What to Do If You Forget to Take Out Your NuvaRing

Are you at risk of an unplanned pregnancy?

The NuvaRing is a clear, bendable prescription contraceptive ring placed in the vagina for three weeks each month. This hormonal birth control method slowly releases a low dose of estrogen and etonogestrel (a type progestin) to protect you against pregnancy for the month. But if you are going to use NuvaRing, you need to remember when it is time to take it out as well pay attention to whether or not it may have accidentally fallen out.

How the NuvaRing Is Prescribed

Each NuvaRing is prescribed on a 28-day cycle. To use the product correctly:

  • You would insert the NuvaRing on day 1 of week 1.
  • You would leave it in place for week 2 and week 3.
  • On day 1 of week 4, you would take out your NuvaRing. This is the week that you'll likely have your withdrawal period.
  • When week 4 is over, you would insert a new NuvaRing to begins the 28-day cycle anew.

When used as prescribed, the NuvaRing delivers enough estrogen and etonogestrel into the bloodstream to provide ample protection during the one-week gap between rings.

If You Forget to Remove a NuvaRing

If it is day 2 (or later) of week 4, and you just realized that you forgot to take it out, don't worry; you will still have pregnancy protection for this entire week. However, you would need to make a slight adjustment to your prevention schedule

  1. Keep your NuvaRing in place for the entire week 4 (completing the 28 days of the cycle).
  2. Take the NuvaRing out on day 1 of your next 28-day cycle.
  3. Wait seven days and insert a new NuvaRing. You can consider this the beginning of your next 28-day cycle (day 1 of week 1).
  4. You will need to use a backup birth control method (like a spermicide or condoms) for the first seven days after inserting the NuvaRing.

Forgetting for More Than 28 Days

If you forget to remove the NuvaRing and it remains in place for longer than 28 days, the levels of estrogen and etonogestrel may have dropped to such a level that a pregnancy is possible. Under these circumstances:

  1. You would need to remove your NuvaRing immediately.
  2. To check your pregnancy status, you can either take a home pregnancy test or schedule one at your doctor's office.
  3. If you are not pregnant, you can insert a new NuvaRing and consider it to be day 1 of week 1 (the beginning of your next 28-day cycle).
  4. You must then use a backup birth control method for the next seven days.

Loss of Effectiveness

Generally speaking, the NuvaRing is 91 percent to 99.7 percent effective. Your NuvaRing is still effective if you forgot to take it out during week 4. If you leave it in for more than 28 days (and do nothing), then the NuvaRing may no longer be effective.

However, current research is unclear on exactly how much of the protective benefit, if any, may be lost after 28 days.

A small study from Albert Einstein University suggested that the NuvaRing may provide ample protection for up to 35 days. On the downside, doing so appears to increase the risk of spotting or bleeding (a primary cause of treatment discontinuation).

To this end, until further research can support the extended use of the NuvaRing without complications, it is strongly advised to follow the manufacturer's instructions approved by the U.S. Food and Drug Administration.

How to Insert a NuvaRing

The NuvaRing is relatively simple to use but requires a little insight and preparation to ensure that is inserted correctly. To do so:

  1. Choose a position that makes you feel comfortable.
  2. Wash and dry your hands before removing NuvaRing from its pouch.
  3. Open the resealable foil pouch using the notch on both sides near the top of the package.
  4. Take out your NuvaRing.
  5. Keep the foil pouch. You can place your used NuvaRing into it before you throw it into the garbage.
  6. Hold your NuvaRing between your thumb and index finger. Then press the sides of the ring together so that it is compressed into a long, oval shape.
  7. Insert the folded NuvaRing into your vagina.
  8. Using your index finger, slowly and gently push it further up into your vagina.

The NuvaRing doesn't need to be in an exact location to work. Your NuvaRing may also slightly move around within your vagina. This is normal.

However, if it feels uncomfortable or is hurting you, there is a chance you may not have inserted it far enough. If so, use your finger to carefully push your NuvaRing as far as you can into your vagina. Don't worry about pushing too far; it won't get lost.

When to Call a Doctor

If you experience pain or bleeding after inserting a NuvaRing, or can't seem to find it, call your doctor. Seek emergency care if you have sudden chest pain, shortness of breath, jaundice, high fever, persistent leg pain, vomiting, fainting, or a severe rash.

How to Remove a NuvaRing

The instructions for removing a NuvaRing are very straightforward and simple:

  1. Wash and dry your hands.
  2. Choose a comfortable position. Either lie down, squat or stand with one leg up on a stool or chair. 
  3. Put your index finger into your vagina and hook it through the NuvaRing. Slowly pull downward and forward to remove the NuvaRing and then just pull it all the way out.
  4. You can put the NuvaRing in the resealable pouch it came in, and dispose of it in a trash can. Do not flush your NuvaRing down the toilet.
  5. Seven days after you have taken out your old NuvaRing, it is time to insert a new NuvaRing. You can still do this even if your period has not yet stopped. 

A Word From Verywell

The NuvaRing remains an effective means of birth control that doesn't require daily dosing. To ensure that it provides optimal protection, always be sure to:

  • Store the NuvaRing at room temperature, avoiding direct sunlight.
  • Store your NuvaRing for no longer than four months.
  • Always check the expiration date. If it is expired, throw it away.
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