Not necessarily. You can start your first ring with or without your period. If you start without your period, you should use a backup method, like condoms or abstinence from vaginal sex, for the first seven days.
After that first month, you should put in the NuvaRing right on schedule, whether you're bleeding or not. For a large proportion of Nuva Ring users, that means inserting the next month's ring while you're still bleeding.
It's not unusual to have breakthrough bleeding during the first few months of use.
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