How does NuvaRing fit into the vagina?

NuvaRing is specially designed to be fitted by yourself therefore it doesn’t require your attendance at a doctor’s surgery or sexual health (contraceptive) clinic. It is flexible and may be squashed into shape using your fingers to allow you to place it inside your vagina. You should place NuvaRing into the top of the vagina where it meets the womb (the cervix). It should be pushed back into the vagina using your fingers, to this point only. The exact position will not affect the release of the hormones and hence the contraceptive effect, therefore as long as it is in a comfortable position and secure (not easily dislodged) it will work. The cervix is a narrow area that won’t allow the NuvaRing through, so it cannot be inserted past this point. It would feel very painful if it were forced into your cervix.If there is pain then you may be pushing the ring into your cervix or you may have existing problems within your vagina and cervix areas. You should see your doctor if you experience pain when inserting the NuvaRing. Full instructions for use with images are available with the product packaging.

Once the NuvaRing is in place, much like a tampon it will not be noticeable once inserted. It may be noticeable by some women however this may be because it is placed low down in the vagina. The presence of the ring inside the vagina is usually well tolerated and doesn’t cause a reaction because the vagina is designed to accept external insertion such as during intercourse. You do not need to remove the ring during intercourse and it should remain in place throughout, not usually noticed by your sexual partner.

When you do want to remove Nuva (and this will regularly occur, beginning on the 4th week of your cycle to allow menstruation to occur), the ring is simply, painlessly pulled out with your fingers. It may be accidently dislodged if the ring becomes disconnected (the ring becomes undone, into a straight tube) or you are removing tampons. Always try to remember to gently and slowly remove tampons so that they don’t snag on the ring. The ring may also be dislodged if you are straining for bowel movements. The ring should not be removed for more 3 hours within a 24 hour period unless it is for the 4th week of your cycle, where it is removed for 7 days.

If the ring is disconnected discard it, however do not flush it down the toilet. You should place it into the dustbin to avoid contaminating the water system with hormones. If it is merely dislodged you can rinse it under warm water and reinsert within three hours and you will still be protected against pregnancy. However do not use hot water as this can alter the shape of the plastic and also destroy the hormones inside the ring. If the ring has been out of your vagina for more than 3 hours or you cannot remember how long the ring has been out, the level of protection against unwanted pregnancy depends on how many weeks it has already been inserted. If you were at week 1 or week 2 after insertion then you should use condoms for 7 days as you may not be fully protected. However if you were in week 3 when the ring became dislodged, throw away the ring and either insert a new ring , this will restart your monthly cycle so you will not have a period as you normally experience in the following week but would be in another 3 weeks’ time. However you must still use protection such as condoms for 7 days. Alternatively do not insert the ring and allow menstruation to occur then restart using the ring after 7 days. You will therefore have a period earlier in your monthly cycle than expected. If you take this option you must reinsert a new ring no later than 7 days later even if you are still menstruating.

When should NuvaRing be inserted to protect from pregnancy?

If you have not been using any form of contraception in the preceding month you should insert NuvaRing on the first day of your period. You will be protected against unwanted pregnancy immediately. If you insert the ring after this point, it should be inserted during day 2-5 of menstruation, this is day 2-5 of your cycle. The start of your cycle is the first day of your period. If you are still on your period at day 5 you can still insert NuvaRing. However you will need to use additional contraception for 7 days such as a condom.

If you have been using combined oral contraceptives or any other combined oestrogen and progesterone contraceptive you can switch any day, you should be protected straight away but it may be wise to use condoms for 7 days to be sure. Do not leave any gap between finishing the oral contraceptive pill and starting NuvaRing. If there is any gap you will not have been unprotected against pregnancy and may have become pregnant.

If you are using progesterone only contraceptives you switch the day that the contraception ends e.g.) the day that the IUD is removed. If you were taking progesterone only oral contraceptives, the NuvaRing can be exchanged for the pill on any day. However when switching from progesterone only, protection doesn’t occur immediately and the condom of another method of protection should be used during intercourse for the next 7 days.

If you have experienced an abortion or miscarriage then you can insert NuvaRing at day 5 and be completely protected, if you are later than day 5 when you insert NuvaRing then use alternative protection for 7 days.

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