How Is Annovera Different From NuvaRing?

Choosing the right birth control method is a very personal decision. Finding a balance of effectiveness, minimal side effects, and convenience can take some time. But with a large number of contraception (birth control) options available, most people can find something that works for them.

If you’re weighing your birth control options, one method to consider is a vaginal birth control ring. Vaginal rings are an effective and discreet form of birth control. There are currently two vaginal birth control rings available: Annovera (ethinyl estradiol/segesterone acetate) and NuvaRing (ethinyl estradiol/etonogestrel).

Here, we’ll discuss the differences between Annovera and NuvaRing so you can make a more informed decision about whether one of these vaginal rings might be a good option for you.

What are the similarities between Annovera and NuvaRing?

The biggest similarity between the Annovera ring and the NuvaRing is that they’re both vaginal rings. With both rings, you insert them into your vagina and keep them in for 21 days. At the end of that time, you remove them for 7 days so you can get your period.

You insert both Annovera and NuvaRing in a similar way to how you would insert a tampon. Once either ring is in place, most people can’t feel it. You can (and should) wear both rings during sex.

Neither ring requires daily maintenance. So they may be more convenient to use than oral contraceptives (“the pill”) for some people.

These two vaginal rings also kick in within the same amount of time when you first start using them. Depending on whether you’ve been using other hormonal birth controls, Annovera and NuvaRing could take up to 7 days to fully protect you against pregnancy. Typically, if you insert the ring during the first 5 days after you get your period, it will start working right away. Discuss when protection will kick in for you with your healthcare provider.

It’s important to note that neither Annovera nor NuvaRing protect against HIV or sexually transmitted infections (STIs). Barrier methods like male and female condoms are still the best way to protect against these.

The most common Annovera side effects are also similar to common NuvaRing side effects. Side effects for both include:

• Headaches and migraines

• Nausea or vomiting

• Sore or tender breasts

• Abdominal pain

• Changes to your period or breakthrough bleeding

• Menstrual cramps

• More vaginal discharge than usual

What are the differences between Annovera and NuvaRing?

While Annovera and NuvaRing have many similarities, they also have notable differences. The biggest difference between the two is how long each ring lasts.

One Annovera ring provides medication for 13 menstrual cycles (about 1 year). This means that at the end of your ring-free week, you’ll clean and reinsert the same ring. Cleaning your ring properly is very important to help limit infections. So the Annovera ring requires more care than NuvaRing, but you have to make fewer trips to the pharmacy.

On the other hand, you should use a new NuvaRing for each menstrual cycle. When you remove the ring at the end of the 21-day timeframe, you throw that ring away. After your 7-day break, insert a brand new NuvaRing.

Annovera and NuvaRing also differ in their ingredients. While they both contain ethinyl estradiol (a type of estrogen), they have different progestins (forms of progesterone). Annovera contains segesterone acetate, and NuvaRing contains etonogestrel. These two progestins both effectively prevent pregnancy. But since everyone responds to hormones differently, you may find that one gives you less side effects.

You’ll also find a difference between what to do if your vaginal ring falls out. With Annovera, you simply clean off the ring like you would before inserting it for the 21-day ring-in time. If it’s been out for more than 2 hours total during those 21 days, you should reinsert it and use a back-up birth control (e.g., condoms) until Annovera has been in again for 7 days in a row.

If NuvaRing falls out and has been out for less than 3 hours, rinse it with lukewarm water and reinsert it. If it’s been out for more than 3 hours, whether you reinsert it depends on what week of your cycle you’re in. If your NuvaRing fell out and has been out for more than 3 hours, contact your healthcare provider or pharmacist for detailed instructions on how to proceed.

How effective are Annovera and NuvaRing?

Both Annovera and NuvaRing are very effective at preventing pregnancy when used as instructed. In studies, Annovera was over 97% effective. This means that fewer than 3 of every 100 women got pregnant during the study. Similarly, NuvaRing is about 98% effective. This means that about 2 of every 100 women will get pregnant while using it.

What are the pros and cons of using Annovera?

Weighing the pros and cons of any medication is important. Annovera’s pros and cons may be different for everyone. This is because everyone’s response to hormonal birth control is unique.

Potential Annovera benefits include:

• You only need to refill your Annovera prescription once a year. This can help lower the number of times you have to go to the pharmacy.

• No one knows when you’re using Annovera.

• Annovera is an environmentally friendly vaginal ring option, since you reuse the same ring for 13 menstrual cycles.

• Inserting the ring is easy for most and similar to inserting a tampon.

• Annovera doesn’t require daily maintenance. Once you insert it, it’ll keep working for the entire 21 days that you have it in.

• It’s less invasive to start using Annovera than other long-acting birth control methods, such as intrauterine devices (IUDs).

• Annovera is included in the Affordable Care Act (ACA). This means that most private insurance companies must fully cover Annovera.

Potential Annovera drawbacks include:

• You must clean Annovera between uses. This makes it slightly more high maintenance than NuvaRing.

• Annovera can cause yeast infections and urinary tract infections (UTIs), especially if you don’t clean it well between uses. These infections haven’t been reported with NuvaRing.

• Annovera has no generic version available yet. If you don’t have insurance or are underinsured, it could be expensive.

• Annovera carries a risk of blood clots and heart-related problems. This is especially true if you’re over 35 and you smoke.

What are the pros and cons of using NuvaRing?

You’ll find that many of NuvaRing’s pros and cons are similar to those of Annovera. This is because the two rings have a lot of similarities, as discussed above. But there are some key differences that could help you decide which vaginal ring might better fit into your lifestyle.

Potential NuvaRing benefits include:

• NuvaRing is discreet, so no one will know you’re using it.

• Inserting NuvaRing is easy for most people.

• You don’t need to do anything from day to day to make sure NuvaRing is working. As long as it’s in place, it’ll prevent pregnancy.

• NuvaRing requires no maintenance in between your 21-day use cycles. Just throw away your old ring, and start a new one next cycle.

• NuvaRing is less invasive to start using than IUDs and other long-lasting birth control methods.

• Due to the ACA, most private insurance companies must cover the cost of NuvaRing.

• NuvaRing has a generic version available. This could save you money if you don’t have insurance.

Potential NuvaRing drawbacks include:

• You need to use a new NuvaRing for every menstrual cycle. This could mean more pharmacy visits.

• Mood changes and vaginal pain are common with NuvaRing. These side effects have been rarely reported with Annovera.

• NuvaRing raises the risk of developing blood clots and heart-related problems. Your risk is even higher if you’re over 35 and you smoke.

Which ring is the best for me?

Neither Annovera nor NuvaRing is the “better” vaginal birth control ring. They’re both similarly effective at preventing pregnancy. The best birth control option for you is the one that you feel most comfortable using. If you’re unsure which one would work better for you, speak with your healthcare provider.

How to save on Annovera and NuvaRing

There are many ways to save on Annovera and NuvaRing. Both are available as brand-name medications. But you can also find NuvaRing as a lower-cost generic. GoodRx can help you navigate many ways to save on your prescription.

• Save with GoodRx. GoodRx can help you save over 80% off the average retail price of the generic version of NuvaRing. Generic NuvaRing’s price at certain pharmacies is as low as $$46.33 with a free GoodRx discount. Anyone with a valid prescription, regardless of insurance status, can use GoodRx to purchase 1 ring (a 1-year supply) of Annovera at an exclusive cash price of $575.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $0 for Annovera using a savings card from the manufacturer.

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Written by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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