Contraception - vaginal ring

What is a vaginal ring?#

A vaginal ring is a soft plastic ring that contains two hormones – estrogen and progestogen. These are similar to the hormones produced by the ovaries and are also used in the combined contraceptive pill. The ring works in much the same way as the combined pill to prevent pregnancy.

How well does it work?#

If used correctly, a vaginal ring is at least 99% effective at preventing pregnancy. If you forget to put a new ring in on time, use it incorrectly, or take certain medications, it may be around 93% effective.

How a vaginal ring works#

A vaginal ring works by stopping your ovaries from releasing an egg each month. It also thickens the fluid around the cervix (the opening to the uterus or womb), which helps to prevent sperm from entering.

When you first start using a vaginal ring, or restart it after a break, it can take up to 7 days to begin working. During that time, use condoms as well.

How to use a vaginal ring#

To use a vaginal ring, squeeze the ring and insert it into your vagina, much like inserting a tampon. It stays in place for three weeks. You then take it out and throw it away, wait seven days, and insert a new ring.

Most people cannot feel the ring once it is in place, and it does not need to be taken out for sex. Partners are usually not bothered by it.

You will usually have a period (bleeding from your vagina) a few days after removing the ring. You can skip your period by inserting a new ring straight away and missing the seven-day break.

It helps to write down the date, or set a phone reminder, for when your ring is due to be removed and the next one inserted.

Where to get a vaginal ring#

A vaginal ring is usually available on prescription. Your doctor can provide a prescription that you take to the pharmacy. Many community health services and some public hospitals have family planning, sexual health or women’s health clinics that provide contraception – book an appointment to discuss the best option for you.

Benefits#

As well as preventing pregnancy, a vaginal ring:

• can be used to skip your period
• may make your periods lighter, more regular and less painful
• may help acne to improve
• may reduce your risk of cancer of the uterus (womb) and ovaries
• can help with symptoms of polycystic ovary syndrome (PCOS) and endometriosis

Once you stop using a vaginal ring, your fertility quickly returns to normal.

Side effects#

A small number of people notice side effects, which often settle with time. They can include:

• an increase in vaginal discharge
• irregular vaginal bleeding
• nausea
• sore or tender breasts
• headaches
• bloating
• changes to your skin
• mood changes

The vaginal ring has not been shown to cause weight gain. A small number of people find it uncomfortable.

Serious health risks#

The vaginal ring slightly increases your risk of a deep vein thrombosis (blood clot), heart attack or stroke. It may also lead to a tiny increase in your risk of breast cancer – for people under 35 years, the risk of breast cancer linked to ring or pill use is about 1 in 50,000.

When a vaginal ring may not be a good option#

A vaginal ring may not suit you if you:

• are taking certain medicines or natural remedies that might stop it working (check with your doctor, nurse or pharmacist)
• have certain types of migraine headache
• have a high body mass index (BMI) or are obese
• have a close family member who has had a deep vein thrombosis
• have had health problems such as high blood pressure, heart or liver conditions
• are over 35 years and smoke
• have been treated for breast cancer
• are unable to move around for a long time, for example because of surgery or disability

If you forget to insert a vaginal ring#

Insert a new ring as soon as you remember, and use condoms for the next seven days. What else you need to do depends on how long the ring has been out – check with your doctor, nurse or pharmacist. If you have had sex without a condom in the seven days before missing the ring, you may need emergency contraception.

Pregnancy and after having a baby#

A vaginal ring will not harm a pregnancy. If you become pregnant while using one, it is safe to continue the pregnancy (and stop using the ring) or to have an abortion.

If you are not breastfeeding, you can usually start using a vaginal ring once your baby is three to six weeks old. If you are breastfeeding, you can use a ring after about six weeks, but other types of contraception might be better choices. Check with your doctor, nurse or pharmacist.

Protection from sexually transmitted infections#

Vaginal rings do not protect you from sexually transmitted infections (STIs). The best way to lower your risk of STIs is to use barrier protection, such as condoms, with all new sexual partners. Vaginal rings are safe to use together with condoms.

The vaginal ring is one of many types of contraception.

Key points#

• A vaginal ring is a soft plastic ring containing estrogen and progestogen that prevents pregnancy.
• Used correctly, it is at least 99% effective.
• It stays in for three weeks, followed by a seven-day break before a new ring.
• It does not protect against STIs, so use condoms with new partners.
• Fertility quickly returns to normal once you stop using it.

Where to get help#