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Contraceptive Pearl: Contraception During COVID-19: One Year Vaginal Ring

In 2018, the FDA approved a one-year contraceptive vaginal ring. It’s a flexible silicone ring that slowly releases segesterone acetate and ethinyl estradiol. The brand name is Annovera. The label instructs patients to insert the ring for three weeks and remove it for one week, repeating the cycle a total of thirteen times before starting again with a new ring. Unlike the monthly ring, the new yearly ring can be stored at room temperature, making it more appropriate for low-resource settings.

The one-year vaginal ring is expensive. In the US, it costs approximately $2,000. Insurance plans may not cover the yearly ring.

Side effects are similar in type and rate to those seen with other estrogen-progestin methods. In trials, about 25% of patients experienced expulsion of the ring over the course of a year, and 1% stopped using the ring for this reason. Studies included few patients with body mass index (BMI) over 29 kg/m2. There are no published studies of continuous use or of non-contraceptive indications.

The one-year contraceptive ring may be a good option for patients who want to control their method. However, this ring is expensive and needs more study among people with high BMI and those who want to use it for non-contraceptive purposes.



Archer DF, Merkatz RB, Bahamondes L, et al. Efficacy of the 1-year (13 cycle) segesterone acetate and ethinyl estradiol contraceptive vaginal system: results of two multi-centre, open-label, single-arm, phase 3 trials. Lancet Glob Health. 2019;7(8):e1054-e1064.

Lee AL. Segesterone acetate and ethinyl estradiol vaginal ring (Annovera) for contraception. American Family Physician. 2020 May 15;101(10):618-620.

Policar M. The scoop on two new FDA-approved contraceptive methods. Contraceptive Technology. September 2018. 

Population Council. FDA approves the first one year contraceptive fully under a woman’s control. 2018 August. 



The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.