Annovera (segesterone acetate/ethinyl estradiol) is a brand-name drug prescribed for birth control in adults and some children. Annovera comes as a hormone-releasing vaginal ring that’s inserted in the vagina as directed.

Annovera is approved by the Food and Drug Administration (FDA) to help prevent pregnancy in females who’ve started their menstrual period. (Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.)

Annovera belongs to a drug class called combined hormonal contraceptives. Annovera is not available in a generic version.

Keep reading for specific information about the dosage of Annovera, including its strength and how to use the medication. For a comprehensive look at Annovera, see this article.

Note: This article describes typical dosages of Annovera provided by the drug’s manufacturer. When using Annovera, always follow the dosage prescribed by your doctor.

Below is information about the form, strength, and dosage of Annovera.

Annovera form

Annovera comes as a hormone-releasing flexible ring that you insert in your vagina. The ring is made of silicone, which is like rubber. The ring is 56 millimeters (mm) across, which is 2.2 inches (in). It’s 8.4 mm thick, which is less than 1/2 in.

Annovera strength

Annovera comes in one strength of 103 milligrams (mg) segesterone acetate and 17.4 mg ethinyl estradiol. When it’s in the vagina, the ring releases an average of 0.15 mg of segesterone acetate and 0.013 mg of ethinyl estradiol daily.

Typical dosages

The following information describes the dosage that’s commonly prescribed or recommended in adults. However, be sure to use the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Dosage for pregnancy prevention

Doctors may prescribe Annovera to help prevent pregnancy.

If your doctor prescribes Annovera for birth control, you’ll insert one Annovera ring into your vagina and leave it there for 21 days. You’ll remove it after 21 days and leave it out for 7 days. This is the week you’ll have your period.

You’ll reinsert your Annovera ring after the week off and repeat the 28-day cycle (in for 21 days, out for 7 days) for 13 cycles. After 13 cycles, your doctor will need to prescribe a new ring.

For more information about your specific dosage, talk with your doctor.

Children’s dosage

Annovera is approved to help prevent pregnancy in females of any age who’ve started their menstrual period. The dosage in children is the same as the adult dosage. See “Dosage for pregnancy prevention” just above for details.

Talk with your child’s doctor if you have questions about their dosage.

How to use Annovera

Using your thumb and index finger, gently pinch the ring into an oval and insert it into your vagina. You’ll push it up as far as you can, using your index finger. Make note of the day and time you insert Annovera.

After 21 days, remove the ring using your index finger. Then wash and dry the ring and place it in the case provided. After 7 days, reinsert the ring around the same time of day as the first time. To help you remember, you can set an alarm or place a note where you’ll see it. You can also download the Annovera tracking app on your phone.

If you have questions about how to use Annovera, talk with your doctor or pharmacist. There’s also a helpful video and step-by-step instructions on the manufacturer’s website.

Your start day

Your doctor will determine what day you should start Annovera. Your start day depends on several factors, such as whether:

Talk with your doctor or pharmacist if you have questions about your start day.

Long-term treatment

Annovera is meant to be a long-term method of birth control. If you and your doctor determine that Annovera is safe and effective for you, you’ll likely use it long term.

Before you start Annovera, your doctor will discuss your treatment plan with you.


Some pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.

It’s important that you do not use Annovera more than your doctor prescribes. For Annovera, this may mean forgetting to remove it for 7 days or accidentally inserting a second ring. For some medications, using more than the recommended amount may lead to harmful effects or overdose.

Effects of an overdose

Overdose effects of Annovera can include:

If you use more than the recommended amount of Annovera

Call your doctor right away if you believe you’ve used too much Annovera. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

Read on for some frequently asked questions about Annovera and dosage.

How long does it take for Annovera to start working?

How long Annovera takes to start working to help prevent pregnancy depends on several factors, such as:

  • what day of your menstrual cycle you begin Annovera
  • whether you’re switching to Annovera from another hormonal birth control
  • whether you’ve had a recent pregnancy or pregnancy complication

Depending on your situation, Annovera may start working to help prevent pregnancy right after it’s inserted. Or, it may take up to 1 week to be effective. Your doctor will let you know when to start Annovera. They’ll also let you know if you need to use a backup method of birth control, such as condoms, with Annovera.

Talk with your doctor if you have questions about what to expect with Annovera.

What should I do if Annovera falls out?

If Annovera comes out unexpectedly, wash it with soap and water, pat it dry, and reinsert it. If it’s been out for less than 2 hours, you’ll still be protected from pregnancy.

You may not be protected from pregnancy if Annovera has been out of your vagina for:

  • more than 2 hours at one time during the 21 days Annovera is in
  • several instances within these 21 days that add up to more than 2 hours of total time

If this happens, talk with your doctor. They’ll likely recommend using backup birth control until Annovera has been in place for 7 days in a row.

If you’d like more information about birth control, see this list of birth control and contraception articles.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.