Annovera® vs. NuvaRing®

When it comes to birth control, finding a method that fits your life is key. If you’re considering a vaginal ring, both Annovera® and NuvaRing® offer safe, effective protection—but they work a little differently, and those differences can make a meaningful impact depending on your routine and preferences.

Both options are small, flexible rings placed in the vagina, where they steadily release hormones to prevent pregnancy. 

NuvaRing® is a monthly method; you insert a new ring each month, wearing it for three weeks and removing it for one week. Annovera®, on the other hand, is a reusable ring that lasts for a full year (13 cycles). You follow the same schedule of three weeks in and one week out, but you use the same ring each cycle.

How Do They Differ?

Vaginal rings are flexible birth control options that offer effective, low-maintenance protection. Annovera® and NuvaRing® are two options that work in similar ways—but how you use them, how long they last, how accessible they are, and how much they cost, will all play a role in how well they suit your life.

How Long They Last

This is the biggest difference between Annovera® and NuvaRing®

NuvaRing® is a monthly method—you insert it for three weeks, take it out for one week, and then start fresh with a new ring. If you like the idea of starting with a new, clean ring each month (and not needing to think about maintenance), NuvaRing® might feel more straightforward.

Annovera® lasts for a full year (13 cycles) with the same ring. You follow the same schedule—three weeks in, one week out—but instead of picking up a new ring each month, you wash and store the same one between cycles. It’s a great option if you want fewer pharmacy trips and don’t mind a little upkeep.

What Hormones They Use

Both rings release a steady dose of estrogen and progestin to prevent pregnancy.

NuvaRing® uses ethinyl estradiol (a common estrogen) and etonogestrel.

Annovera® also contains ethinyl estradiol, but pairs it with segesterone acetate—a newer progestin that some users find works better for their body, because it doesn’t impact androgen hormone activity (which can lead to weight changes or acne).

Both are safe and effective; it’s just about finding the one that agrees with you.

Routine and Maintenance

With NuvaRing®, you get a new vaginal ring each month, insert, remove, and replace. There’s no cleaning or storing required; you just dispose of your old ring and get a new one. That simplicity works well for many people.

With Annovera®, you reuse the same ring for a year. After removing it, you wash it gently with mild soap and lukewarm water, dry it off, and store it in the case until you’re ready to reinsert it. If you like the idea of a year’s worth of birth control in one small device, Annovera® might be a great match.

Generics and Affordability

NuvaRing® has been around longer and now has generic versions, like EluRyngTM, which may lower the cost, especially if you’re paying out of pocket. That said, both NuvaRing® and its generics are covered by most insurance plans.

Annovera® doesn’t have a generic yet, but many insurance plans do cover it. The price tag without insurance can be steep—around $2,000–$2,500 for the year—but when you break it down month by month, it often comes out similar to NuvaRing®. And you only need one vaginal ringa year, which can be a plus for busy schedules.

How Do Vaginal Rings Work?

Understanding how vaginal rings work can help you feel more at ease when choosing the right birth control for your body and lifestyle. Both Annovera® and NuvaRing® use a combination of hormones to prevent pregnancy in multiple ways—and when used correctly, they’re both highly effective.

Estrogen and Progestin

Vaginal rings like Annovera® and NuvaRing® use a combination of estrogen and progestin to prevent pregnancy. These two hormones work together to stop ovulation, so your ovaries stop releasing eggs. No egg, no chance of pregnancy.

Progestin also thickens the cervical mucus, making it harder for sperm to reach an egg, and alters the uterine lining to reduce the likelihood of implantation. Think of it as a multi-layered approach: block, prevent, and protect—all in one small ring.

Consistent Hormone Delivery

Because vaginal rings release a steady dose of hormones throughout the three weeks they’re in place, your body maintains consistent hormone levels. This can lead to more predictable cycles and fewer hormone-related symptoms for some people.

Annovera® is reused for 13 cycles (a full year), while NuvaRing® is replaced each month. Both provide the same steady hormone support, just with different routines.

Cervical Mucus and Ovulation

One of the key ways vaginal rings help prevent pregnancy is by changing the consistency of your cervical mucus. Instead of the fertile, slippery textured discharge your body produces around ovulation, the ring helps maintain a thicker, stickier barrier that makes it much harder for sperm to pass through.

At the same time, steady hormone levels from the ring tell your ovaries to pause ovulation. This is completely safe, and for many people, it can actually bring relief, especially if you’ve experienced painful periods.

How Are They Different from Birth Control Pills?

If you’ve used the pill before, you know the routine—taking it every day, around the same time. It works well, but missing a dose can add unnecessary stress.

Vaginal rings offer a different kind of rhythm. Once inserted, the ring steadily releases hormones for three weeks, giving you effective protection without the need for daily reminders.

