“God made woman beautiful and foolish; beautiful, that man might love her; and foolish, that she might love him.” ~ anon
NuvaRing: the Vaginal Ring
What is this ring you put in your vagina once a month for three weeks to prevent pregnancy?
- Safe, effective, and convenient
- Easy to get with a prescription
- Costs about $15–$70 a month
What Is the Vaginal Ring?
The vaginal ring is a small, flexible ring a woman inserts into her vagina once a month to prevent pregnancy. It is left in place for three weeks and taken out for the remaining week each month. The vaginal ring is commonly called NuvaRing, its brand name.
How Does the Vaginal Ring Work?
Like other methods of birth control, NuvaRing releases hormones. Hormones are chemicals made in our bodies. They control how different parts of our bodies work. The hormones in NuvaRing are the same hormones as in the birth control pill — estrogen and progestin
.
The hormones work by keeping a woman’s ovaries from releasing eggs — ovulation. Pregnancy cannot happen if there is no egg to join with sperm. The hormones in NuvaRing also prevent pregnancy by thickening a woman’s cervical mucus. The mucus blocks sperm and keeps it from joining with an egg. The hormones also thin the lining of the uterus. In theory, this could prevent pregnancy by keeping a fertilized egg from attaching to the uterus.
How Effective Is the Vaginal Ring?
Effectiveness is an important and common concern when choosing a birth control method. The vaginal ring is very effective. It works best when a woman inserts it, keeps it in place for three weeks, takes it out for one week, and then inserts a new ring. That keeps the correct level of hormone in a woman’s body.
- Less than 1 out of 100 women will get pregnant each year if they always use NuvaRing as directed. o About 8 out of 100 women will get pregnant each year if they don’t always use NuvaRing as directed.
Certain medicines and supplements may make NuvaRing less effective. These include:
- the antibiotic rifampin — other antibiotics do not make the ring less effective
- certain medicines that are taken by mouth for yeast infections
- certain HIV medicines
- certain anti-seizure medicines
- St. John's wort
Keep in mind the ring doesn’t protect against sexually transmitted infections. Use a latex or female condom to reduce the risk of infection.
How Safe Is the Vaginal Ring?
Most women can use NuvaRing safely. But all medications have some risks, so safety is a concern when choosing a birth control method. Serious side effects of the ring, though rare, may be more likely if you have certain conditions. Some of these conditions may even rule out using the ring. Talk with your health care provider to find out if the ring is likely to be safe for you.
You should not use the vaginal ring during prolonged bed rest or if you:
• are pregnant
• get migraine headaches with aura
• have certain inherited blood-clotting disorders
• have had blood clots or vein inflammation
• have had breast or liver cancer
• have had a heart attack, stroke, or angina
• have had serious heart valve problems
• have lupus with certain conditions
• have serious liver disease
• have uncontrolled high blood pressure
• have very bad diabetes
• have weak pelvic floor muscles
• smoke and are 35 or older
• smoke and have high blood pressure
If you have a condition that makes it unsafe to use the ring, don’t worry. There are many other methods of birth control that may be safe for you if you cannot use it. There are many other methods of birth control that may be safe for you if you cannot use the ring.
What Are the Benefits of the Vaginal Ring?
Using the vaginal ring is safe, simple, and convenient. There is nothing to do right before having sex. Some women say it improves their sex lives because it helps them feel more spontaneous.
Many women who use the vaginal ring have more regular, lighter, and shorter periods. And a woman’s ability to become pregnant returns quickly when use of the ring is stopped.Because the ring works like the pill, it probably offers the same benefits. These health benefits may include some protection against:
- acne
- bone thinning
- bad menstrual cramps
- breast growths that are not cancer
- cysts in the breasts and ovaries
- ectopic pregnancy
- endometrial and ovarian cancers
- heavy and/or irregular periods
- iron deficiency anemia
- pelvic inflammatory disease
The ring can be used to control when and how often you have your period. It can also be used continuously — without a monthly break — to eliminate monthly periods.
What Are the Disadvantages of the Vaginal Ring?
Because NuvaRing works like the pill, it probably carries the same possible disadvantages.
Possible Side Effects of the Vaginal Ring
Some women may have undesirable side effects while using NuvaRing. But many women adjust to it with few or no problems.
Some of the most common side effects usually clear up after two or three months. They include:
- bleeding between periods
- breast tenderness
- nausea and vomiting
NuvaRing may also cause more long-lasting side effects. It may cause increased vaginal discharge, vaginal irritation, or infection. The hormones in NuvaRing may change a woman’s sexual desire.
It’s important that you find a method that won’t make you feel sick or uncomfortable. If you continue to experience side effects after using the vaginal ring for three months, talk with your health care provider.
After ring use is stopped, it usually takes one or two months for a woman’s periods to return to the cycle she had before using it. Once in a while, a woman may have irregular or absent periods. This may go on for as long as six months after stopping. This is more likely if her periods were irregular before using the ring.
Regularly using oil-based medicines in the vagina for yeast infections while the ring is in place may increase the level of hormones released into the blood. This will not reduce the effectiveness of the ring. The effect of using these types of yeast infection medications with the vaginal ring long-term is unknown.
Serious Side Effects of the Vaginal Ring
Many women have concerns about the possible risks of taking hormones in birth control. Serious problems do not occur often.
Women who use birth control with estrogen — like NuvaRing —have a slightly greater chance of certain serious problems than nonusers. The most serious — in very rare cases — may be fatal. These include heart attack, stroke, or having a blood clot in the legs, lungs, heart, or brain.
