Contraceptive Vaginal Ring

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What is the vaginal ring?

It is a soft plastic ring that you place into the vagina once a month. It is left in place for 3 weeks and taken out for a week. Once inserted the ring slowly releases two artificial hormones (oestrogen and progestogen) which prevent pregnancy. The hormones are the same as those used in the Pill, but at a lower dose.

There is one brand currently available in Australia, called NuvaRing.

The ring works by:

  • stopping the release of an egg by the ovary (ovulation)
  • making the mucus (sticky fluid) at the opening of the uterus thicker so sperm can’t get through
  • changing the lining of the uterus so a fertilised egg can’t take hold

The ring is a very effective method of contraception if used correctly (99%).

  • Periods become more regular, shorter, lighter and less painful.
  • The timing of bleeding can be controlled.
  • It usually improves acne.
  • The ring contains a lower dose of hormones than the Pill and so side effects can be reduced.
  • The hormones are absorbed directly into the bloodstream. They don’t go through the stomach and so are not affected by vomiting or diarrhoea.
  • You don’t have to remember to take a pill every day.

As the ring contains the same hormones as the Pill it should also reduce the chance of cancer of the uterus and ovaries, benign breast disease, endometriosis and ovarian cysts.

The ring has few side effects because of the low dose of hormones. However, some women experience:

  • increased vaginal discharge
  • headaches (more than normal)
  • irregular bleeding
  • an increase in appetite (which may lead to weight gain)
  • occasionally sore breasts, mood changes or nausea

Some of these side effects will settle within the first months of using the ring. If they persist discuss them with your doctor.

The ring is safe for most women. In particular, the risks of using the ring are less than the risks of being pregnant.

The ring is not suitable for women who:

  • have had a stroke, heart attack, blood clot or high blood pressure
  • have some types of migraine, diabetes or liver disease
  • are over 35 years and smoke

It may not be suitable for women who are breastfeeding or have chronic constipation or vaginal prolapse.

Thrombosis is an extremely rare but serious complication.

Stop using the ring immediately and seek urgent medical attention if you have:

  • severe and unexplained chest pain or headache
  • sudden blurred vision or loss of sight
  • severe calf pain or swelling in one leg

You need a prescription from your doctor or SHine SA clinic. You then get the ring from a pharmacy. There is no government subsidy or Health Care card concession for the ring.

  • To insert the ring squeeze it between your thumb and index finger, and then gently insert it into your vagina. Remember, the exact position is not important for the ring to work. If you feel discomfort simply slide it further into your vagina. Your vaginal muscles will keep the ring securely in place, even during sex and exercise. Anyone who is able to insert a tampon should be able to insert the ring.
  • To remove the ring simply put your finger into your vagina, hook it inside the rim of the ring and pull it out.
  • Insert your first ring anytime within the first 5 days of your period starting, so that pregnancy protection is immediate. If you insert it more than 5 days after your period started, you will need to use other forms of contraception for 7 days.
  • After insertion, the ring is left in place for 3 weeks, then removed and a new ring inserted a week later. A bleed should occur in the week when there is no ring. It is important to put in a new ring no more than 7 days after removal of the previous one, even if you have not stopped bleeding.
  • Though it is not necessary, the ring can be removed for sex if desired. It must be reinserted within 3 hours of removal to maintain the contraceptive effect.
  • It is important to store and use the ring according to the manufacturer’s instructions. It needs to be kept cool and only lasts for 4 months after you get it from the pharmacy.

The ring is not effective if:

  • you have forgotten to insert a ring for the next cycle (more than 7 days since your last ring was removed)
  • your ring has been removed from the vagina for more than 3 hours
  • your ring has been left in place continuously for more than 4 weeks

If this happens use condoms and consult your doctor or SHine SA clinic as soon as possible. You may need emergency contraception.

Some medications interfere with the ring. Always check with your doctor, SHine SA clinic or Sexual Healthline.The ring does not protect against sexually transmitted infections (STIs).

 

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