Contraceptive ring

What is the contraceptive ring?

The vaginal ring is a hormonal birth control method, like the pill or the patch. It’s a combined method containing both progestogen and oestrogen hormones, and it protects you from becoming pregnant unexpectedly.

The ring is inserted into the vagina. It’s worn for three weeks out of every four, and the ring-free week is when you have your period. Because it requires so little effort to protect you, it’s a great option for women who don’t want to fuss with a pill every day.

You can’t use a diaphragm, cervical cap or female condom while using the ring, but condoms, menstrual cups and tampons are perfectly fine.

How does the contraceptive ring work?

The vaginal ring works in the same way as the combined birth control pill: by releasing hormones into your body. But instead of every day, like the pill, the hormones in the ring are steadily released into your bloodstream every three weeks.

The ring protects you from becoming pregnant by stopping ovulation (that’s when an egg is released from the ovary). Pregnancy occurs when a fertilised egg attaches to the lining of the uterus, which becomes thicker every month, to make itself more inviting to an egg to embed there.

By stopping an egg from being released, the ring makes pregnancy less likely. It also changes the mucus in your cervix, so it’s more difficult for sperm to reach an egg.

The hormones in the ring also stop the uterine lining from getting thicker, so the egg can’t attach to it easily. This last bit is what makes periods lighter for women who take hormonal birth control.

What are the advantages of using the vaginal contraceptive ring?

One of the biggest advantages for women who use the ring is that it requires the least amount of effort. Because it only has to be inserted once a month, kept in for three weeks and then taken out, you don’t have to worry about it every day. This gives it an edge over the pill.

Depending on when you insert the ring, it will work straight away. So you’ll be protected from becoming pregnant as soon as you’ve put it in. It won’t interrupt sex, and once you learn how to use it, it’s pretty easy to take out and put in.

With the pill, your protection is lowered if you vomit or have diarrhoea whilst taking it. Because the ring doesn’t involve your digestive system at all, being sick won’t impact how effective it is.

The vaginal ring can also help with premenstrual symptoms like headaches, stomach cramps and mood swings, and the periods you’ll have while using it should become lighter and easier to manage.

How effective is the contraceptive ring?

As a method of birth control, the vaginal ring is one of the most effective available. When it’s used ‘perfectly’, it’s more than 99% effective.^[1] But when it’s used typically (making the occasional mistake, such as inserting it late), the effectiveness drops slightly to around 91% — which is still higher than typical use for condoms.

When to start using the vaginal ring

When to insert the vaginal ring depends on whether you’re already using hormonal birth control or not.

If you aren’t currently on hormonal birth control, you’ll insert the ring on the first day of your period. You’ll be protected straight away. If you wait to insert the ring between days two and five of your period, though, you should use condoms for the following week as your protection won’t start immediately. Whenever you’re using additional protection, don’t use a second hormonal method. Just use condoms.

If you’ve been taking the combined pill, insert the ring the day after taking any pill in the pack.

If you’re switching from the patch, insert the ring on the day you remove the patch. You should avoid any gaps in your protection.

If you’ve been getting the depo shot, you can insert the ring up to 15 weeks after your last injection.

You should let our clinician know if you’re switching from another birth control method during your consultation.

How to insert the vaginal birth control ring

Before you use the ring for the first time, it’s helpful to see a sexual health nurse in person so they can show you how to insert it properly. You’ll easily be able to do it yourself after that (or if you’ve had the ring before and already know the ropes), but it’s good to get a little help the first time to make sure you’re doing it correctly.

Always double-check the expiration date on your ring before you use it. Then, wash your hands and get into a comfortable position. You can try lying down, squatting or standing with one leg lifted up and balanced on a chair. Take the ring out of its packaging, hold it between your thumb and forefinger, squeeze it and push it up into your vagina using your index finger.

When you’ve got it in place, you shouldn’t feel it. If you can, or if it feels uncomfortable, you might need to push it in a little more.

After the ring has been in for three weeks, it’s time to take it out. You should change the ring on the same day of the week that you inserted it.

To take the ring out, insert your index finger into your vagina and hook it around the ring. Once you’ve hooked your finger around the rim, you should be able to pull the ring out. Taking the ring out should be a straightforward, easy process. If you have any problems getting the ring out, you should see your GP or sexual health nurse right away.

Throw the ring away, but don’t flush it down the toilet. Some brands like the NuvaRing come with a foil pouch you can use for disposal.