It's like set it and forget it..but with my last ring that I got I have had it in now for about a month and all of a sudden I've got back pain..uterus pain and I tried to remove it and there was a lot of blood apparently inside my uterus when I removed the ring..now my question is "as expensive as this ring was I removed it..how long can I leave the ring outside of my body before trying to replace it and giving it another try..obviously if I replace it and these symptoms occur again I will contact my dr. Immediately... but I pay 300.00 every 3 months for this with my insurance and I would like to try and use this till I need another one than I will consider other options..I am a 54 yr old woman who is going through menopause and can't deal with the hot flashes without using this femring..so how long will the effectiveness of it last outside of my body?