The vaginal ring is a thin, colorless, flexible ring that is inserted into the vagina for three weeks and is then removed for one week while the woman has her period. Low doses of estrogen and progestin are continuously released from the ring, which is replaced monthly. Like birth control pills, the vaginal ring is 99% effective at preventing pregnancy, though its effectiveness decreases if used improperly.
Advantages of the ring include:
Only needs to be changed once a monthIs easy to insert and removeDoes not require a visit to the doctor for insertion or removalDoes not interrupt sexual activityMay have less spotting or irregular bleeding compared with birth control pillsMay reduce the possibility of migraines in some women
Disadvantages of the ring include:
Does not protect against
sexually transmitted infections
HIV/AIDSRequires a prescription
Potential side effects include:
Vaginal infections and irritationWeight gainHeadachesLightheadednessBreast tendernessFatigueNausea
Some serious side effects of hormonal contraceptives like the vaginal ring include blood clots in the legs, lungs, stroke, and heart attack. Smoking increases these risks. These are similar to many other types of hormonal contraception. Talk to your doctor about all possible side effects.
Certain drugs, such as antibiotics, antiseizure drugs,
(TB) medications, and migraine medications can affect the effectiveness of the vaginal ring. The herb
St. John's Wort
can also interfere with effectiveness of this ring. Talk to your doctor about all of the medications and supplements you are taking.
If any of the following symptoms occur while you are wearing the vaginal ring, contact your doctor right away:
Severe abdominal pain or headachesChest pain or shortness of breathBlurred visionSevere leg or arm pain or numbnessRedness and swelling in legsSkin appears yellow in colorYou fail to have a regular period
Do not use the vaginal ring if you might be pregnant or are breastfeeding. It is also not advised for women with the following health concerns:
high blood pressureCertain cancers
Storing the ring—The ring should be stored at room temperature (no more than 77°F) and away from direct sunlight.Taking the ring out—If the ring slips out of the vagina, simply wash it off with cold to lukewarm water (not hot) and reinsert it. The ring can be taken out during sex as long as it is not out for more than three hours. In which case, a back up method of birth control should be used for seven days.Pricing—The ring costs about $15-$80 at the pharmacy.Switching from other forms of birth control—You can switch directly to a vaginal ring from other hormonal methods of birth control. Talk to your doctor for details.
Birth control vaginal ring (NuvaRing). Planned Parenthood website. Available at:
http://www.plannedparenthood.org/health-topics/birth-control/birth-control-vaginal-ring-nuvaring-4241.htm. Accessed May 6, 2014.
Contraception. American Congress of Obstetricians and Gynecologists website. Available at:
http://www.acog.org/~/media/Departments/Adolescent%20Health%20Care/Teen%20Care%20Tool%20Kit/Contraception.pdf?dmc=1&ts=20120614T1305469301. Published 2010. Accessed May 6, 2014.
Contraceptive patch and vaginal rings. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 14, 2014. Accessed May 8, 2014.
How does it NuvaRing work? Nuvaring website. Available at:
http://www.nuvaring.com/Consumer/how-it-works/index.asp. Accessed May 6, 2014.
MacGregor EA. Contraception and headache. Headache. 2013 Feb;53(2):247-276.
American Pregnancy Association website. Available at:
http://americanpregnancy.org/preventingpregnancy/vaginal-ring/. Accessed May 6, 2014.
Last reviewed May 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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