Common questions

NuvaRing is a new, once-monthly, low dose combined hormonal contraceptive containing estrogen and progestogen. It is particularly suitable for women who prefer not to take oral contraception, those who want a regular bleeding pattern and would like a contraceptive method that they can stop easily at any time.

NuvaRing is a soft, flexible, clear-coloured ring that you insert into your vagina. After 3 weeks you remove the ring, wait a week and then insert a new ring.

The ring is made from a non-silicone plastic. This material has been approved for use in a wide range of medical products; from infusion tubes to baby teethers.

The ring is simple to use and women have reported how easy it is to insert and remove. The muscles in your vaginal wall keep the ring comfortably in place so you should not be aware of it. After your doctor or nurse has shown you how to use the ring, you will be able to manage this yourself, putting you in control of your contraception.

Insertion is easy, similar to inserting a tampon - just follow the four simple steps shown below:

1. Before inserting the ring, check it is not out of date
2. Wash your hands. Remove the ring from the sachet and squeeze it between your thumb and forefinger
3. Find a comfortable position to slide the ring into your vagina – just like inserting a tampon. Standing with one foot elevated on a stool or the toilet, squatting, or lying down will make this easier
4. Gently push the ring into your vagina until it is in a comfortable position – precise positioning is not required, as it will not affect the reliability of the ring

Leave ring in position for three weeks without interruption

Insert your finger into the vagina, locate the ring and gently pull it out. If you are unable to remove the ring at first, relax and try again. Contact your doctor or nurse if you have any difficulty with removal.

After removal put the ring into the reclosable sachet and then dispose of it along with your normal household waste. NuvaRing should not be flushed down the toilet.

The majority of women do not feel the ring, but if you do, use your finger to push it further into your vagina. While the nerve endings in your lower vagina are sensitive to touch, the ones in the upper vagina are not.

Although some men may feel the ring in the vagina during intercourse, 90% of couples surveyed found this was acceptable.

You should remove the ring after 3 weeks and have 1 ring-free week during which your monthly withdrawal bleed should occur.

NuvaRing is an effective monthly method of contraception. Once inserted, you don’t have to think about your contraception for 3 weeks. With today’s lifestyles, this is both convenient, and it eliminates the possibility of forgetting to take a daily pill.

Throughout the 3 weeks that it is in place, the ring slowly releases low doses of estrogen and progestogen; which enter your bloodstream through the wall of your vagina. These hormones prevent your ovaries from releasing eggs (if there is no egg to be fertilised, you cannot become pregnant) and thicken the mucus in your cervix (neck of the womb), so that sperm cannot enter your uterus (womb).

No contraceptive method is 100% effective, but used correctly, NuvaRing is 99% effective offering the same protection as the combined oral contraceptive pill (COC – ‘the pill’). NuvaRing offers this high level of contraceptive cover from a lower dose of hormones than most COC pills.

No. As with other hormonal contraceptives, the ring does not protect against HIV infection (AIDS) and other STIs such as chlamydia, genital herpes, genital warts, gonorrhoea, hepatitis B, and syphilis. If you are concerned about STI protection, use a condom in addition to NuvaRing.

Yes. It is important to be consistent in order to maintain the level of active hormones within your body. Choose a time that suits you and keep to that schedule every month. For example, if you start using NuvaRing on a Saturday morning, you should remove it on Saturday morning at about the same time 3 weeks later and insert the next ring on the morning of the following Saturday. Diary stickers and a free SMS reminder service are available to help you remember when to insert and remove the ring.

Wait until your next period and insert the ring at any time between the 1st and 5th days of bleeding. If you are having your period now, and more than 5 days have passed, wait until your next period before starting to use NuvaRing.

You should use an additional form of contraception - such as a cap (diaphragm) or condoms - for the first 7 days of the ring use. You will only need to do this the first time you use NuvaRing.

Tampons can still be used while using the ring. Just make sure the ring is in place before you start to insert tampons. When removing tampons, be careful to ensure you don’t accidentally pull the ring out at the same time. If this happens, simply rinse the ring in cool to lukewarm – not hot - water and replace it immediately.

Start using NuvaRing on the day following the usual tablet-free week (or after placebo tablets, if you have been given them). In other words, begin using NuvaRing when you would otherwise have started taking your next pack of pills. NuvaRing will provide contraceptive protection straight away. You don’t need to use another method of contraception.

Switch from the contraceptive patch on any day, but at the latest on the day following the usual patch-free interval.

You can start using NuvaRing when you like, but you should use another form of contraception such as a cap or condoms, for the first 7 days after you stop taking the mini-pill. You will only need to do this the first time you use the NuvaRing.

Switch from the progestogen-only injection on the day when the next injection would be due. Use another form of contraceptive such as a cap or condoms, for the first 7 days when you use the ring.

Speak to your doctor or nurse if you need more information about starting to use the ring.

The positioning of the ring in your vagina doesn’t affect its reliability. Simply find a position that’s comfortable for you.

Don’t worry. If you accidentally drop the ring, simply wash it in cool to lukewarm water (not hot) and carry on as normal. There may be times when you may want to open a new sachet and use a new NuvaRing, e.g. if the ring accidentally falls into the toilet.

No. There is no danger of the ring being pushed too far up in the vagina or getting lost. The ring cannot go further than the cervix (neck of the womb).

