A Vaginal Ring is a thin, transparent, flexible ring that you insert into the vagina yourself to provide contraception protection. Leave the Vaginal Ring in for 3 weeks while it slowly releases estrogen and progestin hormones into the body. These hormones stop ovulation and thicken the cervical mucus, creating a barrier to prevent sperm from fertilizing an egg. Wear it continuously for three weeks then take a week off. Each Vaginal Ring provides one month of birth control. The Vaginal Ring is 91 to 99.7% effective as birth control. It does not protect against sexually transmitted infections, including HIV/AIDS.
Insert the Vaginal Ring immediately or within the first 5 days of your monthly period. The Vaginal Ring is effective after 7 days of continuous use. To reduce the chance of pregnancy and reproductive tract infections, especially during the first week of use, male condoms or spermicide can be used with a Vaginal Ring. (If breastfeeding, consult your health care provider.)
Insertion: Insertion may be awkward at first. However, since the vaginal ring is not a barrier method, the Ring will be effective as long as it is inside your vagina – there is no “correct” position it has to be in. You may choose to sit with knees apart, stand with one leg raised, or lie on your back with your knees spread. Squeeze the outer sides of the ring into a tight oval and gently push it into your vagina. Push the ring far enough in so it feels comfortable or so you can’t feel it at all.
Removal: A Vaginal Ring remains in the vagina for three weeks. To remove the Ring, hook it with a finger and pull it out. To dispose, wrap it in the original foil wrapper and dispose in the trash to protect the hormones from being released into the environment. Within the next few days, your menstrual period bleeding from should begin. For another month of birth control, insert a new Vaginal Ring seven days after removal of the last one, even if your period has not ended.
Storage: Vaginal rings for future use should be stored at room temperature, no more than 77 degrees Fahrenheit, and away from direct sunlight.
Continuous Use: Naturally, a woman has a period when the lining of the uterus thickens in preparation for a possible pregnancy. After ovulation, if a pregnancy has not occurred, the uterus sheds that thick menstrual lining. With continuous hormonal use, the lining of the uterus does not thicken and thus there is nothing or very little for the uterus to empty. It is okay to wear the Vaginal Ring constantly and not have a monthly period. Wear the Ring for 4 weeks, take it out and insert a new one. Continue replacing the Ring every 4 weeks with no interruption. By adding hormones to the body by using a new vaginal ring every 4 weeks continuously with no breaks, a woman can stop the monthly bleeding. Break through bleeding, or bleeding mid cycle is very common in the first six months of continual hormonal use. Over time your body will get used to the constant level of hormones and this side effect will usually disappear within 4-6 months of continuous hormonal use.
A Vaginal Ring can slip out of the vagina. If this happens, you can wash the ring with cold to lukewarm water (not hot) and reinsert it. If you lose the original ring, insert a new one as soon as possible. If more than three hours pass without the ring in your vagina, there is a chance of becoming pregnant. The Vaginal Ring must be worn continuously for 7 days to regain effectiveness. During this week, you may wish to use a back up method of birth control such as like male condom, female condom or spermicide; a diaphragm is not recommended as a back up method for the Ring.
Missing a period does not necessarily mean you are pregnant. However, if you miss a period, you may want to consider the likelihood of pregnancy and get a pregnancy test. Pregnancy is more likely if the last ring used was outside the vagina for more than three hours, two periods are missed consecutively, or if a ring was worn for longer than four weeks. If you are pregnant, discontinue use of the Vaginal Ring.
Some women may not be able to use the Vaginal Ring because of the risk of serious health problems. Women over 35 who smoke or have any of the following conditions should not use the Vaginal Ring:
- History of heart attack or stroke
- Chest pain
- Blood clots
- Unexplained vaginal bleeding
- Severe high blood pressure
- Diabetes with kidney, eye, or nerve complications
- Known or suspected cancer
- Known or suspected pregnancy
- Liver tumors or liver disease
- Headaches with neurological symptoms
- Disease of the heart valves with complications
- Require long bed rest following surgery
- Allergic reaction to the vaginal ring
Women with a family history of breast cancer, diabetes, high blood pressure, high cholesterol, headaches or epilepsy, depression, gallbladder or kidney disease, recent major surgery, easily irritated vagina, dropped uterus, dropped bladder, rectal prolapse, severe constipation, or are breastfeeding may not be able to use a Vaginal Ring. Your clinician or doctor can decide with you.
As the body adjusts to hormonal changes from the vaginal ring, women may experience some minor side effects, including:
- Vaginal discharge
- Vaginal irritation
- Weight gain
- Irregular bleeding
- Breast tenderness
- Mood changes
The effectiveness of a Vaginal Ring is lowered when taken with certain medications, including antibiotics, St. John’s Wort, anti-seizure, tuberculosis, and migraine medications. If you are taking any medications, tell your clinician. When taking medications that may interfere with the Vaginal Ring, consider adding a backup method of birth control, like male condom, female condom or spermicide. As with all drugs, it is useful to inform all your medical providers if you are using hormonal birth control.
Women who experience any of the following symptoms while wearing a Vaginal Ring should call the clinic immediately:
- Abdominal pains (severe)
- Chest pain or shortness of breath
- Headaches (severe)
- Eye problems, such as blurred vision
- Severe leg or arm pain or numbness
- Easy to use.
- Can be worn for three weeks.
- Effects fertility one month at a time.
- Does not interrupt sex play.
- Does not protect against sexually transmitted infections, including HIV/AIDS.
- Raised risk of heart attack and stroke.
- Requires a prescription.
- NuvaRing (the manufacturer’s website)