Don’t let uncertainty over how to insert NuvaRing scare you away from trying this mode of birth control if you think it may be right for you. NuvaRing is a flexible, transparent ring that contains the hormones estrogen and progestin to prevent an unwanted pregnancy. Walking around with one inside of you is kind of like your vagina has a cool pregnancy-fighting secret. NuvaRing can also come with other possible benefits like relieving intense period pain.
For all its advantages, learning how to actually insert NuvaRing can feel intimidating. Not only are you putting something foreign into your vagina, it needs to stay there in order to offer protection against pregnancy. Luckily, experts say that NuvaRing is typically easier to use than people might think. Here’s what to know about NuvaRing and how to make it stay put.
Before we talk about how to insert NuvaRing, let’s discuss how it works.
Like in combination birth control pills, the estrogen in NuvaRing suppresses ovulation. This is really doing you a solid; when you don’t release any eggs, sperm can’t fertilize them and get you pregnant. The progestin in NuvaRing beefs up your cervical mucus to make it harder for sperm to traverse and also thins your endometrial lining so a fertilized egg can’t implant in your uterus, according to the Mayo Clinic. This reduced lining can also lead to a less heavy and painful period. Score.
According to the best available research, with perfect use, NuvaRing’s failure rate is 0.3 percent. Translation: Fewer than one out of every 100 people who use NuvaRing perfectly will get pregnant within the first year of use. When you’re talking about typical use, like not inserting and removing your ring exactly when you should, the failure rate is 9 percent, or nine out of every 100 people who use NuvaRing becoming pregnant within the first year of use. These rates appear to mirror those of birth control pills.
However, NuvaRing has a huge benefit that combination birth control pills do not. “[NuvaRing] is ideal for somebody who is a good candidate for an oral birth control pill but doesn’t want the hassle of taking something every day,” Mary Jane Minkin, M.D., a clinical professor of obstetrics and gynecology and reproductive sciences at Yale Medical School, tells SELF. Instead, you’re supposed to keep NuvaRing in for three whole weeks at a time. After that, you remove the ring for a week (during which you’ll get a withdrawal bleed that mimics your period), then replace it with a new one.
Worth noting: You may be able to manipulate your period with NuvaRing by keeping each ring in for four weeks instead of three or by going ring-free for a week when it’s convenient for you to get your period (instead of going ring-free based on the prescribed schedule). However, both of these are off-label uses, which means you should definitely discuss all of this with your doctor before attempting it on your own. Messing up the way you take NuvaRing could potentially make it easier for you to accidentally get pregnant, so it’s best to have a doctor confirm your plan before you forge ahead.
OK, here’s how to insert NuvaRing and make sure it’s secure.
The process is pretty straightforward:
- Choose an insertion position that feels comfortable, because tensing up won’t make any of this easier. That could be lying down, squatting, or standing with one leg propped up, according to NuvaRing’s instructions.
- Wash and dry your hands.
- Open up the foil pouch that contains your ring. Save the pouch if you want to toss your used ring into it when the time comes for removal.
- Hold the ring between your thumb and index finger, and squeeze the sides of the ring together so it’s compressed in the middle.
- Push the folded ring into your vagina, and gently press it up there with your index finger. “The ring will pop open in the correct position,” Laura Carinci, M.D., a gynecologist at NYU Langone Health, tells SELF. If you can’t feel it, great. “If you can feel it, push it in a little more,” Lauren Streicher, M.D., a professor of clinical obstetrics and gynecology at Northwestern University Feinberg School of Medicine, tells SELF.
- And…that’s it. Now you know how to insert NuvaRing. Dr. Carinci recommends setting an alert in your phone for three weeks from the time you inserted the ring to remind you when you should remove it, because you’re supposed to remove it at the same time of day.
If you’re nervous about trying to insert the ring on your own, ask your doctor for help when they prescribe it. They can usually walk you through the process in their office to make sure you feel comfortable, Dr. Minkin says. They may also suggest that you use a NuvaRing insertion applicator, which is kind of like a tampon applicator and may feel easier or more familiar to you. When you talk this over, ask your doctor how often it makes sense to check your NuvaRing to make sure it’s still where it should be.
When the three weeks are up, it’s time to remove your NuvaRing at the same time of day as you inserted it. This should also be fairly simple:
- Wash and dry your hands.
- Get into a position that’s comfortable for you. The insertion positions tend to work well here, according to NuvaRing’s instructions.
- Stick your index finger into your vagina and hook it through the ring.
- Gently pull downward and forward to remove the ring.
- Place it in the foil pouch you saved (or just throw it in the trash), and take the trash out to keep the used ring away from kids and pets if necessary.
If your NuvaRing falls out, your next steps depend on how long your vagina’s been freewheeling it.
It’s possible for the ring to become dislodged and fall out if you haven’t pushed it in far enough, or for it to work its way out when you poop, have sex, or take out a tampon. (This doesn’t mean it’ll always happen in those instances, just that it can.)
If this happens to you and the ring has been outside of your body for fewer than three hours, NuvaRing’s prescribing information recommends washing the ring with cool or lukewarm (not hot) water and inserting it again. As long as you’re within that three-hour window, you’ll still have the same level of protection against pregnancy. (This also means you can take NuvaRing out for short periods when you have sex, if you like, but it’s not necessary. If you do keep it in during sex, though, you may want to check that it’s in place before and after, according to the Mayo Clinic.)
If your ring has been out for longer than three hours and you’re in weeks one or two, NuvaRing’s prescribing information recommends washing the ring, putting it back in, and using a backup method of birth control for seven days.
If you’re in week three and it’s fallen out for longer than three hours, you should throw it away and either put in a new one right away to kickstart the next three-week span (you may experience some breakthrough bleeding), or wait seven days (more breakthrough bleeding potential here), then put in a new ring.
Finally, if you check for your NuvaRing, realize it’s gone, and you have no idea how long it’s been, put in a new one immediately. Use backup birth control for seven days just to be safe. NuvaRing’s prescribing information also recommends taking a pregnancy test if you think you might have accidentally had unprotected sex in that time.
Overall, experts stress that NuvaRing insertion should be pretty easy once you get the hang of it. But, of course, if you’re having issues figuring out how to insert NuvaRing or just aren’t sure if you’re doing it correctly, don’t hesitate to call your doctor. Making sure you’re as protected as possible against unintended pregnancy is worth it.