What you can expect

To insert a vaginal ring:

• Find a position that's comfortable, such as standing with one leg up, squatting or lying down. Separate your labia with one hand. With your other hand, squeeze together the opposite sides of the vaginal ring between your thumb and index finger.
• Gently push the vaginal ring deep inside your vagina. An applicator, similar to a tampon, can help with insertion. The exact placement of the ring doesn't change its effectiveness.
• If you feel discomfort, try pushing the vaginal ring deeper inside your vagina.
• Keep the ring in place for three weeks.
• You don't need to remove the vaginal ring during sex. But if you prefer, you can remove the ring for up to three hours and then reinsert it.

To remove a vaginal ring:

• Hook your index finger under the rim of the ring or grasp the ring between your index finger and middle finger and gently pull it out.
• Discard the used vaginal ring. Don't flush it down the toilet.
• Wait one week to insert a new ring. Withdrawal bleeding usually begins two to three days after removing the ring. You may still be bleeding when you insert the new ring.

If the vaginal ring accidentally falls out, rinse the ring with cool or warm — not hot — water and reinsert it within two hours for Annovera or three hours for NuvaRing.

If the vaginal ring remains outside of your vagina for longer than two (for Annovera) or three (for NuvaRing) hours:

• Reinsert the vaginal ring as soon as possible and use backup contraception for a week, if the expulsion occurs during the first or second week of vaginal ring use.
• Discard the ring if the expulsion occurs during the third week of using the vaginal ring. You can start using a new ring right away, which might cause breakthrough spotting or bleeding. Use a backup method of contraception until you have used the new ring continuously for seven days.

Or, if you used the vaginal ring continuously for at least seven days prior to expulsion, you can:

• Discard the ring and wait up to seven days from the time the ring was removed or expelled to insert a new ring. You'll have withdrawal bleeding.
• Use a backup method of contraception until you use the new ring continuously for seven days.

Your doctor will probably recommend that you check regularly to make sure the vaginal ring is in place, for example, before and after intercourse. If a ring breaks, discard it and use a new ring.

You can use a tampon while using a vaginal ring. But don't use a diaphragm as a backup method of birth control while using a vaginal ring because the ring can interfere with the placement of the diaphragm.

Your health care provider might recommend an annual blood pressure check while you use the vaginal ring.