Vaginal Contraceptive Ring

Vaginal Contraceptive Ring (NuvaRing)

What is it?

The vaginal contraceptive ring is a flexible, latex free ring that is inserted by a woman into her vagina. The ring releases a continuous low dosage of the synthetic hormones estrogen and progestin over a three week period. A new ring is inserted every month. You will need a prescription from a health care provider to get the ring. 

Annovera is the brand name of a vaginal contraceptive ring that is reusable and lasts for a year. It is softer and thicker than the monthly ring.

How does it work?

The ring prevents ovulation. The ring may also thicken the cervical mucus and thin the lining of the uterus. The ring is inserted by the user and remains in the vagina for 3 weeks. The ring is then removed for one week during which bleeding will occur. A new ring is used each month.

How effective is the ring?

The ring is as effective as oral contraceptives. When used perfectly, it is 99.7% effective. But people are not perfect, so for most users it is about 92% effective. 

How do I get started?

Your health care provider will help you decide the best time to start the ring based on your menstrual cycle and your previous birth control method. You may need to use condoms for 7 days after starting the ring.

The ring is gently pushed inside the vagina with your finger much like inserting a tampon. If you feel discomfort, try pushing it deeper into your vagina. Most women don’t feel the ring once it is in place. The ring does not have to be in a specific place in the vagina for it to be effective. Once in place, keep the ring in for 3 weeks. You don’t have to remove the ring when you have sex.

What are the advantages unique to the ring?

  • The woman does not have to take a pill every day.
  • It is monthly rather than daily routine.
  • It can have fewer side effects than oral contraceptives.

What are the disadvantages unique to the ring?

  • Possible vaginal discharge and irritation
  • Some women dislike placing and removing the ring
  • It does not protect you from sexually transmitted infections

What are the side effects of the ring?

The most common side effects reported by ring users are:

  • vaginal infections and irritation
  • vaginal discharge
  • headache
  • nausea
  • changes in your period

If you have side effects that cause you discomfort after 2-3 months, ask your provider about a different birth control method.

What are possible complications?

Use of ring may cause elevated blood pressure, migraines, gall bladder problems, and very rarely a benign liver tumor.

Hormones increase the risk of blood clots in veins and arteries. The risk of a blood clot is extremely small in young, healthy women. The highest risk is seen in older women who smoke. However, pregnancy causes an even greater risk of blood clots than does using a hormonal birth control method. Clots in the veins can cause thrombophlebitis (mostly in the leg) and pulmonary embolism (a blood clot that travels to the lungs.) Clots in arteries cause heart attacks or strokes. Know the warning signs of these problems (see below) and get medical evaluation immediately.

We advise women to quit smoking if they want to use the ring.

Call your physician/clinician if you have:

A—Abdominal pain (severe) that cannot be explained
C—Chest pain (severe or sudden) or shortness of breath
H—Unusual or suddenly severe headaches with dizziness or vomiting
E—Eye problems (blurred vision, flashing lights or blindness)
S—Severe leg pain, one-sided weakness or numb-ness (calf or thigh)