If NuvaRing® has been left in your vagina for up to one extra week (four weeks in total or less), remove it and insert a new contraceptive ring after a one-week ring-free break. If NuvaRing® has been left in place for more than four weeks, you may not be adequately protected against pregnancy and you must check to be sure you are not pregnant. If you know or suspect that you're pregnant, do not use NuvaRing®. If you are not pregnant, insert a new contraceptive ring. You must use an extra method of birth control, such as male condoms or spermicide, until the new NuvaRing® has been in place for seven days in a row.

This is from the Nuva Ring's website.

I love the nuvaring :) i had been on the depo shot and it was killing me! all those side effects and i begin having pain in my side and kidneys my vaginal area became very sensitive to the rubbing during sex and when my partner ejaculated inside of me it burned! i began to worry and thought i had an std even though i was in a monogamous relationship and i have my pap smear and checkup every six months even urination after sex was stinging i only think i stayed with the depo for so long because i absolutely loved the fact i had no period so i switched to this snazzy new device i was seeing on all the television commercials the nuva ring i decided i should go for a combination birth control method with estrogen to reduce my side effects but i knew i would lose myself with the pill and i was afraid the patch would just fall off plus im very close to the weight limit on these products turns out that your weight could make them less effective! but i love my nuva ring with the continuous use that is another option i don't have to get my period for very long and when i do its no problem plus ive experienced steadier hormones no more mood swings like on the depo ive started losing weight my breast got larger my sex drive and want of my partner grew and in turn his sex drive grew as well i feel like i don't even know why i was waisting my time with basic barrier methods then the shot when i could have been flying by with this all the time something else to keep in mind is that your partner may be able to feel the ring with their penis even if you cant feel it so i always let him place it in and make it comfortable for himself makes it something we can both do together :)

I have been using the NuvaRing for several years after using the pill and OrthoEvra (the patch). It is by far the only thing I would recommend to anyone. I first went on the pill to avoid very painful cramps...then I was using it for more than just cramps. Slowly I figured out what was the best method for me...the NuvaRing. Recently I went to the doctor for my yearly appointment and mentioned I was having cramps again. She immediately told be to wear it every 3 weeks and then put a new one in

(I need to check out the 4 week thing everyone else is talking about) If you are using it every 4 weeks you would not need a different prescription since birth controls are written for 28 days supply) (If it is a 3 week in and out cycle then you need to talk to your doctor and most importantly your pharmacy to tell them to write it for 21 days supplies) Your pharmacy is what tells your insurance how often you are using it for it to be covered.

I know it sounds scary to not get your period. So I asked her questions up front. I always thought that during your cycle your body is building up a layer of blood tissue which if you got pregnant becomes the lining the egg inbeds in. (All of this is true...unless you are on birth control) Basically when you are on birth control you trick your body not to build up this lining. For me I take the ring out on Sunday and by Thursday I get my period. During those couple days your body is without the hormone it is able to build up this "wall" and then shed it thus you get your period. If you have continuous hormones your body doesn't know to build the lining. My doctor also said it can help with mood swings because you aren't messing with your bodies hormones so much. This all sounds great to me! The only thing that I know we all think about is what if I get pregnant...how will I know? After giving it much thought and research...this is my answer...Many girls get their periods through the beginning of their pregnancy if not all of it-so getting your period doesn't mean your not pregnant. And most girls I know that have been pregnant have known about it from the beginning from either sore breasts or not feeling well or just not feeling themselves. Good Luck with whatever method your choose...you should feel comfortable.

PS about taking it out during sex...If you can feel your ring inside you at anytime you aren't wearing it properly...and if your partner feels it...all I can say is my boyfriend has never complained it felt bad...aka it feels good...(and yes the directions do say you can take it out during sex...I would def. take it out during oral sex.

updated 2-11-08

Stated in the NuvaRing patient information included in the package, "If NuvaRing has been left in your vagina for an extra week or less (four weeks total or less) you will remain protected."

If you would like to skip having periods as much as I do, you can leave one ring in place for 4 weeks still have protection according to the manufacturer. There is no need to replace it after 3 weeks and run out of your prescription at the end of a year. This is especially important if you get your birth control through something like Family Pact in California as they will only cover you for one year's worth.

First, when you use a combination method like the Pill or NuvaRing, you don't have a menstrual period. At all. For the entire duration of use. [The hormones suppress ovulation and the fluctuations in body hormones necessary to cause the menses.]

What you do have is a monthly withdrawal bleeding episode.

The menstrual period and the withdrawal bleed are not one and the same thing.

