The Vaginal Contraceptive Ring

What is the vaginal contraceptive ring?

The vaginal contraceptive ring, also known as the NuvaRing®, is a bendy, soft, one size fits all, see-through ring about two inches (5 cm) wide. The NuvaRing® is inserted in the vagina and changed once a month to prevent pregnancy. The NuvaRing® contains two hormones - estrogen and progestin, which are absorbed through the walls of the vagina and then distributed in the blood. The NuvaRing® does not require sizing or fitting and is 99.7 per cent effective if used the right way.

How does the NuvaRing® work?

The NuvaRing® prevents the ovaries from releasing an egg each month (ovulation). If there is no egg to meet the sperm, pregnancy will not occur. The NuvaRing® also changes the lining of the uterus making it difficult for an egg to attach itself. Finally, the NuvaRing® changes the mucus in the cervix making it harder for sperm to enter the uterus.

Who can use the NuvaRing®?

Persons seeking a reliable and reversible method of birth control that does not require daily attention.

How do I use the NuvaRing®?

The NuvaRing® is made to release a steady amount of hormones over a 21-day period with a seven-day ring-free period. Each ring is used for one cycle and then removed. Insert a NuvaRing® into your vagina between day one and day five of your period and keep it in place for three weeks in a row. Remove the Nuvaring® for a seven-day break after which you will insert a new ring. Your period should begin during the ring-free week. The Nuvaring® should be left in place during sex and is usually not felt by either partner. It can be used with a condom and tampons.

  • To insert: After washing your hands, squeeze NuvaRing® between the thumb and the index finger and insert it into the vagina as far as it will go. The exact placement is not important for NuvaRing® to work and the muscles of the vagina should keep the ring in place.
  • To remove: Put a finger into the vagina and pull it out. Dispose of the used ring in the foil pouch it came in, but not in the toilet.


What if it slips out?

On rare occasions, the NuvaRing® can slip out. This can happen if the ring is not properly inserted, if you strain for bowel movements (stool) or sometimes during sex.

Out for less than three hours:

  • The ring should be rinsed with cool-to-lukewarm (not hot) water and re-inserted as soon as possible (within three hours).
  • You should still be protected against pregnancy. No backup method of birth control is needed.
  • If NuvaRing® is lost, you should insert a new ring and stay on the same schedule.

Out for more than three hours:

  • You may not be protected against pregnancy.
  • During week 1 and 2: The ring should be rinsed with cool-to-lukewarm (not hot) water and re-inserted as soon as possible. You must use a backup method of birth control until the ring has been in place for seven days in a row.
  • During week 3: The ring should be discarded and a new ring should be inserted.

This will start a new 3-week cycle. You may not experience a period, however, some spotting or bleeding may occur. You must use a backup method of birth control until the ring has been in place for seven days in a row.

What are the advantages, possible side effects or complications of the NuvaRing®?


  • Convenient - once a month and discreet
  • Decreased cramping and menstrual bleeding
  • Improved cycle control
  • Reduced risk of ovarian and endometrial cancer
  • Can reduce acne

Possible side effects (will likely resolve within the first three months):

  • Irregular bleeding
  • Nausea
  • Headaches
  • Sore breasts
  • Vaginal irritation with whitish vaginal discharge

Possible complications:

Individuals who have any of these symptoms while on the NuvaRing® should go to the hospital immediately:

  • Abdominal pain (severe pain or lump in the abdomen)
  • Chest pain or shortness of breath
  • Headache (severe) with dizziness, weakness or numbness
  • Eye problems (vision loss or blurred vision) or speech problems
  • Severe leg pain or numbness (calf or thigh)


The NuvaRing® does not protect you against sexually transmitted and blood borne infections (STBBIs) including HIV. Use condoms or dentals dams to lower your risk.

For more information on the vaginal contraceptive ring, please visit:

Call the Sexual Health Infoline Ontario at 1-800-668-2437 if you have questions or need help.

For more information:

Sexual Health Centre
179 Clarence Street
Ottawa K1N 5P7
613-234-4641 TTY: 613-580-9656

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