How the NuvaRing Works

The NuvaRing is a type of reversible prescription birth control. It is a comfortable, flexible birth control ring that is about 2 inches in diameter.

The NuvaRing is considered to be a hormonal contraceptive. This is because the birth control ring contains 11.7 mg of the progestin, etonogestrel and 2.7 mg of ethinyl estradiol. When used correctly, it is very effective at preventing pregnancy.

How to Use It

The NuvaRing is super simple to use. You only need to insert this birth control ring into the vagina one time each month. So...

  1. You insert NuvaRing on Day 1 of Week 1 of your cycle.
  2. During this time, the muscles in your vaginal wall will keep the NuvaRing in place.
  3. After 21 days (or 3 weeks), you need to remove your Nuvaring from your vagina.
  4. You leave the NuvaRing out during Week 4—at this time, you will most likely have your period.
  5. Once Week 4 is over, you begin all over again with Week 1 of your next cycle... by inserting a new NuvaRing.

Using the NuvaRing this way will allow for you have continuous pregnancy prevention (you are still protected against pregnancy if you have sex during Week 4 when your NuvaRing is not inserted).

Keep in mind, you have to insert your vaginal ring on the same day of the week that you inserted it during your last cycle. If not, there is a chance that you could become pregnant.

How It Prevents Pregnancy

The NuvaRing is a combination hormonal birth control option that slowly releases a low dose of synthetic estrogen (around 0.015 mg per day) and etonogestrel (0.12 mg each day) to protect you against pregnancy for one month.

The release of hormones is activated by contact with the vagina. So, the walls of your vagina absorb the hormones and distribute them into your bloodstream.


  • It is simple, comfortable, and safe.
  • The exact position is not important for NuvaRing to be effective.
  • Using the birth control ring is convenient and you don't need to take it daily (like the pill).
  • Due to the low and steady hormone delivery, the NuvaRing has fewer hormonal ups and downs than daily or weekly birth control methods.
  • NuvaRing is discreet—nobody will know that you are using it (and it usually can't be felt by you or your partner).
  • You can use your NuvaRing to skip your period.
  • It doesn't need to be fitted by a doctor.
  • Using NuvaRing can lead to regular, lighter, and shorter periods.
  • The birth control ring is completely reversible—the ability to become pregnant returns quickly after stopping use.
  • NuvaRing does not interfere with having sex and can allow for more spontaneity than a diaphragm or sponge—you can have sex whenever you want while protecting against pregnancy (but not against STDs; a condom is still necessary).

Non-Contraceptive Advantages

The NuvaRing may offer some of the same non-contraceptive advantages as the birth control pill. Some of these additional benefits may include protection against:

  • Ectopic pregnancy
  • Cancer of the ovaries and ovarian cysts
  • Irregular menstrual cycles
  • Depression associated with PMS
  • Acne
  • Headaches associated with PMS
  • Excess body hair
  • Anemia (iron deficiency) that results from heavy periods
  • Painful menstrual cramps
  • Pelvic inflammatory disease
  • Cancer of the lining of the uterus
  • Vaginal dryness
  • Osteoporosis
  • Noncancerous breast growths

Disadvantages and Side Effects 

There is a low occurrence of side effects for most women who choose to use the NuvaRing. If you do have side effects, they will usually go away after 2-3 months of use. The most common reported side effects include:

  • Breast tenderness
  • Headaches
  • Weight gain or loss
  • Nausea
  • Changes in mood
  • Breakthrough bleeding (lower incidence as compared to the pill)
  • Increased vaginal discharge
  • Vaginal irritation or infection

Some disadvantages linked to NuvaRing use:

  • If you are using the NuvaRing, you cannot also use a diaphragm, cervical cap, or sponge as a back-up method of contraception.
  • If you have a history of depression, you may need to stop using NuvaRing if your depression worsens.

Who Can Use It

The NuvaRing is a safe birth control option for most healthy women. It is important that you honestly discuss your complete medical history with your doctor before using the NuvaRing.

Typically, serious problems do not occur very often with hormonal birth control use. You may even be able to still use NuvaRing even if you have certain risk factors—as long as you remain under close medical supervision.

The NuvaRing is not recommended for women who have:

  • Uncontrolled high blood pressure.
  • Smoke cigarettes and are 35 or older.
  • A history of serious heart valve problems or heart attack.
  • Had an abnormal growth or cancer of the uterus or breast.
  • Controlled blood pressure and smoke more than 15 cigarettes a day.
  • A history of blood clots, vein inflammation, or certain inherited blood clotting disorders.
  • Certain types of migraine headaches.
  • Need prolonged bed rest after major surgery.
  • A history of severe liver disease or liver growths.
  • Weak pelvic floor muscles.
  • Chronic constipation.
  • Certain vascular conditions or have had a stroke.

How to Obtain It

In order to get the NuvaRing, you will need a prescription from your doctor. Your doctor will most likely conduct a medical evaluation, blood pressure check, and pelvic exam. You can then have your NuvaRing prescription filled at a local pharmacy.

Associated Costs

If you use NuvaRing, costs will include the price of each month's NuvaRing pack, plus the expense of having a medical exam (in order to get the prescription).

In many communities, Medicaid covers the cost of this birth control method.

If you have private health insurance, you can check with your provider since NuvaRing should be covered with no out-of-pocket costs for all non-grandfathered insurance plans.

The manufacturer of NuvaRing has also created a co-payment assistance program. Eligible privately insured women who qualify for this program can save 50% of their out-of-pocket cost on each month's supply of NuvaRing—up to 12 qualifying prescriptions.


The NuvaRing is 91 percent to 99.7 percent effective. This means that with perfect use, less than 1 out of every 100 women who use the birth control ring will become pregnant in one year. With typical use, 9 out of every 100 women who use NuvaRing will become pregnant in one year.

Certain medications may also decrease the effectiveness of hormonal contraceptives, like the NuvaRing.

The effectiveness of the NuvaRing can also be lowered if you do not use it the correct way. You may be more at risk for pregnancy if:

  • The ring does not stay in your vagina for 3 weeks in a row.
  • If the ring is left in the vagina for more than 3 weeks.
  • The ring slides out of the vagina and is not replaced within 3 hours.
  • The unopened NuvaRing package is exposed to direct sunlight or very high temperatures.

You should read the insert inside the NuvaRing package for more detailed information about the use, risks, and effectiveness of the birth control ring. It may also be helpful for you to know, ahead of time, what to do if your NuvaRing falls out or breaks.

STD Protection

The NuvaRing offers no protection against sexually transmitted diseases. If you want to have STD protection while using NuvaRing, you can ask your partner to wear a condom.

Was this page helpful?

Article Sources

  • Roumen FJME, Mishell DR. "The contraceptive vaginal ring, NuvaRing, a decade after its introduction." The European Journal of Contraception & Reproductive Health Care. 2012;17(6):415–427. doi:10.3109/13625187.2012.713535.