Ring

vaginal contraceptive ringThe vaginal ring is a small, soft plastic ring that you place inside your vagina. It’s about 4mm thick and 5.5cm in diameter. You leave it in your vagina for 21 days, then remove it and throw it in the bin (not down the toilet) in a special disposal bag. Seven days after removing the ring, you insert a new one for the next 21 days.
It releases oestrogen and progestogen. This prevents ovulation (release of an egg), makes it difficult for sperm to get to an egg and thins the womb lining, so it’s less likely that an egg will implant there.

Benefits:

• Easy to put in and take out yourself
• Doesn’t interrupt sex – can have sex with it in place
• You don’t need an examination before use
• Usually makes periods regular, lighter and less painful
• Contraception for a month, so you don’t need to think about it every day
• Fertility returns to normal when removed.

Disadvantages:

• You and your partner may feel it during sex, but this isn’t harmful.
• Does not protect you against STIs, so you may need to use condoms as well.
• A few women develop a blood clot (thrombosis) when using the ring, but this is rare.
• Some women have temporary side effects, including more vaginal discharge, breast tenderness and headaches.
• It can sometimes come out on its own, but you can rinse it in warm water and put it back in as soon as possible. You might need emergency contraception, depending on how long it has been out.

How effective is it?

If the vaginal ring is used correctly and according to instructions it is over 99 percent effective. This means that less than one woman in 100 will get pregnant in a year. When used typically, the vaginal ring is 91% effective.

What makes it less effective?

• If the ring falls out and is not replaced after the 7-day break
• Use of some prescription medicines including some antibiotics, medicines used to treat epilepsy, HIV and TB and the complementary medicine St John’s Wort.

If you forget to take the ring out

If you forget to take the ring out after 21 days, what you should do depends on how much extra time the ring has been left in.

If the ring has been in for up to seven days after the end of week three:

  • take the ring out as soon as you remember
  • don’t put a new ring in – start your seven-day interval as normal
  • begin your new ring after your seven-day interval as normal
  • you’re still protected against pregnancy, and you don’t need to use additional contraception

If the ring has been in for more than seven extra days (more than four weeks in total):

  • take the ring out as soon as you remember
  • put a new ring in straight away

The license for the vaginal ring states that you should use additional contraception (such as condoms) until the new ring has been in for seven days.
The FSRH advice is different. Talk to your doctor or nurse about when you should use additional contraception.
You may need emergency contraception if you had sex in the days before changing the rings over. Talk to your doctor or nurse.

If you forget to put a new ring in

Put in a new ring as soon as you remember, and use additional contraception, such as condoms, for 7 days.
You may need emergency contraception if you had sex before you remembered to put the new ring in, and the ring-free interval was 48 hours or longer than it should have been (9 days or more in total). If this is the case, talk to your doctor or nurse.

If the ring comes out by itself

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.
The license for the vaginal ring states that if the ring is out for more than three hours, you will not be protected against pregnancy. The FSRH advises that you'll be protected for longer – up to 48 hours if the ring was in for seven continuous days before it came out. Talk to your doctor or nurse about whether you'll be protected against pregnancy or not.
The information below is based on the license information on what to do if the ring comes out.
If the ring is out for more than 3 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 3 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:

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

For more information visit: http://www.fpa.org.uk/