Because the hormones are absorbed through the vaginal walls and go directly into your bloodstream, they don’t depend on your digestive system. That means if you’ve struggled with nausea from pills—or had concerns about absorption during illness—rings might feel like a more stable option.

How to Use a Vaginal Ring

Starting something new—especially when it comes to your body—can feel like a lot. But once you know how a vaginal ring works, it becomes a simple part of your routine. Whether you’re using Annovera® or NuvaRing®, the process of insertion, removal, and care is simple.

How to Insert a Birth Control Ring

• Wash your hands to prevent introducing bacteria.
• Find a comfortable position—you might try:
  • Standing with one foot on the toilet
  • Squatting
  • Lying down
• Pinch the ring between your thumb and index finger to make it narrower.
• Gently insert the ring into your vagina until it feels comfortable.
• Don’t worry about placing it perfectly—it will naturally settle into place around your cervix.
• If you can feel it or it’s uncomfortable, use your finger to push it a bit farther up.

Can’t feel it? Perfect! That means it’s in the right spot. The ring should sit comfortably without you noticing it during daily activities, exercise, or sex.

Three Weeks In, One Week Out

Both Annovera® and NuvaRing® follow the same general schedule: wear the ring for three weeks, then take it out for one week. During that ring-free week, most people experience a withdrawal bleed (similar to a period, but usually lighter).

When it’s time to remove the ring, hook your finger under the edge and gently pull. NuvaRing® gets tossed after use—wrap it in tissue or the original pouch before disposal. Annovera® is reusable: rinse it with mild soap and lukewarm water, dry it off, and store it in its case for the week.

Even during the ring-free week, you’re still protected from pregnancy, as long as you’ve used the ring consistently and as directed.

Caring for Your Ring (Annovera® Users)

If you’re using an Annovera® ring, you’ll do a quick clean between cycles. After removing it, rinse it with lukewarm water and a small amount of mild, fragrance-free soap. Avoid anything harsh or oily, as that can damage the ring. Pat it dry with a clean towel or paper towel and store it in its case, at room temperature, until you’re ready to reinsert.

NuvaRing® users can skip this step—since you use a new ring each month, there’s no cleaning required.

Some people appreciate the simplicity of monthly rings. Others love the convenience and lower waste of using the same ring for a full year. What matters most is what fits your lifestyle and feels right for you.

If the Ring Comes Out

If your NuvaRing® or Annovera® falls out, rinse it with cool or lukewarm water and reinsert it right away. For NuvaRing®, if it’s out for less than 3 hours, you’re still protected; if more than 3 hours, reinsert it and use backup for 7 days (especially important during weeks 1 and 2). 

For Annovera®, if it’s out for less than 2 hours, you’re still protected; if more than 2 hours, reinsert and use backup for 7 days. In either case, consider emergency contraception if you had unprotected sex during the time it was out and coverage was compromised.

If you’re unsure, contact a healthcare provider for guidance—it’s always okay to ask.

Side Effects and Health Considerations

Like any medication, hormonal birth control rings can cause side effects, and while many people use them without any issues, it’s important to know what to expect. Understanding both the common symptoms and more serious risks can help you feel confident talking with your provider and making the right decision for your body.

Common Side Effects

Most people tolerate vaginal rings well, but some side effects are common—especially during the first few months as your body adjusts.

• Vaginal discharge may increase, which is completely normal. The hormones in the ring can increase natural lubrication, and your body may respond to having something in place. If the discharge has an unusual color, odor, or causes itching, it’s a good idea to check in with your provider.
• Breast tenderness is another common side effect. Your breasts might feel fuller or more sensitive, especially around your period. This often improves within a few cycles. Wearing a supportive bra and limiting caffeine may help ease the discomfort.
• Other side effects might include mild headaches, nausea, mood shifts, or spotting between periods. These typically settle down after the first few months. If they persist or feel disruptive, it’s okay to explore other options.

Blood Clots and High Blood Pressure

This is where we move from the mild and manageable side effects to the more serious. 

Any hormonal birth control method that contains estrogen—including Annovera® and NuvaRing®—can increase your risk of developing blood clots, depending on your specific risk factors and general health. 

The risk remains small, especially if you’re young and healthy. But for people who have certain risk factors, that risk can increase. Smoking (particularly if you’re over 35), obesity, a personal or family history of blood clots, and high blood pressure are all important to mention to your provider.

Warning signs of a blood clot include:

• Severe pain or swelling in one leg
• Chest pain or shortness of breath
• Sudden vision changes or severe headaches

These symptoms are rare, but if they show up, they require immediate, in-person medical attention at urgent care or the emergency room

Who Should Avoid Vaginal Rings?

