Fact Sheet

The Ring

Worn inside your vagina for three weeks at a time, the ring is an effective hormonal method.

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The birth control ring (sometimes called Nuvaring or Haloette in Canada) is a thin plastic ring containing 2 hormones (estrogen and progestin) that you can put inside your vagina* yourself. It is highly effective when used correctly and consistently.
It is a circular, flexible device around 54mm (2.1in) in length and 4mm (0.12in) in width.

In order to get pregnant, sperm must enter your vagina, swim up to the uterus and fertilize an egg released from the ovaries during ovulation. The patch works by preventing you from ovulating.
It also thickens the mucus on your cervix (the opening to your uterus), making it harder for sperm to reach an egg. This reduces the risk of fertilization.
The patch thins the lining of your uterus (the endometrium), reducing the chance of a fertilized egg from implanting and starting a pregnancy.

The ring is 99% effective. This means that if 100 people used the ring correctly for one (1) year, only one (1) person would get pregnant.
Because the ring may be used incorrectly, it is closer to 92% – 97% effective with usual use.
If you use the ring incorrectly, your risk of getting pregnant increases.

The ring works on a 28-day (4 week) cycle. You will insert one (1) ring, leave it in for 3 weeks and then remove it for one (1) week.
After that “ring-free” week is over, you insert a new ring and the cycle starts all over again.
Week 1: put one ring into your vagina. Leave it in for 21 days (3 weeks).
Week 4: on day 22, remove your ring. Put the used ring into the foil pouch it came in and throw it away. The next 7 days (week 4) will be “ring-free”. You can expect your period sometime during this week.
At the end of that 7 day ring-free week, insert a new ring.
Remember, you are protected from pregnancy during the ring-free week as long as you have been using your ring correctly and you insert your next ring on time.
Some people use the ring continuously (no ring-free week) to avoid having their period, sometimes called “stacking”. If you are interested in doing this, speak to your clinician first.
If you’re late removing or inserting your ring check the instructions in your package, contact your clinician to see if you need an appointment, and/or use a backup barrier birth control method for the next 7 days (such as condoms). Apps like Stay on Schedule (https://www.sexandu.ca/sos/) can be used to help you find out if you need to use backup methods.

If you decide, along with your clinician, that the ring is right for you, they will write you a prescription. You can purchase your rings at a pharmacy (approximately $30/month) or at PPT’s Health Services (approximately $10/month).
If you start the ring within the first 5 days of getting your period, you are protected from pregnancy right away.
If you start the ring 6 or more days after getting your period, you are not protected from pregnancy until you have been using the ring for a full week (7 days). To avoid pregnancy during this time, use a back-up method of birth control, such as internal/external condoms or spermicides.
A clinician may recommend that you use a back-up method of birth control for a longer period of time when you start the ring.
Some people like to start the ring on the first Sunday following the start of their period, whether they are still bleeding or not. This will likely keep you from getting future periods on the weekend.

Get into a comfortable position – standing with one foot on a chair, lying down, or having a partner insert the ring may help. It may help to put one foot up on a chair, lie down or have your partner insert the ring.
If you have a physical disability, a partner or support person can help you with inserting and removing the ring.
With clean, dry hands, pinch the sides of the ring to form an oval. Gently push it into your vagina as high as possible. Once inserted, you shouldn’t feel it.
The ring doesn’t need to be in a specific position – if it’s high enough that you don’t notice it, it’s working. It cannot get lost or stuck in your vagina.

You may experience minor side effects such as nausea, sore breasts*, irritation in your vagina and/or spotting (light bleeding between periods). These usually go away within the first 3 months of using the ring.
If after 3 months you are still experiencing side effects or your side effects are severe, you may want to try a different method.
If side effects last longer than 3 months or become severe, you may want to talk about different birth control options with your clinician. There is a rare risk of getting blood clots or having a heart attack or stroke while using the ring. Smoking, obesity, and other health conditions increase this risk. Speak to your clinician for more information.
Warning signs of a blood clot include: blurred or loss of vision, chest pain or trouble breathing, migraine headaches, severe abdominal cramps, or severe pain in the leg. If you experience any of these symptoms, get medical help right away.

If you use the ring correctly and consistently, your chances of getting pregnant are very low.
You don’t have to do anything before or after you have sex for it to work.
You only have to insert it every 4 weeks.
You are less likely to have side effects than you are with the pill.
Your period may become shorter, lighter, less painful, and more regular.
The ring can reduce acne and increase bone strength.
It does not affect your ability to get pregnant in the future.
A partner doesn’t have to be involved. They may feel the ring during sex but it shouldn’t hurt or interfere with pleasure.
The ring lowers your risk of ovarian and endometrial cancer.

The ring does not protect you from sexually transmitted infections (STIs). Speak to your clinician for ways to protect yourself from STIs while using the ring.
You have to remember to remove and insert a new ring.
If the ring is out for more than 3 hours during the 3 week period it should be in your vagina, if you forget to take it out after that 3 week period, or if you forget to insert a new one after your ring-free week, your risk of getting pregnant increases and you may need to use a back-up method of birth control (e.g. internal or external condoms) for seven days (1 week).
You have to be comfortable touching the inside of your vagina.
You may experience side effects.
If you have certain health conditions, the ring may not be the best option for you. Talk to your clinician for more information.
If you smoke or vape and you use the ring, there is an increased risk of getting a blood clot.
You need a prescription.
It can be expensive. However, PPT’s Health Services sells the ring at a reduced cost.

*We know that these aren’t the words everyone uses for their bodies (e.g. trans folks) and support you using the language that feels best for you.