What If You Forgot to Take out Your NuvaRing?

Steps to Follow on Replacing Your NuvaRing and When You Need a Pregnancy Test

Take Out NuvaRing
Forgot to Take Out NuvaRing. Sandy Huffaker Collection/Getty Images News

The NuvaRing is a clear, bendable prescription contraceptive ring you place in your vagina for three weeks each month. This hormonal birth control method slowly releases a low dose of estrogen and etonogestrel (a progestin) to protect you against pregnancy for the month.

But if you are going to use NuvaRing, you need to​ remember when it is time to take it out as well pay attention to whether or not it may have accidentally fallen out.

When Do You Need to Take Out Your NuvaRing?

Each ring is part of a 28-day cycle:

  • You insert the NuvaRing on Day 1 of Week 1.
  • You leave it in place for Week 2 and Week 3.
  • On Day 1 of Week 4, you take out your NuvaRing. This is the week that you'll likely have your withdrawal period.
  • When Week 4 is over, you insert a new NuvaRing, and this begins the start of your next 28-day cycle.

If You Forgot to Take Out Your NuvaRing

If it's Day 2 (or 3 or 4 or 5 or 6) of Week 4, and you just realized that you forgot to take out your NuvaRing at the beginning of the week, you will still have pregnancy protection for this entire week. 

If you forgot to take out your NuvaRing during Week 4:

  1. Keep your NuvaRing in place for the entire Week 4 (completing the 28 days of the cycle).
  2. Take the NuvaRing out on Day 1 of your next 28-day cycle.
  3. Wait one week (seven days) and then insert a new NuvaRing. You can consider this the beginning of your next 28-day cycle. The day that you insert the NuvaRing will now be Day 1 of Week 1.
  1. You will need to use a back-up birth control method (like spermicide or condoms) for the first seven days after you insert the NuvaRing.

If you forgot to take out your NuvaRing and it's been longer than four weeks (28 days):

  1. Remove your NuvaRing immediately.
  2. You need to make sure that you are not pregnant. You can take a home pregnancy test or schedule a pregnancy test at your doctor's office.
  1. If you are not pregnant, then you can immediately insert a new NuvaRing and consider it to be Day 1 of Week 1 (the beginning of your next 28-day cycle).
  2. You must use a backup birth control method for the next seven days in a row.

Does Forgetting to Take Out Your NuvaRing Make It Less Effective?

Generally speaking, the NuvaRing is 91 percent to 99.7 percent effective. Your NuvaRing is still effective if you forgot to take it out during Week 4. If you leave it in for more than 28 days (and do nothing), then the NuvaRing may no longer be effective. The NuvaRing will not dissolve, so you do need to take it out of your vagina.

In order to be most effective:

  • Keep your NuvaRing stored at room temperature (avoiding direct sunlight).
  • Only store your NuvaRing for up to four months after you receive it.
  • Always check the label for the expiration date.
  • Do not insert your NuvaRing if the expiration date has passed—just throw it away.

Taking Out Your Nuvaring

The instructions here are very simple:

  1. Wash and dry your hands.
  2. Choose a comfortable position. Either lie down, squat, or stand with one leg up on a stool or chair. 
  3. Put your index finger into your vagina and hook it through the NuvaRing. Slowly pull downward and forward to remove the NuvaRing and then just pull it all the way out.
  1. You can put the NuvaRing in the re-sealable pouch it came in and put it in a trash can. Do not flush your NuvaRing in the toilet.
  2. Seven days after you have taken out your old NuvaRing it is time to insert a new NuvaRing. You can still do this even if your period has not yet stopped. 

NuvaRing Insertion

Here are the steps to insert the NuvaRing:

  1. Choose a position that makes you feel comfortable.
  2. Wash and dry your hands before taking out the NuvaRing from its pouch.
  3. Open the re-sealable foil pouch. There's a notch on both sides, near the top.
  4. Take out your NuvaRing.
  5. Keep the foil pouch. You can place your used NuvaRing into it before you throw it away in the garbage.
  1. Hold your NuvaRing between your thumb and index finger. Then press the sides of the ring together (so it is compressed into a long, oval shape).
  2. Insert the folded NuvaRing into your vagina.
  3. Using your index finger, slowly and gently push it further up into your vagina.

When you use Nuvaring, it may end up in different positions inside your vagina. It doesn't need to be in an exact location to work. Your NuvaRing may also slightly move around within your vagina. This is normal also.

If your NuvaRing is feeling uncomfortable or it is hurting you, there's a chance that you may not have inserted it far enough. Use your finger to carefully push your Nuvaring as far as you can up into your vagina. Don't worry that you pushed it too far up or that it will end up getting lost in there. That won't happen. But if you are experiencing any type of pain during or after inserting your Nuvaring, or if you can't seem to find it, call your doctor right away. 

Sources:

Kubba A, Lete I, Briggs P. NuvaRing: A vaginal contraceptive. Trends in Urology, Gynaecology & Sexual Health. 2010; 15(1):17-22.

NuvaRing Frequently Asked Questions. Merck. https://www.nuvaring.com/frequently-asked-questions/.

 

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