Other rare risks include developing high blood pressure, liver tumors, gallstones, or yellowing of the skin or eyes (jaundice). The risk for these problems increases if you:
- are age 35 or older
- are very overweight
- have certain inherited blood-clotting disorders
- have diabetes
- have high blood pressure
- have high cholesterol
- need prolonged bed rest
- smoke
Serious problems usually have warning signs. Report any of these signs to us as soon as possible:
- a new lump in your breast
- a sudden very bad headache
- achy soreness in the leg o aura — seeing bright, flashing zigzag lines, usually before a very bad headache
- bad pain in your abdomen or chest
- headaches that are different, worse, or happen more often than usual
- no period after having regular monthly cycles
- trouble breathing
- yellowing of the skin or eyes
How Do I Start the Vaginal Ring?
To find out what day is best for you to start using the ring, talk with your health care provider. Most often, women start using the ring within the first five days after the start of their periods. That way, they are protected against pregnancy right away. That means that if your period starts on a Wednesday morning, you can insert the vaginal ring as late as the following Monday morning to be protected right away.
If you insert the vaginal ring later than five days after the start of your period, protection will begin after seven days. Use another method of birth control — like a condom or spermicide — if you have vaginal intercourse during the first week of ring use.
The ring can interfere with the placement of the diaphragm and sponge. They cannot be used as backup methods with the vaginal ring.
Starting the Vaginal Ring After Pregnancy
It’s possible to get pregnant again shortly after being pregnant. Starting birth control after pregnancy is an important concern for many women.You can start using the vaginal ring:
- right after an abortion
- right after a miscarriage
- after waiting at least three weeks after childbirth
- after waiting at least six weeks after childbirth if you are nursing
If breastfeeding:
You should wait to start using the ring if you are nursing because it may reduce the amount and quality of milk in the first six weeks of breastfeeding.
Also, the milk will contain traces of hormones. It is unlikely that these hormones will have any effect on your child. But talk with one o as to help you choose what birth control method might be right for you after giving birth.
How Do I Use the Vaginal Ring?
It is easy! Teenagers use the Nuvaring comfortably, why not you?
Insert one new ring into your vagina and keep it in place for three weeks in a row. Then remove it for one week: three weeks in, one week out. During the week it is out, you will get your next period.
Insert a new ring after one week.
- Store unused rings at room temperature, out of direct sunlight.
- Check the expiration date of each ring package before insertion.
- Wash your hands with soap and water.
- Use your fingers to press the sides of the ring together.
- Gently push the ring into your vagina.
- The exact position of the ring doesn’t matter.
- There’s no need to remove the ring during vaginal intercourse.
- Remove it in three weeks on the same day of the week that it was inserted.
- Hook your finger under the forward rim (under the pubic bone) and gently pull it out of the vagina.
- Wrap it up in the original wrapper, and throw it out in the trash — do not flush. Used rings still contain some hormones. Using the foil wrapper protects children and pets who might play with a used ring. It also reduces the chance that hormones will get into the soil and water supply.
- After one week without the ring, insert new one — on the same day of the week that the previous one was inserted in your last cycle.
During the one-week break, you will usually have your period. You may still be bleeding when it is time to insert a new ring. This is normal and fine, too. But the vaginal ring must be inserted on the same day of the week as it was inserted in the last cycle, or you could get pregnant.
Continuous Use
Some women use the ring every day without a one-week break to keep from getting their periods. They simply replace the ring every three weeks with a new ring. If you use the ring continuously, it is normal to have spotting or bleeding the first six months. It should be less of a problem over time. Some women stop having any bleeding at all. This is normal and will not harm your body.
Helpful Tips About Using the Vaginal Ring
- The ring will work best if you always remember to insert the ring and take it out at the right time.
- A missed period does not mean you are pregnant, if you have used the ring correctly. Even though the chance of pregnancy is very low, you should take a pregnancy test if you miss two periods in a row. There is a very slight chance that you will become pregnant even if you use the ring as directed. It is unlikely that using the ring during early pregnancy will increase the risk of birth defects.
- If you decide you want to become pregnant Stop using NuvaRing. It’s possible to get pregnant right after stopping. It usually takes about one or two months for your period to return to the cycle you had before using the ring.
- It’s pretty common for women to make a mistake at some time when using the vaginal ring.If you use the ring, the key to protecting yourself from an unplanned pregnancy is knowing what to do if you make a mistake or if the ring slips out of your vagina.
Pregnancy can happen if:
- the ring slips out of your vagina and is not replaced within three hours
- the ring does not stay in your vagina for three weeks in a row
- the ring is left in your vagina for more than three weeks
- you forget to insert a new ring more than a week after taking out the previous ring
General Tips:
- If the Ring Slips Out of Your Vagina: Wash the ring with lukewarm or cool water and put it back in as soon as possible. Use a backup method of birth control for seven days if the ring is out of your vagina for more than three hours.
- If you leave the ring in your vagina for longer than you should: Up to four weeks after insertion:
- Remove the ring.
- Take a ring-free week.
- Insert a new ring after the ring-free week.
More than four weeks after insertion:
- Remove the ring.
- You may have become pregnant if you had vaginal intercourse more than four weeks after you inserted the ring. You may want to take a pregnancy test.
- When you restart with a new ring, use backup birth control for seven days.
When Backup Birth Control Is Needed
- Use a backup method of birth control for seven days in a row
- if the ring stays out of your vagina for more than three hours
- if your ring-free time lasts for more than a week
- when you restart with a new ring after you left the ring in place for more than four weeks
- Do not use a diaphragm, cap, or sponge as a backup method. The ring could keep them from being placed properly in your vagina. Latex condoms or spermicide, used separately or together, are good choices for backup protection.
- You can also use emergency contraception(morning after pill) as backup. This is a great option if you had vaginal intercourse before you realized your ring was not in place or had been in place too long. Emergency contraception can prevent pregnancy if started up to five days after unprotected intercourse. The sooner you start it, the better it will work.
