A vaginal ring is a hormonal contraceptive method that is used as an alternative to birth control pills and transdermal patches. Like other hormonal contraceptive methods, the vaginal ring averts pregnancies through preventing ovulation through a combination of two hormones. The benefit of using a vaginal ring compared to birth control is that you don’t have to remember to take pills every day, but have the same high protection of over 99%.

What’s on this page?

How does a vaginal ring work?

The vaginal ring is a small plastic ring in a soft material that can be compressed and then inserted in the vagina. It is 54 mm in diameter and is available in one size only. It will fit all vaginas and does not need to be customized. The most common ring is the NuvaRing, that must be purchased through a valid prescription.

The ring contains sex hormones that are transmitted from the ring and straight into the mucous membrane where they are absorbed into the blood. The hormones are a replacement for the female hormone estrogen and work in the same way as contraceptive pills. This means that they affect the body in a way that prevents ovulation. At the same time, the uterus is thickened, which makes it harder for sperms to permeate the uterus. The combination of these multiple effects in the body gives a high protection from pregnancy.

How do I use it?

The ring is clamped and inserted in the vagina. The first time that you use it the rings needs to be inserted on your first day of menstruation, after which it gives immediate protection. You can also insert it later, but then the protection will be delayed by seven days.

When the ring is inserted, it should be stay put in three weeks. Remove it and take a break of seven days. During this period you will experience menstrual bleeding. This is corresponding to the same process of the birth control pills. After your seven day break, you can insert a new contraceptive ring in the vagina and let it sit there for another three weeks.

The ring shall not be removed during the three weeks. In case it falls out you can rinse it and reinsert it. It can be removed from the vagina up to three hours before it will affect your protection against pregnancy.

How efficient is the protection?

This form of contraception is on the same high level of protection as birth control pills and transdermal patches. The success rate is almost 100%. For the protection to be efficient the ring should be used according to instructions and inserted at the right moment.

If you follow the instructions the risk of getting pregnant is very small. It is important that you always keep your eyes open on the menstrual bleeding. If not, you should regularly check if you are pregnant or not. The same is true if the ring has fallen out and has been outside of the body for more than three hours.

Hormonal contraception is not protecting you from sexually transmitted diseases such as herpes or chlamydia. To protect yourself from these diseases you will need barrier protection such as a condom. Read more about those, here

3 questions regarding vaginal rings

When starting a new form of contraception many questions might arise. Here are three of the most common things that can trouble the mind and answers to those.

Can I have sex with a vaginal ring?

Yes, you can. The ring is not an obstruction, so you can have sex whilst having the ring in the vagina. When the ring is in the right position, you don’t have to think about it the three upcoming weeks.

Can the ring fall out?

It is rare that the ring falls out. It is designed to fit the anatomy of female genital parts. If it would fall out you can simply reinsert it as soon as possible. You should use barrier protection for seven days if you have been without the ring for more than three hours.

Can I have too many hormones in my body?

The hormones in the ring will be picked up by the brain so that it knows that there are enough hormones in the body. This means that the body itself stops the production of the relevant sex hormones. You will therefore not have an excess of hormones, but rather a slightly different composition of hormones that stops the ovulation and thus pregnancies. When you stop using the hormones your body will take up the production of the hormones as normal.

Vaginal ring and side effects

There are some side effects connected to use of hormonal contraceptives, even if most users don’t experience them. The most common ones are:

  • Nausea
  • Acne
  • Tender breasts
  • Migraine and headache
  • High blood pressure
  • Weight gain
  • Depression
  • Decreased libido

Just like birth control, the vaginal ring can give you a higher risk of blood clots. This is especially true for women older than 40 years that previously have suffered from embolism or if someone in your family has been affected by blood clots. Hormonal contraception is thus not suitable for women that already have a heightened risk of emboli. Symptoms following the initiation of the vaginal ring can be stronger during the first 6-12 months of the treatment. It is recommended that you wait at least 6 months before you decide to try another form of contraception.