The period is the shedding of a thickened uterine lining under the influence of body hormones at ~ regular 21 days intervals. The withdrawal bleed is a designer artifice; it's the destabilization of a thin uterine lining caused by the hormones in the birth control method at *arbitrarily* chosen intervals--monthly, q month and a half, 3 months, six months, etc.

Bottom line: Changing the regular regimen (3 weeks on/1 week off for NuvaRing) to an extended one (say, 12 weeks on/1 week off) has no effect on your menstrual period. It only shifts the frequency of your monthly withdrawal bleed.

Second, I've posted a link in the sidebar (Skip period Regimens) with details on extended regimens for the Pill (monophasic and triphasic), Ortho Evra, and NuvaRing.

Third, the following are incorrect:

It is important to make sure that you do have those quarterly periods....Having a period less than once every three months has been linked to a serious condition; I'm fairly sure it's endometrial cancer. If you think about it, it makes sense that you might not want the material that comes out during your period to stay there for more than three months at a time.

and

why would you want to only have a period 4 times a year, when it can increase the chances of you harming your body. That blood builds up ,and eventually you are going to have severe bleeding, and you can pass a lot of clots, which isn't good.

There's no known medical reason to have quarterly withdrawal bleeding vs. say, yearly, or never.

Having an withdrawal bleed ("period") once q three months has *not* been linked to any medical problems, serious or otherwise.

Using a combination Pill [not having a menstrual period for an extended interval of time] *decreases* your risk of endometrial cancer by >50%. NuvaRing is a newer method [hence, lack of long-term data] so we don't know exactly if it offers a comparable protective effect against uterine cancer. What we do know is that theres' no evidence it has any deleterious effect on the uterine lining/risk of uterine cancer.

The material that comes out during your period [aka tissue/blood from the thickened uterine lining] does not exist while you're using a combination method. The lining of the uterus remains thin throughout the duration of use of the method. A thin lining = no excess tissue to shed.

Bottom line: There's no uterine lining tissue/blood build-up, hence no need to shed part of the lining on a regular basis.

Yes, it is, and my doctor wrote me a prescription to do just that.

Contrary to the previous person's answer, the NuvaRing is NOT a barrier method like a diaphragm or cervical cap. It is a hormonal birth control method, more comparable to birth control pills or Depo Provera than to diaphrams. Inserting the ring in your vagina is the way the hormones are dispensed, but it works because of the hormones it releases, not because it's physically there. In fact, you can take it out to have sex if you want to, as long as you put it back within 3 hours of when you took it out (after rinsing it in cool water).

Talk to your doctor about getting a prescription to replace it after three weeks. That way you can get enough of them for the year. If you just do it yourself, your prescription will not give you enough of them. (You should always ask your prescriber before modifying the way you use any drug, anyway.)

My doctor reccomended the nuvaring to me after I asked about Seasonale. Seasonale is the birth control pills that are taken to only allow you 4 periods a year. This is also true of the nuvaring. My doctor is a specialist and suggested nuvaring to me. I have been using it for almost 10 months. I wear one for 4 weeks, take it out put in another, after the 3rd 4th week, I take it out for a week, and have a very light period. Then I put another one in and repeat the 4 week process. I find it to be a GODSEND. I have no side effects from the nuvaring that I notice. I no longer have period cramping, migraines, or irritibility caused by my period, but the best part is NO BLEEDING. I love the nuvaring and I will continue to use it.

SO the answer is, wear it 4 weeks, take it out, put in another, wait 4 weeks take it out and put in another, wait 4 weeks take it out, and wait a week before putting in another, you might have your period, or light spotting. Then start over. Of course Im not a doctor, but that is how I was told I can use it.

It is important to make sure that you do have those quarterly periods - as your doctor should tell you when you are discussing using the Nuvaring to skip periods. Having a period less than once every three months has been linked to a serious condition; I'm fairly sure it's endometrial cancer. If you think about it, it makes sense that you might not want the material that comes out during your period to stay there for more than three months at a time.

That said, I've been using the Nuvaring to have quarterly periods for a couple of years, and I love it.

i am on nuva ring now. i have never missed a period, or have ever been told that it can be used for quarterly periods. I never knew that nuva ring could be used for that. why would you want to only have a period 4 times a year, when it can increase the chances of you harming your body. That blood builds up ,and eventually you are going to have severe bleeding, and you can pass a lot of clots, which isn't good.

Not true. When you are using NuvaRing you trick your body into thinking you are pregnant and therefore do not produce as much blood. In fact, many ObGyn's believe there is really no need to have any periods when you are on hormonal birth control.

