How does this sound to you: A birth control method you almost never need to think about, but can get (and get rid of) without a medical procedure? If it sounds intriguing, you might want to know more about Annovera, a new type of birth control ring you use for an entire year.
What is Annovera?
Annovera is a flexible silicone birth control ring that you slip into your vagina and leave there, similar to the original birth control ring, Nuvaring. But instead of replacing the ring every month like you do with Nuvaring, you use one Annovera ring for an entire year (13 cycles) meaning no trips to the pharmacy or worries about refills.
It may sound weird to have a ring inside you all year, but Annovera is no bigger than a tampon and placed far enough into your vagina that you won’t feel it. (Don’t worry, there’s no risk that it can go up too far or “get lost.”)
How Annovera Works
Similar to other forms of hormonal birth control, including combination birth control pills, the patch, and Nuvaring, Annovera contains the hormones estrogen and progestin to prevent the release of an egg and thin the uterine lining, preventing pregnancy. Compared to Nuvaring, Annovera contains a tiny bit lower dose of estrogen and a different type of progestin (called segesterone acetate), and it releases these hormones steadily over 13 cycles.
People who can’t safely take birth control containing estrogen (this includes people over 35 who smoke and those who experience migraine with aura, among others) should not use Annovera. Nurx offers two progestin-only pills and the birth control shot. (Two progestin-only alternatives are an IUD and the Nexplanon implant, available from your provider or clinic.) Additionally, if your body max index is 29 or above, Annovera is not recommended because it has not been properly studied in women with higher BMIs. The Nuvaring is a a safe option for women with a BMI over 29, as are many other combination and progestin-only contraceptive options.
Periods on Annovera
After leaving Annovera in for 21 days, you remove it for 7 days when you have a period (or, technically, a “withdrawal bleed”). When you remove the Annovera ring, clean it with a mild soap and water, pat it dry with a cloth or paper towel, then store it in its case for a week. Like other forms of hormonal contraception, Annovera will likely make periods lighter and less painful, with reduced premenstrual symptoms. Annovera is not FDA-approved for continuous use to skip periods, but some doctors may prescribe it this way for “off label” use. If you do use it to skip periods for a year you might need to replace it after 12 cycles instead of 13.
Sex with Annovera
It makes sense that you’d wonder if a birth control ring would be noticeable for your or your partner during sex. Annovera is designed to be kept in during sex, and usually doesn’t affect it in any way. However, you can remove the birth control ring during sex if you prefer, as long as you remember to put it back in afterwards. You can safely take the ring out for up to two hours during a three week cycle (either for one two-hour stretch or multiple shorter stretches that add up to two hours), but if it is outside of your body for longer than two hours you should use a back-up birth control like a condom for seven days.
If you think Annovera might be a good birth control option for you, request it through Nurx and a member of our medical team will evaluate whether it would be safe and appropriate for you (if so, we can deliver it to your door). Although Annovera is expensive without insurance, most plans cover it with a low (or no) copay. You can learn more and request Annovera here.
About the Author
Dr. Julie Graves is a family medicine and public health doctor, as well as the Associate Director of Clinical Services at Nurx. She has more than 20 years of experience and has practiced medicine in Texas, Florida, Maryland, Wisconsin, Washington, DC, Sint Maarten, Germany, and even on a cruise ship. Dr. Graves also enjoys working in telehealth because it provides patients with convenience and comfort, enables them to ask questions at any time, and protects their privacy.
All hormone-containing birth control may cause side effects. Fortunately, these are rare and are less common than similar problems that can occur during pregnancy. Make sure to review Annovera’s side effects here. Please note that the above Annovera content is informational and not a substitute for professional medical advice, diagnosis or treatment. A Nurx healthcare provider can help you understand whether Annovera is right for you.