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Ring



The vaginal ring is a soft, flexible plastic ring that you place inside your vagina. It releases the hormones oestrogen and progestogen.

When used correctly it is 99% effective at preventing pregnancy.


How it works

How to use it

At your first appointment the ring will be inserted by a clinician, however going forward you can insert the ring yourself.

  1. With clean hands, squeeze the ring between your thumb and finger, and gently insert the tip into your vagina.
  2. Gently push the ring up into your vagina until it feels comfortable.

You leave it in for 21 days, then remove it and have a 7 day break to have a period/withdrawal bleed. You’re protected against pregnancy during the break.

To remove the ring:

  1. Hook a clean finger under the ring and gently pull it out
  2. Throw the vaginal ring away (in a bin) in the bag provided – don’t flush it down the toilet.

Removing the ring should be painless. If you have any bleeding or pain, or you can’t pull it out, tell your doctor or nurse immediately.

What it does

The hormones released by the ring prevent pregnancy by:

  • Preventing the ovaries from releasing an egg each month (ovulation).
  • Thickening the mucus in the neck of the womb, so it is harder for sperm to penetrate the womb and reach an egg.
  • Thinning the lining of the womb, so there is less chance of a fertilised egg implanting into the womb.


Pros and Cons

Pros

  • It doesn’t interrupt sex.
  • It can help makes periods lighter and more regular, and reduce period pains.
  • You don’t have to think about it every day – each ring stays in place for 21 days.
  • The ring is not affected by diarrhoea or vomiting because the hormones don’t need to be absorbed by the stomach.
  • There is no evidence that it causes weight gain.
  • It can help improve acne in some people.
  • The contraceptive vaginal ring can also have additional health benefits, e.g. reducing the risk of some cancers.

Cons

  • It’s common to experience temporary side effects during the first few months, like headaches, nausea, breast tenderness and mood swings.
  • Some people can experience vaginal irritation and discharge
  • You may experience breakthrough bleeding or spotting during the first few months.
  • It doesn’t protect against STIs.
  • You may not feel comfortable inserting or removing it.
  • Some medicines can reduce the effectiveness of the contraceptive vaginal ring, such as those used to treat epilepsy, HIV and TB and the complementary medicine St John’s Wort.

Questions?


Can I miss out the ring-free week?

Some people do this when they want to put off bleeding, for example if they are going on holiday or want to have sex. You can miss out the ring-free interval by using another ring straight away. This isn’t harmful and you will still be protected against pregnancy. Sometimes you will still get bleeding.


What do I do if my ring falls out?

Sometimes the ring may come out on its own (this is called expulsion). This is most likely to happen after or during sex, or when you're constipated. What you should do depends on how long the ring is out for, and whether you’re in the first, second or third week of using it.

If the ring is out for more than three hours in the first or second week of using it, rinse it and put it back in. You need to use additional contraception for 7 days. You may need emergency contraception if you have had sex in the last few days – talk to your doctor or nurse.

If the ring is out for more than three hours in the third week of using it, don’t put it back in. Dispose of it in the normal way. You now have two options:

  1. You can put a new ring in straight away. You may not have a period-type bleed, but you may have spotting.
  2. Don’t put a ring in and have a 7 day interval. You’ll have a period-type bleed, and you should put a new ring in 7 days after the old one came out (you can only choose this option if the ring was in continuously for the previous 7 days).

Whichever option you choose, you need to use additional contraception until the ring has been in for 7 days in a row. You should also talk to your doctor or nurse if you’ve had sex in the last few days, as you may need emergency contraception.


What are the possible long term side effects?

A very small number of people may develop venous thrombosis, arterial thrombosis, heart attack or stroke. If you have ever had thrombosis, you should not use the vaginal ring. Some users of the ring appear to have a small increased risk of being diagnosed with breast cancer or cervical cancer compared to non-users of hormonal contraception, which reduces with time after stopping the ring.

See a doctor straight away if you have any of the following:

  • Pain in the chest, including any sharp pain which is worse when you breathe in
  • Breathlessness
  • You cough up blood
  • Painful swelling in your leg(s)
  • Weakness, numbness, or bad 'pins and needles' in an arm or leg
  • Severe stomach pains
  • A bad fainting attack or you collapse
  • Unusual headaches or migraines that are worse than usual
  • Sudden problems with your speech or eyesight
  • Jaundice (yellowing skin or yellowing eyes)

What should I expect if I go to get a vaginal ring?

When you first start using the vaginal ring you will be given a supply to see how it suits you. After that you should go back to the doctor or nurse to get new supplies and to have your blood pressure checked. If there are no problems, you can be given a further supply of vaginal rings.

You will only be able to get the ring in 3 month intervals as they need to be stored in a fridge before dispensing.


What can make the vaginal ring less effective?

Medications used to treat epilepsy, HIV and TB, and the herbal medicine St John’s Wort). Ask your GP, clinician or pharmacist and read the information that comes with your medicine. Always tell your doctor that you are using the ring if you are prescribed any medicines.


Can I continue to use my vaginal ring after having a baby/while breastfeeding?

If you have just had a baby and are not breastfeeding, you can start using the ring on day 21 after the birth. You will be protected against pregnancy straight away. If you start using the ring later than 21 days after giving birth, you will need additional contraception (such as condoms) for the next 7 days.

If you are breastfeeding a baby less than six months old, using the ring can reduce your flow of milk. It is recommended that you use a different method of contraception until you stop breastfeeding.


Who is the ring suitable for?

Most people can use the ring, but your GP or clinician will ask about your family and medical history to determine whether or not it is the best method for you. The ring is not suitable for people who:

  • Are pregnant
  • Are breastfeeding
  • Smoke (or stopped smoking less than a year ago) and are 35 or older
  • Are very overweight
  • Are over 50 years old
  • Take certain medicines (ask your GP about this)
  • Have or have had thrombosis
  • Have or have had a heart abnormality or heart disease, including high blood pressure
  • Have or have had diabetes
  • Are immobile for a long period of time or use a wheelchair
  • Have systemic lupus erythematosus
  • Have loose vaginal muscles