The vaginal ring (also known as NuvaRing) and intrauterine devices (IUDs) are placed in different parts of the body and prevent pregnancy in different ways. Vaginal rings must be replaced much more frequently and are less effective than IUDs. Each of these contraceptive methods has unique benefits and drawbacks.
Some of the confusion between NuvaRing and an IUD stems from the fact that they’re both inserted through the vagina. However, their placement differs:
- Vaginal ring: This flexible ring is placed deep inside the vagina. To insert Nuvaring, remove it from the package and hold it between your thumb and forefinger, folding it inward slightly. While lying down, squatting, or standing with one leg up, slide it gently into the vagina. It may feel slightly uncomfortable until you push it in far enough. You can also use an applicator similar to that of a tampon to put it in the correct position. To remove it, hook your index finger under the front rim and then gently pull it out.
- IUD: This small, T-shaped device passes through the vagina and cervix into the uterus. You cannot insert an IUD yourself; your medical provider must place the IUD, and you’ll need to go back for another appointment when you’re ready to have it removed.
How They Work
The NuvaRing uses estrogen and progestin to prevent pregnancy. These are the same hormones used in combination birth control pills. Once it is in place, the ring slowly emits the hormones, which are absorbed into the bloodstream from the vaginal walls. The hormones prevent pregnancy by keeping the ovaries from releasing eggs and thickening the mucus of the cervix so sperm can’t get through.
IUDs work differently, though they have some of the same effects. The two types of IUDs are:
- Hormonal IUDs: These IUDs do not contain estrogen, but they do contain a progestin called levonorgestrel. This hormone prevents ovulation, thickens cervical mucus, and makes it harder for a fertilized egg to implant in the uterus. The device’s T shape also acts as a barrier to the sperm so it can’t reach an egg.
- Copper IUDs: This type of IUD does not contain hormones. Instead, it emits copper ions that are toxic to sperm. In addition, the device’s shape acts as a barrier to sperm the same way it does in hormonal IUDs.
The NuvaRing stays in place for 21 days, after which you remove it for one week. After seven days, you can put in a new NuvaRing.
An IUD can last for up to three to 10 years, depending on the brand.
The vaginal ring is 91% effective with average use, while both hormonal and copper IUDs are more than 99% effective.
There is more room for error when using NuvaRing because you must replace it once a month. You must also remember to remove the vaginal ring on a specific day. With the IUD, the possibility of user error is practically nonexistent because the device remains in place for years.
The are advantages to using both types of birth control. With the NuvaRing, you can expect these benefits:
- DIY replacement at home (no need to visit a local medical provider)
- Lighter periods
- Fewer menstrual cramps
- Less acne
- Stronger bones
The advantages of using an IUD include:
- No replacements for years
- Lighter, shorter periods or no periods (with hormonal IUDs only)
After considering the benefits of each birth control method, it’s important to weigh them against the potential drawbacks. Some of the disadvantages of using NuvaRing include:
- May cause vaginal discharge or mild vaginal irritation
- Slightly increased risk of toxic shock syndrome (TSS)
- May increase the risk of blood clots, heart attack, and stroke
- Certain medications and supplements, including some antibiotics, anticonvulsants, antiretroviral medications, and St. John’s wort, might make NuvaRing less effective
- Does not protect against sexually transmitted infections (STIs).
Drawbacks associated with the IUD include:
- Requires a visit to a medical provider for insertion and removal.
- May cause pain, cramping, dizziness, or irregular bleeding shortly after insertion.
- Can potentially be expelled from the uterus, though this is rare.
- Slightly increased risk for pelvic infection, though this is rare.
- Does not protect against STIs.
Possible side effects of NuvaRing include:
- Tissue irritation in the vagina or cervix
- Headache or migraine
- Mood changes, including depression
- Nausea or vomiting
- Vaginal discharge
- Breast tenderness or pain
- Painful menstrual periods
- Abdominal pain
- Weight gain
- Lower sex drive
Side effects of IUDs differ based on whether the device uses hormones or copper to prevent pregnancy. Hormonal IUD side effects include:
- Breast tenderness
- Cyst formation
Copper IUD side effects include:
- Heavier, longer periods (mostly in the few months after insertion)
- More intense or frequent menstrual cramps
NuvaRing is the only brand of vaginal ring available.
There are five IUD brands. The hormonal IUD brands are:
- Mirena: Mirena is the IUD that has been on the market the longest. For years, it was the only option available. Today, it’s still the most commonly used IUD. This brand has also been FDA-approved to help treat heavy menstrual bleeding. You can keep the Mirena IUD for up to five years before removing or replacing it.
- Liletta: Liletta was developed to offer a more affordable IUD option. You can use Liletta for up to three years.
- Kyleena: Kyleena has been available since 2016, making it the newest IUD option. It lasts up to five years.
- Skyla: Skyla has a lower dose of hormones than other IUD brands. It’s also smaller, making it a good fit for nulliparous women (those who haven’t given birth before). The Skyla IUD can last up to three years.
There is only one brand of nonhormonal IUD, called Paragard. This hormone-free IUD uses copper to prevent pregnancy. It can last up to 10 years and can also be used as emergency contraception.
If you’re trying to choose between NuvaRing and IUDs, talk to your healthcare provider to determine the best fit for your needs.