There are some medical conditions that make vaginal rings less safe. If you’re over 35 and smoke, have a history of blood clots or stroke, or get migraines with aura, your provider may recommend a non-estrogen option instead. Other considerations include:

• Uncontrolled high blood pressure
• Certain liver conditions
• Estrogen-dependent cancers
• Complicated diabetes
• Certain medications that interact with hormonal contraceptives

Be as open as you can about your full health history and any medications or supplements you’re taking. It’s the best way to find a birth control method that’s safe, effective, and fits your life.

Annovera® vs. NuvaRing® Effectiveness

Both Annovera® and NuvaRing® are reliable, highly effective birth control options. Understanding how their effectiveness plays out in real life can help you set clear expectations and choose what fits best for you.

How Effective Are They When Used Perfectly?

When used exactly as directed—meaning you insert and remove the ring on schedule and never let it stay out for more than two hours—both Annovera® and NuvaRing® are about 98% effective. That means only about two out of 100 people using these rings perfectly for a year will get pregnant.

This high level of protection comes from the steady, continuous release of hormones. Unlike daily pills, the ring works around the clock once it’s in place, so you don’t have to worry about remembering a daily dose.

Both rings deliver similar hormone levels, so their perfect-use effectiveness is essentially the same. When choosing between them, consider factors like convenience, cost, and how the routine fits your lifestyle, rather than differences in effectiveness.

What About Real-World Use?

Let’s be honest: life gets busy, and perfect use doesn’t always happen. With typical use, which includes the occasional late insertion or brief ring removal beyond two hours, vaginal rings are about 91% effective. This means roughly nine out of 100 people using the ring typically over a year might get pregnant.

That rate is still comparable to (or better than) typical use rates for birth control pills, which also require daily attention. The advantage with rings is that they only need your focus once a month, instead of every day.

Common reasons effectiveness drops include:

• Forgetting to put in a new ring on time after the ring-free week
• Leaving the ring out too long
• Not using backup methods when needed
• Improper storage, like exposure to extreme heat
• Using an expired ring

That said, using vaginal rings correctly often gets easier with time. Setting phone reminders for insertion and removal, keeping spare rings handy if you use NuvaRing®, and building the habit into your routine can help you stay on track and maximize protection.

Choosing Between Annovera® and NuvaRing® for Your Birth Control Needs

Both Annovera® and NuvaRing® offer safe, effective pregnancy prevention with the flexibility of monthly use—no daily pills required.

The main difference is in how often you need a new ring: NuvaRing® is replaced each month, while Annovera® is the same ring reused for a full year.

Think about what feels easier for you. Do you like the idea of a fresh ring every cycle, and don’t mind monthly pharmacy trips? NuvaRing® might be a great match. Prefer a low-maintenance option you can use for the entire year (with a quick clean each month)? Annovera® could be the way to go.

The good news is that you’re not locked in. If one option doesn’t feel quite right, it’s okay to switch. The best birth control is the one you feel good about using consistently—one that supports your health, your lifestyle, and your goals.

Not sure if a vaginal ring is right for you? Start your birth control consultation with Nurx today—it’s simple, affordable, and convenient. 

Frequently Asked Questions (FAQ):

Is Annovera® or NuvaRing® better?

It really depends on your preferences. Annovera® is a single ring you reuse for a year, while NuvaRing® is swapped out monthly. Both work well—it just comes down to what feels more convenient and manageable for you.

Can I leave Annovera® in all year?

Not quite. Annovera® is used in cycles: three weeks in, one week out. You reuse the same ring for 13 cycles (about a year), cleaning and storing it during your ring-free week.

Who should not use Annovera®?

People who are over 35 and smoke, or who have a history of blood clots, certain cancers, liver disease, or migraines with aura, should talk to a healthcare provider first. We’ll help you decide what’s safe and right for you.

Can Annovera® make you emotional?

Hormonal birth control can cause mood changes for some people. If you notice mood swings or emotional shifts, check in with your provider—we can help you find an option that feels better.

The information provided is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon this content for medical advice. If you have any questions or concerns, please talk to a medical professional.

NuvaRing® (etonogestrel 0.12 mg in 1d, /ethinyl estradiol vaginal ring 0.015mg in 1d), Rx only, is used as contraception to prevent pregnancy. This drug may cause side effects, including irregular uterine bleeding, nausea, breast tenderness, headache, and increased or unusual vaginal discharge. If you would like to learn more, see full prescribing information, here. You are encouraged to report negative side effects to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Annovera® (segesterone acetate and ethinyl estradiol vaginal system, 0.15mg/0.013mg), Rx only, is used as contraception to prevent pregnancy. This drug may cause side effects, including headache, nausea/vomiting, yeast infection, and abdominal pain. If you would like to learn more, see full prescribing information, here. You are encouraged to report negative side effects to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.