Also, there is significant research demonstrating that modern women actually are having some problems because of the amount of periods. Consider the fact the average family contained over four children just a century ago. Women were pregnant or nursing for much more of their lifetimes and have FAR fewer periods.

Talk to your doctor and get educated

As a physician I want to emphasize it is NOT harmful to your body to not have periods! When you are taking hormonal birth control (the pill, patch or vaginal ring) your uterine lining is very thin and you will not have excessive bleeding when you stop. I plan to start the Nuva ring and there is no medical reason to stop even quarterly to have a period. I have been using birth control this way for years and am thrilled to not have periods! If men had periods they would have figured this out a long time ago-just my opinion. Talk to your ob/gyn or family doctor to get the correct information.

DO NOT TAKE OUT THE NUVA RING TO HAVE SEX! There is a reason that there are specific directions to follow. The reason you hear a lot of people saying they got pregnant on birth control is because they change the rules for themselves and do not use it correctly. If you have sex for close to 3 hours in a month, and take out the ring everytime than it no longer protects you. ALWAYS FOLLOW THE DIRECTIONS. Leave in the ring during sex. It won't bother anybody.

you can feel the ring, and also, you can remove it for up to 3 hours w/out changes.

I've had 2 partners while on the ring they both said they couldn't feel anything

Actually, the package insert does say that it can be out for up to three continuous hours. Three continuous hours is the maximum amount of time it can be out and you would still be protected against pregnancy. Naturally, the less time it is out, the better, and three hours sounds (to me) like a pretty long sex session! if you take it out every time you have sex, say it's about an hour, you'll be fine.

I have been using Nuvaring for three years now with no complaints. At first I didn't know about the option to skip periods, but that 3-4 week length of use made it possible to adjust when my period occurred if desired. After I learned about it, I skipped it once in a while, especially if I wanted to shift the days of bleeding away from special occasions. Now I'm leaning toward skipping it all the time. I'm 36 now, and my doctor just told me that since I'm not a smoker, the blood clot risk is negligible and not increased significantly by keeping it in continuously.

As for keeping it in during sex, I always do. My partner can feel it, and he actually likes the goal of trying to get a ringer! (This happened once a couple years ago -- after he withdrew, there it was around the base of his penis! We enjoy laughing about that.) It has never fallen out on its own, and it never bothers me. I had been thinking about switching to Mirena (I have one child and am happy with him as an only.) but I've heard the ends of the strings poke some men uncomfortably. I might try it if I have to start paying for Nuvaring, because its cost without insurance is the only drawback I see.

My husband and I have been using the Nuva Ring on and off for almost five years and we love it. HOWEVER! The first two years of using it were troublesome, since I had a loss of sex drive for some time. It also made me nauseated and I had diarrhea for the first few days when I would switch out rings. I did get my sex drive back though; it could have been from stress too. My husband can't feel the ring during sex, but sometimes with foreplay I can feel it and it's uncomfortable, so I take it out right before the actual act of sex. It's not safe to take it out on a regular basis, because you will only increase your chances of unplanned pregnancy. I do recommend this for of BC to anyone who has had a history of mood swings on any kind of pill though. Since the ring distributes a low dose of hormones daily, less than many pills do, mood swings are less likely on the ring. I had horrible mood changes on the pill almost the entire time. But when I switched, the stopped completely. Well, until my period came(LOL). Oh, has anyone been on the ring and not gotten theor period during your week out? I'm kind of freaking out because i switched from the Depo-shot to the ring last month. I took my ring out after three weeks on Wednesday, and now on Sunday still no bleeding. I had moderate cramps throughout Friday and Saturday, and now nothing. Weird. Any input would be appreciated.

I would like to put some input on the length of time in taking the ring out and your period starting. I have been on the ring for a year and a half. I love it! It did get kind of scray when it started taking a while for my period to start, but it always did. So I would say just wait and it will come. As long as you use it correctly you should be fine. How ever does anyone notice pain during sex after putting a new ring in after having a period? I noticed it after a few months of using it? That's the only thing I don't like about it. But other than that this is a great BC.

ANSWER:

Thank you above reader for the input on easing my anxiety about how long it takes to get my period after stopping the ring between cycles. I have just swapped over from the pill to the ring and normally on the pill I take the sugar pill for a day or 2 and i get my period. So far on the nuvaring its been 3 days and no sign of my period. I will wait a few more days and hopefully it will come.

Yes, it might come out, though, when you take the tampon out.
Yes, you can use whatever menstrual products you prefer.
Yes, you can use both at the same time.

yes. i asked the same question and in the pamphlet, it says that it is ok to use tampons. however be careful when you pull the tampon out because the ring might come out with it. if that happens simply rinse it off with warm water and place it back in.