Contraception:
The Vaginal Ring
How does it prevent pregnancy?
- It prevents the ovaries from releasing an egg each month (ovulation).
- It thickens the mucus in the neck of the womb, so it is harder for sperm to penetrate the womb and reach an egg.
- It thins the lining of the womb, so there is less chance of a fertilized egg implanting into the womb and being able to grow.
How effective is it?
- If taken correctly, it’s more than 99% effective.
- With “typical use” of the vaginal ring it’s only about 93% effective.
- That means about 7 out of 100 ring users get pregnant each year.
Make sure you always stay on schedule so it works as well as possible.
Advantages of the birth control vaginal ring
- It’s easy to put in and take out.
- One ring provides contraception for a month.
- You don’t have to think about it every day or each time you have sex.
- You can continue to have sex when the ring is in place.
- The ring isn’t affected if you’re sick (vomit) or have diarrhea.
- The ring may help with premenstrual symptoms.
- Period-type bleeding usually becomes lighter, more regular and less painful.
Potential downsides of the birth control vaginal ring
- You may not feel comfortable inserting or removing it from your vagina.
- You can have spotting and bleeding in the first few months.
- The ring can sometimes come out on its own, but you can rinse it in cold or warm water and put it back in as soon as possible.
- It may cause temporary side effects, such as increased vaginal discharge, headaches, nausea, breast tenderness and mood changes.
- The ring doesn’t protect against STIs.
- You need to remember to change it and put in a new ring.
The vaginal ring isn’t for everyone. It’s not recommended if you:
- Are breastfeeding.
- Are a smoker over 35 (due to increased risk of blood clots, heart attack, and stroke).
- Have poorly controlled hypertension.
- Have a history of breast cancer, stroke, heart disease, liver disease, deep venous thrombosis, or a pulmonary embolism.
- Have advanced diabetes.
- Need to be immobilized for a long-time following surgery.
- Are overweight.
Starting the vaginal ring
Start the hormonal birth control ring on the 1st day of your period. This is when your body is starting the next cycle. If you start the vaginal ring on the 1st day of your period (day 1 of your menstrual cycle) you will have better cycle control and should be protected from pregnancy straight away. We do, however, recommend a backup birth control until you finish the first ring.
The 1st day of your menstrual period is when your body starts the next cycle.
- If you place the ring on day 1 to 5 of your menstrual cycle (the first 5 days of your period), it will provide birth control right away. We do, however, recommend a backup birth control until you finish the first ring.
- If you start using the ring at any other time in your menstrual cycle, you should use an additional form of birth control until you finish the first month.
- The standard way to use the ring is to leave it in for 21 days, then remove it and have a 7-day ring-free break. You’re protected against pregnancy during the ring-free break. After the 7-day break, you then put a new ring in for another 21 days.
- Maintaining a consistent routine is essential when using the ring.
When you’ve taken the ring out, you don’t put a new one in for 7 days (1 week). This is the ring-free interval. You might have a period-type bleed during this time.
After 7 days without a ring in, insert a new one. Put the new ring in even if you’re still bleeding. Leave this ring in for 21 days, then repeat the cycle.
To insert the ring:
- Squeeze the ring between your thumb and finger, and gently insert the tip into your vagina.
- Gently push the ring up into your vagina until it feels comfortable.
To remove the ring:
- Put a finger into your vagina and hook it around the edge of the ring.
- Gently pull the ring out.
If the ring comes out by itself..
Sometimes the ring may come out on its own (expulsion). It may happen after or during sex, or if it wasn’t put in properly.
What you should do depends on how long the ring is out, and which week of your cycle you’re in.
If the ring is out for less than 48 hours (regardless of where you are in your cycle) and you’ve been using that particular ring for 3 weeks or less:
- Rinse it with cool or lukewarm water.
- Re-insert the same ring as soon as possible.
- You don’t need additional contraception and you’re protected from pregnancy if the ring was used correctly in previous weeks.
If the ring is out for more than 48 hours in the first week of using a ring:
- Insert a new ring as soon as possible and keep it in until the scheduled removal day.
- Use additional contraception for 7 days.
- You may need emergency contraception if you’ve had sex since putting in the new ring or during the ring-free break.
If the ring is out for more than 48 hours in the second or third week of using a ring:
- Insert a new ring as soon as possible and keep it in until the scheduled removal day.
- Use additional contraception for 7 days.
- If the ring came out in the third week and you are using the ring the standard way, skip the ring-free break.
- You do not need emergency contraception if you have used the ring correctly in the previous 7 days.