As soon as you hold and squeeze ANNOVERA, you’ll understand how easy it is to insert and remove on your own.

Here’s a step-by-step guide:

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Step 1: Clean The Ring

Wash and dry your hands before starting the insertion process. Once you remove ANNOVERA from the package, wash the ring with mild soap and water and pat dry with a clean towel.

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Step 2: Prepare To Insert

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

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Step 3: Choose a Comfortable Position

ANNOVERA can be inserted while lying down, squatting or standing with one leg up. Just pick the position you find most comfortable.

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Step 4: Insert ANNOVERA Into Your Vagina

The ring should be inserted as far as possible into your vagina. Properly inserted, you shouldn’t be able to feel the ring. If you feel any sort of discomfort, the ring may not have been inserted far enough. ANNOVERA does not need to be in an exact position to work. Don’t forget to record the date of insertion.

For each cycle, ANNOVERA should be inserted and left in place for 21 continuous days and then removed for 7 days. ANNOVERA is designed to be worn during sex, but if you prefer, you can remove it for up to 2 hours. If ANNOVERA is out of your vagina for more than 2 hours at one time or at different times that add up to more than 2 hours over the first 21 days of your cycle, then you will need to use another method of birth control, such as condoms or spermicide.

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Step 5: Removing ANNOVERA

First and foremost, wash and dry your hands. After assuming a comfortable position, reach into your vagina, hook the ring with your index finger and pull downward and forward to remove. You should then wash the ANNOVERA ring with mild soap and lukewarm water, pat dry and store in the case provided. Again, don’t forget to record the date of removal.

ANNOVERA can be accidentally expelled from your body. Accidental expulsion could occur while removing a tampon, during sex, or with straining during a bowel movement.

You have up to 2 hours to put it back in and as long as it hasn’t been out for more than 2 hours in the first 21 days of the cycle, contraceptive efficacy isn’t reduced and you don’t need to use backup contraception. Wash ANNOVERA with mild soap and water before re-inserting the ring.

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Important Risk Information

  • Do not use ANNOVERA 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 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 the 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 moderately obese females. Ask your doctor if ANNOVERA is appropriate for you.

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, Inc. at 1-888-228-0150.

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