I've been using the nuvaring for a little more than a year now (I started back in November of 2009). I always used to put it in/take it out at the same time of day, around noon (give or take an hour), but in the last 3 months I had an issue where we had a giant snowstorm and Planned Parenthood was closed on the day I usually went to pick it up, and then the next day I still couldn't get there on time because of the snow and I ended up putting it back in around 3pm.

Since that messed up my schedule my in/out times have been really random. ^ That was in February, and when I took the last one out at around 11pm at night because I just forgot about it (I set an alarm on my phone but for some reason I ignored it or it didn't go off). When I went to get a refill this month I just put it back in at noon and I'm going to try to keep it that way.

I'm just wondering though, because I do have sex/have been since I started using the ring without other birth control (although I do have backup EC and condoms, I haven't used them), does the fact that I messed up the in/out times change the effectiveness of the ring? I know that it's only 99% effective or whatever the percentage is when it's used "correctly" and it occurred to me that putting it in at the right time might be what they mean by that. I haven't gotten pregnant but since this has occurred to me I've been worried about it.

So, does anybody know? If not the timing then what do they mean by 'when used correctly'? Do we need to be using a backup method (like condoms) in addition to using the nuvaring?

(Also, slightly off-topic, but how easy [if at all possible] is it for younger, childless women to get permanent birth control? I've looked into thinks like essure but I have a feeling that, because most permanent bcs are marketed to women who don't want "more" children, that it would be difficult for me to get it.)