Combined vaginal ring
The combined contraceptive vaginal ring is a small soft ring that contains two hormones, progestogen and oestrogen, similar to the natural hormones in a woman’s body.
The two hormones primarily prevent an egg from being released each month. They also make it difficult for sperm to get to an egg and thin the womb lining to make it difficult for a fertilized egg to implant there.
The ring is kept in the vagina continuously night and day for three weeks and then taken out for a week. During this week, you will have your monthly bleeding. A new ring should be started immediately after a week. Delaying use / insertion can make the ring less effective.
You must insert the vaginal ring in the vagina on the first day of your menstrual period/ cycle. If this is delayed, you will need to use a back-up method e.g. a condom for the first 7 days if you have sex, before the ring starts working to prevent a pregnancy.
Note: Condoms are the only contraceptive methods which protect against sexually transmitted infections. To ensure protection from both pregnancy and infection, we recommend "dual protection". This means using a a male or female condom in addition to the contraceptive method of your choice to prevent pregnancy.
How good is the vaginal ring at preventing a pregnancy?
The vaginal ring works very well at preventing a pregnancy. If one hundred women use a vaginal ring for a year and carry on with their normal sex life then less than one of these 100 women would fall pregnant during the year.
The ability to stop a pregnancy largely depends on using it properly i.e. starting it at the right time without delay.
What are the advantages of the vaginal ring?
- It is easy to put in and remove
- It makes your periods lighter, more regular and less painful over time
- One ring provides contraception for a month, so you don’t have to think about protection every time you have sex.
- It is not required to be used just before sex so will not affect the spontaneity of sex.
- It doesn’t interrupt sex, because you can have sex with the ring in place.
- Your previous fertility will return immediately after you stop using the ring.
- Unlike contraceptive pills, the ring remains effective even if you have vomiting or diarrhoea.
- It helps protect against some forms of cancer (ovary, uterus and colon).
- It reduces the risk of getting fibroids, ovarian cysts and non-cancerous breast disease
- You can start it straight after an abortion without needing to use additional protection.
What are the disadvantages of the vaginal ring?
- It may not be suitable if you don’t feel comfortable inserting or removing it from your vagina.
- Spotting and irregular bleeding while the ring is in your vagina can occur in the first few months.
- The ring has to be left inside the vagina continuously for most of the month. Taking it out and forgetting to put it back within 3 hours (for sex or cleaning) could make it fail.
- Not everyone is suitable for the vaginal ring. It should not be used if you are breastfeeding a baby less than 6 months old, have high blood pressure or complicated diabetes, or if you are a smoker over the age of 35. Please talk to your medical provider about conditions that may make you ineligible for the ring.
- Unlike condoms, the vaginal ring does not protect from sexually transmitted infections. You must use both to protect yourself against STIs
- The most common side effects are disturbances in monthly bleeding in the first few months. You can also have headaches, breast tenderness, nausea, mood changes , vaginal irritation and vaginal discharge
- Use of some medications, such as those for seizures, some HIV medicines or those for tuberculosis, can stop the ring from working. Check with your medical provider if your medications are compatible with use of the ring
- A few women can develop a blood clot (thrombosis), heart attack or stroke when using the ring, but this is rare.
- The ring 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 will need additional protection if the ring has been out for more than 3 hours.