The shape and the design of the ring makes it unlikely that it will fall out. In clinical trials, expulsion was uncommon and this typically occurred before women had got used to using NuvaRing. However, the ring can slip out of your vagina while you’re removing a tampon, straining during a bowel movement, or during intercourse. Should this happen, simply wash the ring in cool to lukewarm (not hot) water and replace it in your vagina as soon as possible. If the ring has been out of the vagina for less than three hours, there is no need to take any extra contraceptive precautions – as the hormones will remain effective.

No. It is no more likely to happen in women who have had children than those who have not.

If the ring has been out of the vagina for more than 3 hours during the 1st and 2nd week of use, contraceptive effectiveness may be reduced. Put the ring back in as soon as you remember and use an extra method of contraception, such as a cap or condoms, until you have used the ring for 7 days in a row.

If the ring has been out for more than 3 hours during the 3rd week, you can either:

1. Insert a new ring immediately. Inserting a new ring will start the next 3-weeks of use. You may not experience a withdrawal bleed from your previous cycle. However, break-through spotting or bleeding may occur.
2. Have your withdrawal bleed and insert a new ring no later than 7 days from the last day the previous ring was removed or expelled. This option should only be used if you have been using the ring continuously for the previous 7 days.

1. If you have gone over the 3 weeks by 7 days or less:
   You should remove the ring and insert a new one after one week.
2. If you have gone over the 3 weeks by more than 7 days:
   If the ring has been left in place for more than a total of four weeks, you may not be adequately protected against pregnancy and you must check to be sure you are not pregnant. Remove the existing ring. If you are not pregnant insert a new contraceptive ring but also use an additional method of contraception, such as the cap or condoms for the next seven days.
   
   Use the diary stickers and /or the free SMS reminder service to help you remember when to remove the ring.

If the ring-free interval has been extended beyond one week, you should insert the ring as soon as you remember but also use an additional method of contraception, such as the cap or condoms for the next 7 days.

If you know or suspect you are pregnant, do not use the ring. Make an appointment to see your doctor as soon as possible.

Most women experience normal withdrawal bleeds during their ring free week. Some find that withdrawal bleeds with the ring are shorter and more regular than their usual periods, and that bleeding is lighter.

It is possible to experience irregular bleeding or spotting during the first 3 weeks of use, but this usually settles down with continued use.

In general, the ring offers regular cycle control, compared to the combined oral contraceptive pill, and need not affect your usual routine.

Please refer to your doctor or nurse. In exceptional circumstances, if withdrawal bleeding needs to be delayed, you may insert a new ring without having a ring-free interval. The next ring can be used for up to 3 weeks again. However, you may experience bleeding or spotting. Regular use of NuvaRing is then resumed after the usual one week ring-free interval.

To shift your withdrawal bleed to another day of the week you can shorten the forthcoming ring-free interval by as many days as you like. The shorter the ring-free interval, the higher the risk that you will not have a withdrawal bleed and that you will experience breakthrough bleeding and spotting during the use of the next ring.

Like all medicines, side effects are possible and it may take a little time for these to settle down. As with all combined oral contraceptives some women may experience side effects such as headache, weight gain and nausea. Other side effects attributed to the ring include vaginal infections, irritation or vaginal secretion; good hygiene may help to minimise these effects (1–10% of women may experience these problems). In clinical trials, only a small number of women stopped using the ring due to side effects. If you have any concerns, you should seek the advice of your doctor or nurse.

For more details about side effects, please read the Patient Information Leaflet.

NuvaRing isn’t suitable for women who have diabetes, gallbladder disease, venous or arterial thrombosis (or a family history of these conditions), certain types of migraine and headaches, high blood pressure, women who have abnormal vaginal bleeding where the cause of which is not yet known, have breast or genital cancer, severe active liver disease, or who are pregnant or breastfeeding. Ask your doctor if you are concerned about your suitability for NuvaRing.

For more details about side effects, please read the Patient Information Leaflet.

Yes. Clinical studies have shown that the ring’s reliability is not affected by the use of common vaginal antifungal treatments.

It is important that you never use more than one ring at a time. There have been no reports of serious harmful effects due to an overdose of the hormones in NuvaRing. If you have accidentally inserted more than one ring, you may feel sick (nausea) or have vomiting or vaginal bleeding. Remove excess rings and contact your doctor if these symptoms persist.

Unlike ‘the Pill’, the effectiveness of the ring is not affected by vomiting or diarrhoea.

Be sure to tell your doctor you are using a hormonal contraceptive. Some medications can reduce the effectiveness of NuvaRing and they include antibiotics (with the exception of amoxicillin and doxycycline), herbal remedy St Johns Wort and drugs to treat epilepsy, tuberculosis and HIV. If you are taking antibiotics, continue using NuvaRing but use another contraceptive method during the antibiotic course and for another 7 days after the course is finished.

Simply stop using NuvaRing and your fertility should return in a short period of time.

You will usually be given 3 months supply. To ensure you have a continuous supply of NuvaRing, make sure you get a new prescription just before you start to use your last ring.

Store NuvaRing in the original package below 30°C, for example in a cupboard or drawer. Do not store in the fridge. You should not use a ring either if it was dispensed to you more than 4 months ago, or if the expiry date or insert by date has passed. The dispensing date and insert by date are shown on both the carton and sachet. Do not use the ring if you notice a colour change in the ring or any visible signs of deterioration.