| Left ring out for 48 hours or less during weeks 1 through 3? |
- Put the ring back in as soon as possible.
- No need for a backup method.
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| Left ring out for more than 48 hours during weeks 1 or 2? |
- Put the ring back in as soon as possible.
- Use a backup method* for the next 7 days.
- If the ring was left out for more than 48 hours in the first week and unprotected sex occurred in the previous 5 days, consider taking emergency contraceptive pills (see Emergency Contraceptive Pills).
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| Left ring out for more than 48 hours during week 3? |
- Put the ring back in as soon as possible.
- Use a backup method* for the next 7 days.
- Start a new ring at the end of the third week and skip the ring-free week. If unable to start the new ring at the end of the third week, use a backup method and keep using it through the first 7 days after starting a new ring.
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| Forgot to insert a new ring at beginning of the cycle? |
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Insert a new ring as soon as possible. If late by only 1 or 2 days (48 hours or less)—that is, the ring is left out no longer than 9 days in a row—no need for a backup method.
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Keep the same ring removal day.
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If the new ring is inserted more than 2 days (more than 48 hours) late—that is, the ring is left out 10 days or more in a row—use a backup method for the first 7 days of ring use.
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Also, if unprotected sex occurred in the past 5 days, consider taking emergency contraceptive pills (see Emergency Contraceptive Pills).
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| Kept ring in longer than 3 weeks? |
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If the same ring is used for up to 28 days (4 weeks), no backup method is needed. She can take a ring-free week or start a new ring immediately.
If the same ring is used for 28 to 35 days (more than 4 weeks but less than 5 weeks), insert a new ring and skip the ring-free week. No backup method is needed.
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* Backup methods include abstinence, male and female condoms, spermicides, and withdrawal. Tell her that spermicides and withdrawal are the least effective contraceptive methods. If possible, give her condoms.
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