You put it in and you take it out.
Birth control that you control.

21 days in, 7 days out, repeat. It’s that simple. Watch our instructional video to learn more about how ANNOVERA works and how you use it (spoiler: you put it in your vagina). Or follow our illustrated step-by-step guide below.

Steps to
ya know

Hands washing ring under water


First wash and dry your hands. Then remove ANNOVERA from the package and wash the ring with mild soap and lukewarm water and pat it dry with a clean cloth towel or paper towel. At the beginning of each cycle, ANNOVERA should be washed and dried before insertion.

Hand squishing birth control ring


Using your thumb and index finger, squeeze the ANNOVERA ring into a narrow oval shape. Admire the squishiness.

Woman comfortably laying down


The ANNOVERA ring can be inserted while lying down, squatting, or standing with
1 leg up on the toilet, bathtub, bed, etc.

Fingers inserting ANNOVERA into vagina


The ring should be inserted as far as possible into the vagina, and should not be felt. If the ring feels uncomfortable, it may not have been inserted far enough. ANNOVERA does not need to be in an exact position to work. It’s not possible for ANNOVERA to get pushed up too far in the vagina or for it to get lost.

Note: Be sure to record the date of insertion. You can also download our ANNOVERA Birth Control Tracker app in the App Store or Google Play.

Woman standing with hands on her hips


Once in place, ANNOVERA sits
in the vagina without obstructing the vaginal canal.

Woman standing with hands on her hips


Wash and dry your hands and assume a comfortable position (see step 3). Then reach into
your vagina, hook the ring
using your index finger and pull downward and forward to remove.

Wash the ring with mild soap and lukewarm water, pat it dry with a clean paper towel or cloth, and store it in the case provided. Store ANNOVERA away from children, pets, and extreme temperatures.

Note: Be sure to record the date of removal.


Woman standing with one leg on toilet


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Important Risk Information

  • Do not use ANNOVERA (segesterone acetate and ethinyl estradiol vaginal system) if you smoke cigarettes and are over 35 years old. Smoking increases your risk of serious heart and blood vessel (cardiovascular) side effects from hormonal birth control methods, including death from heart attack, blood clots, or stroke. This risk increases with age and the number of cigarettes you smoke.
  • ANNOVERA does not protect against HIV infection (AIDS) and other sexually transmitted infections.
  • The use of a combination hormonal contraceptive (CHC), like ANNOVERA, is associated with increased risks of several serious side effects, including blood clots, stroke, or heart attack. Do not use ANNOVERA if you have a history of these conditions, have reduced blood flow to your brain (cerebrovascular disease) or reduced blood flow or blockage in any of the arteries that supply blood to your heart (cardiovascular disease), or any condition that makes your blood more likely to clot. The risk of blood clots is highest when you first start using CHCs and when you restart the same or different CHC after not using it for 4 weeks or more.
  • ANNOVERA is also not for women with high blood pressure that medicine can’t control or high blood pressure with blood vessel damage; diabetes and over 35 years old, diabetes with high blood pressure or kidney, eye, nerve, or blood vessel damage, diabetes for longer than 20 years; certain kinds of severe migraine headaches; liver disease or liver tumors; breast cancer or any cancer that is sensitive to the female hormones estrogen or progesterone; unexplained vaginal bleeding; are allergic to segesterone acetate, ethinyl estradiol or any other ingredients in ANNOVERA; or take any Hepatitis C drug combination containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir, as this may increase levels of the liver enzyme “alanine aminotransferase” (ALT) in the blood.
  • ANNOVERA can cause serious side effects, including: blood clots; toxic shock syndrome (TSS); liver problems, including liver tumors; high blood pressure; gallbladder problems; changes in the sugar and fat (cholesterol and triglycerides) levels in your blood; headache; irregular or unusual vaginal bleeding and spotting between your menstrual periods; depression; possible cancer in your cervix; swelling of your skin especially around your mouth, eyes, and in your throat (angioedema); dark patches of skin on your forehead, cheeks, upper lip, and chin (chloasma). Call your healthcare provider or get emergency medical care right away if any of these serious side effects occur.
  • The most common side effects reported in at least 5% of women who received ANNOVERA were: headache/migraine, nausea/vomiting, vaginal yeast infection (candidiasis), lower/upper abdominal pain, painful periods, vaginal discharge, urinary tract infection, breast pain/tenderness, irregular vaginal bleeding, diarrhea, and genital itching.


ANNOVERA is a ring-shaped vaginal system with hormones used by females to prevent pregnancy.

ANNOVERA has not been adequately studied in females with a body mass index >29 kg/m2.

The risk information provided here is not complete. To learn more, review the ANNOVERA Patient Information and talk with your healthcare provider or pharmacist. The FDA-approved product labeling, including Patient Information, can be found here.

You may report side effects to the FDA at or by calling 1-800-FDA-1088. You may also report side effects to TherapeuticsMD at 1-888-228-0150.

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