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How do you use Annovera for birth control?

Medically reviewed by Last updated on Aug 22, 2023.

Official answer


Annovera is a soft, flexible silicone ring that you can insert and remove yourself. It is used for 3 out of every 4 weeks per month, but you can remove and reuse the same vaginal ring for up to one full year.

Annovera (segesterone acetate and ethinyl estradiol vaginal system) is a hormonal vaginal ring birth control that provides a year of protection against pregnancy. It is 97.3% effective in preventing pregnancy when used as directed. Before using the ring, read the full instructions that come with the medication and follow all directions from your doctor.

After you insert Annovera for the first time, you will remove it at the end of week 3 and leave it out for seven days. You will reinsert Annovera at the end of week 4 of each 4-week cycle. You will repeat this pattern with Annovera for up to 13 cycles (there are 28 days per cycle). Scheduled insertions and removals of Annovera should be at about the same time of the day and the same day of the week for each monthly cycle.

  • The day of the week when you first insert Annovera is known as Day 1 and this is your vaginal system change day. For example, if you insert Annovera on a Sunday, the day you take it out will also be a Sunday (22 days later).
  • For each cycle, you put the vaginal system into your vagina and let it stay there for the entire 3 weeks, for a full 21 days.
  • You take the vaginal system out on your vaginal system change day (Day 22) and let it stay out for 1 week (7 full days).
  • Always put the vaginal system in or take it out on your vaginal system change day at about the same time of day. For example, if you put your vaginal system in on Sunday at 9:00 in the morning, always take it out or put it back in on Sunday at about 9:00 in the morning.
  • Your vaginal system should be cleaned when it is out (see below). It does not need to be refrigerated.
  • Then you repeat this process for another 4 weeks. You may not be bleeding when you put the vaginal system in.
  • Repeat the 4-week cycle for all 13 cycles of the use of the vaginal system. Do not use the Annovera vaginal system for more than 13 cycles (1 year). You will need a new prescription for Annovera each year.

Should I remove Annovera when I have sex?

No, you do not have to take the Annovera vaginal system out before sex. However, if you do decide to remove it, reinsert it within 2 hours after taking it out or you may not be protected from pregnancy. If Annovera is out of your vagina for more than 2 hours at one time or if Annovera is out of your vagina at different times that add up to more than a total of 2 hours over the first 21 days of your cycle, you will need to use another method of birth control (such as male condoms or spermicide) until Annovera has been in your vagina for 7 days in a row.

How do I clean Annovera?

You can clean Annovera with warm water and mild soap, dry it with a clean cloth towel or paper towel, and store it in the case provided. Keep it away from children, pets, and extreme temperatures.

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