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The vaginal ring is a contraceptive method used to prevent pregnancy. It contains the hormones oestrogen and progestogen.
The ﬂexible, latex-free ring is self-inserted into the vagina.
The vaginal ring releases a steady ﬂow of hormones, which are absorbed through the walls of the vagina.
The ring works by:
- Preventing the body from releasing an egg every month (ovulation).
- Thickening mucus in the cervix to prevent sperm from getting into the uterus.
The vaginal ring is about 93% effective. Effectiveness can increase to 99.5% with correct and consistent use.
*Typical use reﬂects how effective methods are for the average person who may not always use methods correctly/consistently.
The vaginal ring is suitable for most people, but there may be health risks for some.
The vaginal ring may be unsuitable for people who:
- are uncomfortable with self-insertion/removal.
- are breastfeeding – discuss with your health professional.
- have cardiovascular risk factors (smokers over 35, obesity, high blood pressure or deep vein thrombosis).
- have had a stroke or a heart attack. have had active liver or gall bladder disease.
- have unexplained vaginal bleeding.
- have certain types of migraines with visual disturbances.
- have breast or uterine cancer.
If the vaginal ring is inserted within the ﬁrst ﬁve days of a menstrual period, pregnancy protection begins straight away. If it’s inserted at any other time, it takes seven days to work.
When the ring is inserted, it remains in place for three weeks. At the start of the fourth week, it is removed and bleeding occurs. A new ring should be inserted after seven days to maintain its contraceptive effect.
If you don’t want to have a bleed, leave the ring in for three weeks, then replace it with a new ring straight away.
To insert the vaginal ring:
- Squeeze it between your thumb and index finger.
- Gently insert it into your vagina (similar to inserting a tampon).
The ring sits high against the back wall of the vagina and if it is inserted correctly, most people will not be able to feel it. If you feel any discomfort, slide the ring further into your vagina. Your vaginal muscles will keep the ring securely in place, even during exercise and sex.
To remove the vaginal ring, simply put your ﬁnger into your vagina and pull it out.
The exact position is not important for the vaginal ring to work.
You may wish to set up a dependable reminder system around when to insert a new ring i.e. on your phone or calendar.
If you are more than 24 hours late inserting a new ring at the start of a new cycle (i.e more than seven days since your ring was last removed) or have left your ring in place continuously for more than four weeks; insert a new vaginal ring as soon as you remember and use another form of contraception for the next seven days (e.g. condoms).
- Bleeding is regular, generally lighter and less painful.
- You can choose to skip bleeds.
- Can improve acne.
- Less likely than the combined oral contraceptive pill to cause side effects such as nausea.
- Not affected by diarrhoea and vomiting.
- Suitable for those with conditions such as inﬂammatory bowel disease.
- You must remember to insert a new ring every month.
- May increase the risk of deep vein thrombosis.
- Does not protect against sexually transmissible infections (STIs).
- Some medications (i.e. prescribed, over the counter or herbal) react with the hormones in the vaginal ring, so let your health professional know what medication you are taking.
- Vaginal rings should be used within four months of purchase.
- The vaginal ring can be taken out (e.g. during sex) but must be reinserted within three hours. If you have removed your ring for longer than three hours, reinsert it as soon as you remember and use another form of contraception for the next seven days.
FSRH Clinical Guidance: Barrier Methods for Contraception and STI Prevention. London: The Faculty of Sexual & Reproductive Healthcare; 2015. Available from: fsrh.org/standards-and-guidance/documents/ceuguidancebarriermethodscontraceptionsdi/
Information last updated February 2021
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