Island Sexual Health Society Be informed, not surprised

close up of flexible vaginal ring called, "nuva ring"

The birth control ring is inserted in the vagina and changed once a month. Make an appointment to get a prescription or find out more.

The vaginal contraceptive ring is a soft plastic flexible ring that is 5.4 cm in diameter. The ring contains the hormones estrogen and progestin (similar to a birth control pill or the patch) which are released in a slow steady dose over 21 days to prevent pregnancy.

The ring does not protect against sexually transmitted infections. We always recommend using condom with the ring to reduce the risk of STIs and increase your protection against pregnancy.

Make an appointment at any of our clinics in Greater Victoria to get a prescription, or to get more information about birth control choices.

Nuva ring in detail

How the Nuva ring works

The ring contains the hormones estrogen and progestin (similar to the birth control pill) which are released in a slow steady dose to prevent pregnancy. The Nuva ring is 99% effective when used perfectly.

It is placed high in the vagina once every 28 days. It is kept in place for 21 days and removed for a 7 day period to permit a withdrawal bleed (period).

The hormones in the ring work much the same way as the birth control pill:

  • prevents ovulation (release of an egg)
  • builds up the cervical mucus which acts like a barrier to help immobilize sperm
  • thins the lining of the uterus to prevent implantation of a fertilized egg.

Advantages and disadvantages of the Nuva ring

Benefits of the Nuva ring as a birth control method include:

  • No need to remember to take a pill every day
  • Self-administered, a doctor is not required to fit it, one size fits all
  • Private and discreet
  • Significant decrease in breakthrough bleeding and spotting compared to the pill or the patch
  • Lower dose hormone levels than the pill or patch
  • In study trials, 98% of users found it easy to insert and remove
  • Most people don’t notice it during intercourse, and those who do, don’t find it a problem.

Possible concerns with using the Nuva ring include:

  • The user must be comfortable touching their genitals
  • May cause vaginal discomfort for some users
  • A small percentage of users may find it uncomfortable during intercourse
  • Not suitable for user who cannot take the birth control pill for medical reasons
  • Rings are shipped to the clinic/pharmacy using cold storage and stored in the fridge, once removed form the fridge in the clinic or pharmacy, the ring must be used within 4 months.

Nuva ring side-effects

Possible side effects of the Nuva Ring are similar to the birth control pill: headaches, nausea, breast tenderness, vaginal dryness and will usually go away within the first 3 months of use. If not, please contact the clinic.

How would I know if I was having a serious health problem related to the Ring?

Call your doctor immediately or go to the nearest medical treatment centre if you have any of the following:

  • A – Abdominal pain, severe
  • C – Chest pain (severe); cough; or shortness of breath
  • H – Headaches (severe) or increased frequency or intensity of headache, dizziness, weakness, or numbness
  • E – Eye problems: vision loss of blurring, speech problems
  • S – Severe leg pain in calf or thigh

While there are some serious risks associated with the ring such as blood clotting problems and stroke, these risks are relatively small when compared with the health risks associated with pregnancy. For most users, the ring is safe, efficient and convenient. Your healthcare professional will help you determine whether or not the ring could be an appropriate option for you.

How to use the Nuva ring

Insert the Nuva Ring within the first 5 days of your period (no later than day 5) even if you haven’t finished your menstrual cycle. Be sure to use a back up method of birth control, such as condoms, for the first 7 days of continuous use.

  1. Insert one ring into the vagina using any position that is comfortable (i.e., standing with one leg up, lying down or squatting).
  2. Press the edges of the ring together and place one end into the opening of the vagina. Push the ring high into your vagina. There is no exact position that is crucial for the placement of the ring. As long as you are comfortable, the ring is placed correctly placed. The hormones will be absorbed into the bloodstream regardless of where the ring is placed inside the vagina.
  3. Leave the ring in place for 3 weeks (21 days).
  4. After 21 days remove the ring for 7 days. To remove the ring, hook your index finger over the edge of the ring and gently slide it out of the vagina. Discard the ring in the foil packet provided and throw into garbage. Do not flush down the toilet! During this 7 day interval you will have a withdrawal bleed (period).
  5. Insert a new ring at the end of the 7 days to begin a new cycle, even if you still have your period. Note that you will always be inserting a new ring on the same day of the week that you inserted the previous ring.

Setting up a  monthly reminder on your mobile phone through the alarm/calendar app is a great way to help you remember to remove/insert your ring on the correct day of the month.

When to use back-up birth control

If the Nuva ring is out of your vagina for more than 3 hours, re-insert it and use a back up method of birth control for the next 7 days. Be sure to rinse the ring with lukewarm (not hot!) water before re-inserting.

If you have had unprotected intercourse in the prior 5 days, use emergency contraception.

If the Nuva Ring is inserted late (after day 28), you will need emergency contraception if you have had intercourse in the prior 5 days and you should use a back-up method (such as condoms) for the next 7 days.

Some medication and herbs may reduce the effectiveness of the Nuva Ring, check with your doctor, nurse or pharmacist if this applies to you.

Switching from another method to the Nuva ring

  • Birth control pill. Insert the Nuva Ring on the same day that you would have started your next package of pills. If switching from progestin-only pills, insert the ring on the same day that you take the last pill in your package and use a back-up method like condoms for 7 days.
  • Depo Provera. Insert the ring on the day that your next injection is due.
  • Postpartum. If not breastfeeding, you can start using the Nuva Ring 4 weeks after delivery.

Common questions about the Nuva ring

Can you use the ring if you have a vaginal infection?

Yes, there is no indication that the Nuva Ring will either cause or worsen a vaginal infection such as a yeast infection.

Can two Nuva Rings be used back to back to skip a period?

Yes, the Nuva ring actually has 4 weeks of mediction in it. You can leave it in for 22 to 28 days, remove the ring and insert a new one right away. Please let a health care professional know if you want to use it this way so you can be educated appropriately.

Can you use a tampon or menstrual cup with a ring inserted?

Yes, the two products can be used at the same time.

Can you use the ring if you have a vaginal infection?

Yes, there is no indication that the Nuva ring will either cause or worsen a vaginal infection.