Vaginal Ring for Birth Control

Medically Reviewed by Traci C. Johnson, MD on August 09, 2021
3 min read

A vaginal ring is a birth control option for women. It’s a small, flexible contraceptive ring, about the size of a silver dollar. There are two options available at this time, Annovera and NuvaRing.

NuvaRing was the first vaginal ring approved for use. It delivers etonogestrel (a syntheic progestin) and ethinyl estradiol and requires use of a new ring each month.

Annovera is a contraceptive vaginal ring that releases segesterone acetate, a synthetic progestin, and ethinyl estradiol. It is the first product to contain segesterone. The Annovera ring can be used for an entire year, but it must be removed for one week each month.

The vaginal ring contains the same hormones as many birth control pills. You put it in your vagina, where it sends a steady, low dose of hormones into your system. There are two ways to use it:

Cyclic use. Insert it and leave it in place for 3 weeks, then remove it for 1 week, during which you have a period. If you use NuvaRing, you’ll put a new ring in at the end of week 4. If you use Annovera, you’ll use the same device for a year. Remove, wash, and store it during your period.

Continuous use. Leave the ring in for 4 weeks, then put a new one in. This is what’s called an off-label use. Your doctor might suggest it if you want fewer days of bleeding and maximum protection.

It’s similar to using a tampon. Follow these steps:

  • Wash and dry your hands.
  • Lie down with your knees bent, squat, or stand with one leg on a chair.
  • Open the foil and remove the ring. If you use disposable rings, you can save the foil package to wrap it in and throw it away later. 
  • Hold the ring between your thumb and index finger.
  • Pinch the sides together so they touch in the center.
  • Insert the ring as far into your vagina as it will go.
  • NuvaRing makes a tampon-like applicator you can order to make inserting it easier. Or you can put the ring in an empty tampon applicator.

The vaginal ring prevents pregnancy 96%-99% of the time when you use it correctly. That means only 1 to 4 women out of 100 who use it would accidentally get pregnant.

The most common ones are:

This product isn’t a good option if you:

  • Have a history of blood clotsheart attack, or stroke
  • Have breast cancer or other hormone-sensitive cancers
  • Are pregnant or think you might be
  • Are older than 35 and smoke cigarettes
  • Have hepatitis or liver problems
  • Have high blood pressure that isn’t controlled

Women who have migraines should talk with their doctor.

You might be more likely to get:

  • Blood clots
  • Heart attack
  • Stroke
  • Toxic shock syndrome

The ring gets high marks for:

  • Ease of use
  • Safety
  • Effectiveness
  • Not having to interrupt sex to put it in
  • Privacy -- it’s your choice to tell your partner
  • Potential to ease menstrual cramps and acne
  • Bone-strengthening effects

No. The male condom provides the best protection from most STDs.

Show Sources






Lea's Sheild. 

Fem Cap. 



Center for Young Women’s Health: “Vaginal Hormonal Ring (NuvaRing®).”

U.S. Department of Health and Human Services: “Vaginal Ring.”

Journal of Family Practice: “When to suggest this OC alternative.”

NuvaRing: “Request an applicator for NuvaRing.”

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