Vaginal Ring (NuvaRing/Annovera)
How does it work?
Read the sections below for details about Vaginal Ring (NuvaRing/Annovera), including how well it works and how to use it.
Compare this method with others, or view the full list of birth control methods using the links below.
More about Vaginal Ring (NuvaRing/Annovera)
The ring has two types of hormones in it: estrogen and progestin. Because hormones can affect the growth of breast cancer cells, we generally recommend against using the ring and other hormonal birth control after a breast cancer diagnosis.
Unfortunately, there is limited high-quality research on the safety of hormones after breast cancer. Because of this uncertainty (and because hormone exposure may increase the risk of breast cancer coming back), we and most medical experts recommend avoiding birth control with hormones after breast cancer - especially for those with hormone receptor (HR) positive breast cancer.
For those who are within 5 years of a breast cancer diagnosis, hormonal birth control, including the ring, should not be used. During this time, the risk of breast cancer coming back is higher, and being exposed to hormones can increase that risk.
For those who are more than 5 years out from diagnosis and in remission, hormonal birth control is still generally discouraged. While the risk of breast cancer coming back decreases over time, it does not go away completely. There is also not enough evidence to confirm that hormonal birth control is safe – even for people whose cancer was not hormone-sensitive.
In some situations, birth control that contains hormones, including the ring, may be considered to treat severe bleeding or pain when options without hormones have not worked. In these cases, decisions should be made carefully and in collaboration with your oncology and primary care teams. These decisions should also be revisited over time as your health and priorities change.
With perfect use, fewer than 1 out of 100 people who use the ring will get pregnant over a year. Perfect use means the ring is always used correctly.
Many people forget to take the ring in or out on time. This is called typical use. With typical use, about 7 out of 100 people who use the ring will get pregnant over a year.
You can also use a birth control method at the time of sex. We call this a Method Boost because it prevents pregnancy better than the ring alone. Method Boost options include outer condom (penile), pull out, spermicides, the vaginal gel (Phexxi), the cervical cap, and the diaphragm.
You can also use these as a Method Backup when you forget to put the ring back in on time. Do not use the ring and the inner condom (vaginal) at the same time because the condom will not stay in place.
The ring releases estrogen and progestin hormones. The hormones stop an egg from being released (ovulation) and make the mucus of the cervix thicker (blocking sperm).
There are two brands: Nuva Ring and Annovera. Both are soft and easy to bend. To use, squeeze the ring and gently push it high into the vagina where it will unfold on its own. You should not feel the ring (and neither should your partner).
The Nuva Ring: Leave it in for 21 days (Week 1, Week 2, Week 3). Then take the Nuva Ring out, wrap it in the pouch it came in, and throw it out in the trash. Wait 7 days (Week 4). With no ring in, there is a drop in hormones, which causes a withdrawal bleed that is usually lighter and shorter than your normal period.
Then put a brand new Nuva Ring in the vagina for the next cycle. Each box comes with 3 rings.
The Annovera Ring: Use it the same way as described above for the Nuva Ring (3 weeks in, 1 week out) But keep the Annovera after you take it out, wash it, and store it until the end of the week. Then you put the same Annovera Ring back in the vagina to start another cycle.
Each Annovera Ring can be used for 1 year. That means no refills for a whole 12 months!
If you want to skip a withdrawal bleed, you can put the next ring in right away—without taking a ring-free week. This is called continuous cycling or "no-bleed months." Skipping the ring-free week is safe and can help with problems like bad cramps, heavy bleeding, or migraines.
How to skip the withdrawal bleed:
Nuva Ring: Keep the ring in for 3-5 weeks in a row. Then take the ring out, and put a new ring in right away.
Annovera: Keep the ring in for as long as you want, but no longer than 12 months. Take the ring out for 1 week when you want to have a withdrawal bleed.
Typically, while you wear the ring, you may not have a period. Instead, you have your period during the "ring free" week. You can use the ring to skip your period. This may cause some spotting, which usually gets better over time.
The ring may make periods lighter, regular, and less painful.
The ring can be used to skip periods. This can improve conditions that get worse with periods such as heavy menstrual bleeding, migraines, anemia, or mood problems.
Common side effects include nausea, mild headache, or breast tenderness for the first 2-3 months. These symptoms usually go away.
You might feel the ring and may not like this feeling. If you do, the ring may be placed better.
Beyond the breast cancer concerns discussed in the section "Special considerations for breast cancer survivors and thrivers," the ring is very safe. In fact, pregnancy carries a higher risk of health problems than the patch does.
Rarely, birth control with hormones have been linked with blood clots, strokes, heart attacks, or liver tumors. The chance is about 5 out of 10,000 people over a year. This chance goes up if you have other risk factors, such as being older than 35, a cigarette smoker, or having diabetes.
No. However, correct use of condoms can prevent HIV and STIs.
You can get a prescription from your health care provider.
You may pay up to $200 or more depending on the brand.
The ring may be low cost if covered by insurance.
There are also online birth control services. A licensed health care provider will review your health history. The patch box can then be mailed to you.
For more info click here: Planned Parenthood: The Ring