Birth control 101: What is the hormonal ring?

If you’re looking for an effective and low-maintenance birth control option, the hormonal ring—also known as “the vaginal ring” or simply, “the ring”—could be a great option for you. The ring is small, flexible, and simple to use. You insert it into your vagina just once a month, and it works continuously to prevent pregnancy. This convenience makes it a popular choice for many people, and it’s available through Hey Jane. You can consult with us about the ring and explore over 100 other birth control options—all from the comfort and convenience of your phone. Ready to find the right option for you? Get started here.

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Continue reading to learn more about how the hormonal ring works, how to use it, and important considerations to keep in mind.

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What is the hormonal birth control ring?

The hormonal ring is a flexible, plastic, ring-shaped device that releases hormones to prevent pregnancy. It works 24/7 by releasing the hormones estrogen and progestin, which stop ovulation, thicken cervical mucus to block sperm, and thin the uterine lining to make it harder for an egg to implant.

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There are two types of hormonal rings:

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Both options are very good at preventing pregnancy, and when used correctly, the ring is 91-99% effective. The ring may also provide additional benefits like lighter, more predictable periods and less cramping.

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How does the ring work?

The ring is inserted into the vagina, where it releases the hormones estrogen and progestin that are absorbed through the vaginal lining, providing continuous protection. This works to prevent pregnancy in three ways:

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The ring is only available by prescription from a health care provider like Hey Jane. Keep reading for more information on how to properly insert and maintain the ring for best results.

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How effective is the ring?

The hormonal ring is over 99% effective at preventing pregnancy when used perfectly (AKA it’s inserted and replaced on time). However, because the ring is inserted at home, it can be prone to user errors which mean its efficacy in practice is more like 91%. To maximize the hormonal ring’s effectiveness, you should:

• Use a calendar or reminder app to track when you insert and remove the ring.
• Check that the ring is in place with your fingers once a day (especially after you’ve had sex) and use backup contraception if it’s been out for too long.
• Be aware of medications or supplements, like St. John’s wort, that can interfere with its effectiveness. Talk to your health care provider about your medications and supplements before starting the ring.

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How long does it take for the ring to start working?

If you start using the hormonal ring during the first five days of your period, it becomes effective immediately, and you won’t need to use backup birth control. For example, if your period begins on a Monday morning, you can insert the ring anytime up until Saturday morning and be protected from pregnancy right away. However, if you start using the ring at any other time in your cycle, it will take seven days to become effective. During this first week, be sure to use a backup method of birth control, like condoms, to protect against pregnancy.

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How long does the hormonal ring last?

The lifespan of your hormonal ring depends on which product you use.

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How long does NuvaRing last?

NuvaRing is designed for single use. After insertion, NuvaRing is worn for three weeks, removed for one week, and then replaced with a new ring.

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How long does Annovera last?

Annovera is a reusable option that lasts for one year (13 cycles). After three weeks of use, you remove the ring for one week, clean it, store it, and reinsert it. 

How to use the hormonal ring 

Using the hormonal ring is straightforward and requires just a few simple steps, depending on whether you use the NuvaRing or Annovera. You should follow the instructions on your prescription, but here’s a quick recap in case you’re curious how the hormonal ring is used.

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Step 1: Insert the ring

Both NuvaRing and Annovera are inserted in the same way. To insert the ring, follow these steps:

1. Wash and dry your hands before removing the ring from its package.
2. Hold the flexible ring between your thumb and index finger and press the sides of the ring together, so it becomes a narrow oval as opposed to a circle.
3. Insert the ring into your vagina and gently push it upwards with your fingers. There’s no risk of inserting the ring too far, and if you can feel the ring or it’s uncomfortable, you may need to insert it further into the vagina.

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Step 2: Remove the ring after three weeks

For both NuvaRing and Annovera, remove the ring three weeks after insertion. To remove the ring, wash and dry your hands, then hook your finger into the ring and gently pull it out. If you’re using the NuvaRing, dispose of the ring in the garbage can (do not flush it down the toilet) and insert a new ring one week later. If you’re using Annovera, proceed to the next step. 

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Note: If you want to skip a period (which is totally safe to do!), just change your ring out the same day of every month. For example, if you start the ring on the first day of the month, on the first of the next month you'll take the old ring out and put a new one in. To make it easier, set an alarm on your phone as a reminder! NuvaRing is effective up to 35 days, so it will prevent pregnancy for the whole month. 

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Step 3: Clean and store Annovera

After removing Annovera, wash the ring in lukewarm water and mild soap. Store the ring in its case during the off week, then reinsert the clean Annovera ring. Store your rings for future use in the refrigerator and out of the heat so that they stay effective. 

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Risks and warnings

The hormonal ring is safe for most people. However, it’s important to be aware of these considerations to determine if the ring is right for you.

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The ring may fall out

Your ring may fall out (e.g., during sex or when using the bathroom). If your Annovera falls out, rinse it with lukewarm water and reinsert it as soon as possible. If the ring has been out for more than three hours, use backup contraception for the next seven days.

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If your NuvaRing has been out for less than three hours, rinse it with lukewarm water and reinsert it as soon as possible. If you lost the NuvaRing, you can reinsert a new one, but stay on schedule (remove the reinserted NuvaRing as originally scheduled).

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If your NuvaRing has been out for more than three hours during week one or two, reinsert the ring and use backup contraception for the next seven days. 

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If your NuvaRing has been out for more than three hours during week three, throw away the ring and insert a new ring, restarting a new three-week cycle (consider this day one) or wait to insert the ring for no more than seven days, during which time, you may have your period. Insert a new ring, and use backup contraception until the new ring has been inserted for seven days.

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Product compatibility

Avoid using silicone-based lubricants, suppositories, or creams with the ring, as these can damage it and compromise the effectiveness. Water-based lubricants are safe to use.

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Health risks and eligibility

If you have a condition like prolapsed uterus (also known as dropped uterus), your ring may be more at risk of falling out. If you find that your ring is falling out consistently, the hormonal ring might not be the best contraception option for you. Like other forms of hormonal birth control, the ring may not be safe for people with certain medical conditions, like a history of blood clots, heart disease, or migraine with aura. Talk to a health care provider to determine if it’s safe for you to use the ring.

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The hormonal ring is a convenient, effective, and low-maintenance way to prevent pregnancy while offering added benefits like lighter periods and less cramping. If you think the ring could be the right birth control method for you, talk to a health care provider like Hey Jane to explore your options.