual cramps and PMS.
- Offers protection against some nasty health problems, like endometrial and ovarian cancer, iron deficiency anemia, ovarian cysts, and pelvic inflammatory disease.
Everyone worries about negative side effects, but for many people, they're not a problem. Most folks adjust to using the ring pretty quickly, but it could take a few months. For a very small number of people there are risks of serious side effects, however, so it's best to discuss those with a provider.
Things that will probably go away after two or three months:
- Bleeding in between periods.
- Breast tenderness.
- Nausea and vomiting.
Things that may last longer:
- Increased vaginal discharge, irritation, or infection.
- A change in sex drive.
If after three months, the ring still feels uncomfortable, it's important to go to a provider and discuss switching methods.