How & When to Start NuvaRing® (etonogestrel/ethinyl estradiol vaginal ring)
Starting NuvaRing
When and how you start using NuvaRing will depend on your health care provider's recommendation and your current birth control method. It is important to talk with your health care provider to make sure you are not pregnant before starting NuvaRing.
How to begin using NuvaRing
How to begin using NuvaRing

As with any birth control, you should talk to your health care provider about your treatment and consult the Patient Information before you start using NuvaRing and each time you get a refill.

See for yourself how to get started.

Insertion of NuvaRing® (etonogestrel/ethinyl estradiol vaginal ring)
If you are switching to NuvaRing from:
The pill (combination progestin and estrogen)

If you have been using the pill correctly and are certain that you are not pregnant, you can start NuvaRing any day. However, do not start using NuvaRing any later than the day you would start taking your next birth control pill.

A patch (combination progestin and estrogen)

If you have been using the patch correctly and are certain that you are not pregnant, you can start NuvaRing any day. However, do not start using NuvaRing any later than the day you would apply your next patch.

A progestin-only method (mini-pill, implant or injection) or from a progestin-releasing intrauterine system (IUS)

You may switch on any day from the mini-pill. Start using NuvaRing on the day that you would have taken your next mini-pill. You should switch from an implant or the IUS on the day of its removal and from an injectable on the day when the next injection would be due.

In all of these cases you should use an additional method of birth control, such as a male condom with spermicide, for the first seven days of using NuvaRing.

If you are starting NuvaRing and:
If you are not currently using hormonal birth control

You have 2 ways to start using NuvaRing:

  • First Day Start: Insert NuvaRing on the first day of your menstrual period. You will not need to use another birth control method since you are starting NuvaRing the first day of your period.
  • Day 2 to Day 5 Cycle Start: You may also start on Day 2 to 5 of your period, but in this case make sure you use an extra method of birth control (barrier method) such as male condoms with spermicide for the first 7 days of NuvaRing use in the first cycle.
If you are starting NuvaRing after childbirth

You may start using NuvaRing no sooner than 4 weeks (28 days) after having a baby if you are not breastfeeding. You should use another birth control method, such as condoms with spermicide, for the first 7 days in addition to NuvaRing.

If your period has not resumed since childbirth, you should talk to your health care provider and you may need a pregnancy test to make sure that you are not pregnant before you begin NuvaRing.

If you are breastfeeding you should not use NuvaRing. Use other birth control methods until you are no longer breastfeeding.

If you had an abortion or miscarriage
  • Following a first trimester abortion or miscarriage:

    If you start using NuvaRing (etonogestrel/ethinyl estradiol vaginal ring) within 5 days after a first-trimester abortion or miscarriage (the first 12 weeks of pregnancy), you do not need to use an extra birth control method.

    If you do not start NuvaRing within 5 days after a first-trimester abortion or miscarriage, use a non-hormonal birth control method, such as male condoms with spermicide, while you wait for your period to start. You can begin NuvaRing at the time of next period. Count the first day of your period as “Day 1” and start NuvaRing one of the following 2 ways below:

  • First Day Start: Insert NuvaRing on the first day of your period. You will not need to use another birth control method since you are using NuvaRing on the first day of your period.
  • Day 2 to Day 5 Cycle Start: You may also start on Day 2 to 5 of your period, but in this case make sure you use an extra method of birth control, such as male condoms with spermicide, for the first 7 days of NuvaRing use in the first cycle.
  • Following a second trimester abortion or miscarriage:

    You may start using NuvaRing no sooner than 4 weeks (28 days) after a second trimester abortion (after the first 12 weeks of pregnancy).


Important Safety Information
Do not use NuvaRing if you smoke cigarettes and are over age 35. Smoking increases your risk of serious heart and blood vessel problems from combination hormonal contraceptives (CHCs) including heart attack, blood clots, or stroke which can be fatal. This risk increases with age and the number of cigarettes smoked.
  • The use of a CHC, like NuvaRing, is associated with increased risks of several serious side effects, including blood clots, stroke, or heart attack. NuvaRing is not for women with a history of these conditions or any condition that makes your blood more likely to clot. The risk of getting blood clots may be greater with the type of progestin in NuvaRing than with some other progestins in certain low-dose birth control pills. The risk of blood clots is highest when you first start using CHCs and when you restart the same or different CHC after not using it for a month or more.  
  • NuvaRing is also not for women with high blood pressure that medicine can’t control; diabetes with kidney, eye, nerve, or blood vessel damage; certain kinds of severe migraine headaches; liver disease or liver tumors; unexplained vaginal bleeding; breast cancer or any cancer that is sensitive to female hormones; or if you are or may be pregnant.
  • NuvaRing does not protect against HIV infection (AIDS) and other sexually transmitted infections.
  • The most common side effects reported by users of NuvaRing are irritation inside your vagina or on your cervix; headache (including migraine); mood changes (including depression); the ring slipping out or causing discomfort; nausea and vomiting; vaginal discharge; weight gain; vaginal discomfort; breast pain, discomfort, or tenderness; painful menstrual periods; abdominal pain; acne; and less sexual desire.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please read the Patient Information for NuvaRing (etonogestrel/ethinyl estradiol vaginal ring), including the information about the increased risk of serious cardiovascular side effects, especially in women who smoke, and discuss it with your health care provider. The physician Prescribing Information also is available.


Learn more about NuvaRing: Call 1-877-NUVARING (1-877-688-2746)
Learn more about NuvaRing: Call 1-877-NUVARING (1-877-688-2746)