NuvaRing

NuvaRing is a small, flexible plastic ring that sits inside the vagina and releases a steady low dose of two hormones — etonogestrel (a progestogen) and ethinylestradiol (an oestrogen). It prevents pregnancy in three ways: stopping ovulation, thickening cervical mucus so sperm struggle to pass through, and thinning the lining of the womb. The hormones are the same family used in the combined pill; the delivery method is just different.

With perfect use, NuvaRing is more than 99% effective at preventing pregnancy. With typical use — accounting for occasional late changes or rings being left out too long — effectiveness sits closer to 91%. It does not protect against sexually transmitted infections, so condoms are still recommended where STI risk is a factor.

Wash your hands, squeeze the ring between your thumb and forefinger, and gently push it into the vagina until it feels comfortable. The exact position doesn't matter — once it's in and not causing discomfort, it's working. To remove it, hook a finger under the rim and pull gently. Most people get the hang of it within the first cycle.

You wear one ring for three weeks (21 days), then remove it for a seven-day ring-free interval, during which most users have a withdrawal bleed. On day eight, you insert a new ring on the same day of the week and at roughly the same time as before. Set a reminder on your phone — it's the easiest way to stay on schedule.

If the ring has been out for less than three hours, rinse it in cool water and reinsert it — contraceptive cover is maintained. If it's been out for longer than three hours during weeks one or two, reinsert it and use additional protection (condoms) for the next seven days. If this happens during week three, speak to a clinician about whether you need emergency contraception. If a ring is left in for longer than four weeks, contraceptive protection may be lost and you should seek advice before relying on it again.

Most partners don't notice it, and the ring shouldn't interfere with intercourse. If it does feel uncomfortable for either of you, the ring can be removed for up to three hours without losing contraceptive cover — just rinse and reinsert afterwards.

The most commonly reported effects are headaches, breast tenderness, nausea, mood changes, and changes in vaginal discharge or mild irritation. Some users experience breakthrough bleeding in the first few months, which usually settles as the body adjusts. More serious risks — including blood clots in the legs or lungs — are rare but real, and the risk is higher in smokers, those over 35, those with a high BMI, and those with certain medical histories. Any sudden chest pain, breathlessness, severe leg swelling, or vision changes should be treated as urgent — call 111 or attend A&E.

NuvaRing isn't suitable for everyone. It's generally not prescribed to women who smoke and are over 35, those with a personal or strong family history of blood clots, certain heart conditions, migraine with aura, poorly controlled high blood pressure, current or recent breast cancer, or some liver conditions. A clinician will go through a full medical history before issuing a prescription to make sure it's a safe option.

If you insert your first ring on day one to day five of your period, it works straight away. If you start it at any other point in your cycle, you'll need to use condoms or another barrier method for the first seven days while the hormones build up.

Tampons don't interfere with how the ring works, so you can use them as normal — just take care when removing a tampon that you don't accidentally pull the ring out with it. Menstrual cups are trickier, because removing the cup can dislodge the ring; many users prefer to switch to tampons or pads while using NuvaRing.

Unopened rings are kept refrigerated by the pharmacy. Once you've collected them, you can store them at room temperature (below 30°C) for up to four months. Keep them out of direct sunlight and away from young children.

Yes — certain medicines can reduce effectiveness, including some epilepsy drugs (such as carbamazepine and phenytoin), the antibiotic rifampicin, some HIV medicines, and the herbal supplement St John's Wort. Always tell your prescriber about every medicine and supplement you take so they can flag interactions.