What Is It?
The birth control ring is a soft, flexible, doughnut-shaped ring
about 2 inches (5 centimeters) in diameter. It is inserted into the
vagina, where it slowly releases hormones - the chemicals the
body makes to control organ function - through the vaginal wall
into the bloodstream. The hormones in the ring control the ovaries
and the uterus.
How Does It Work?
The combination of the hormones progesterone and estrogen in the
birth control ring prevent ovulation (the release of an egg from
the ovaries during a girl's monthly cycle). If an egg isn't
released, a girl can't get pregnant because there's no egg
for a guy's sperm to fertilize.
The hormones in the ring also thicken the cervical mucus, making
it difficult for sperm to enter the uterus and reach any eggs that
may have been released. The hormones in the ring can also sometimes
affect the lining of the uterus so that an egg will have a hard
time attaching to the wall of the uterus.
Like the birth control pill or the patch, a girl uses the birth
control ring based on her monthly menstrual cycle. She inserts it
into the vagina (similar to the insertion of a tampon) on the first
day of her menstrual cycle or before day 5 of her menstrual
cycle. It remains in place for 3 weeks in a row. At the end of the
third week, she removes it and her menstrual period should start.
At the end of the fourth week, she inserts a new ring and the
process begins again.
Because the hormones in the ring don't take effect
immediately, another form of birth control (such as a condom)
should be used for 7 days when a girl first starts using the ring.
After 7 days, the ring should work alone to prevent pregnancy. But
continuing to use
condoms
will protect against
sexually transmitted diseases (STDs)
.
The exact position of the ring in the vagina is not critical as
long as it feels comfortable. This is because the ring does not
work as a barrier method of birth control. If it doesn't feel
comfortable, a girl can push it further back or remove and reinsert
it. Most girls do not feel the ring once it is in place. It can be
left in place during swimming, bathing, and exercise. It can also
remain in place during intercourse.
The ring is held in place by the vaginal muscles, so it's
unlikely that it will fall out. If it does, it can be rinsed under
cool water (not hot!) and reinserted within 3 hours. If more than 3
hours pass without the ring in the vagina, there's a chance a
girl can become pregnant and she'll need to use an additional
form of birth control until the ring has been in place for 7
days.
How Well Does It Work?
The effectiveness of the vaginal ring is still being studied. So
far, results are similar to other hormonal methods of birth
control, like the patch or the Pill. Results show that over the
course of 1 year, 5 to 8 out of 100 typical couples who rely on the
ring to prevent pregnancy will have an accidental pregnancy. Of
course, the chance of getting pregnant depends on whether a girl
uses the ring correctly. Delaying or missing a monthly insertion or
removing a ring too early reduces its effectiveness.
In general, how well each type of birth control method works
depends on a lot of things. These include whether a person has any
health conditions or is taking any medications that might interfere
with its use. It's important for a doctor to be aware of all
medications and herbal supplements that a girl might be taking.
Although using the ring means a girl does not have to remember to
take a pill every day or replace a patch, it still needs to be
removed after 3 weeks and then replaced a week later. If it is not
replaced on time, the ring loses its effectiveness.
Protection Against STDs
The vaginal ring does not protect against STDs. Couples
having sex must always use condoms along with the vaginal ring
to protect against STDs.
Abstinence (not having sex) is the only method that always
prevents pregnancy and STDs.
Possible Side Effects
The vaginal ring is a safe and effective method of birth
control. Most young women who use the ring have no side effects.
Smoking cigarettes and using the ring can increase a girl's
risk of certain side effects, which is why health professionals
advise girls who use the ring not to smoke.
The side effects that some women have while using the ring are
similar to those experienced with the birth control pill. These may
include:
- irregular menstrual bleeding
- nausea, weight gain, headaches, dizziness, and breast
tenderness
- mood changes
- blood clots (rare in women under 35 who do not smoke)
Other possible side effects seen in ring users include:
- vaginal irritation or infections (mainly yeast
infections)
- vaginal discharge
- problems with contact lens use, such as a change in vision or
inability to wear the lenses
These side effects are usually mild and tend to disappear after
2 or 3 months.
Who Uses It?
The vaginal ring may be a good choice for young women who find
it difficult to remember to take a pill every day or who have
difficulty swallowing pills. They must feel comfortable enough with
their bodies to be able to insert a device into the vagina.
Not all women can - or should - use the vaginal ring. In some
cases, medical or other conditions make the use of the ring less
effective or more risky. For example, it is not recommended for
women who have had blood clots, severe high blood pressure, certain
types of cancers, certain types of migraine headaches, or diabetes
with certain complications.
Girls who have had unexplained vaginal bleeding (bleeding that
is not during their periods) or who suspect they may be pregnant
should talk to their doctors, stop using the ring, and use another
form of birth control in the meantime.
Girls who are interested in learning more about the possible
health benefits and risks of different types of birth control,
including the ring, should talk to a doctor or other health
professional.
How Do You Get It?
A doctor or a nurse practitioner must prescribe the ring. He or
she will ask questions about health and family medical history,
then do a complete physical exam, including a blood pressure
measurement and a pelvic exam. If recommending the ring, the doctor
or nurse practitioner will write a prescription and provide
instructions on how to use it. Those who start using the ring may
be asked to return within several months for a blood pressure
measurement and to ensure that there are no problems. After that, a
doctor may recommend routine exams once or twice a year or as
needed.
How Much Does It Cost?
The ring usually costs between $30 and $45 a month, although
health and family planning clinics (such as Planned Parenthood)
might sell them for less. In addition, the vaginal ring and
doctor's visits are covered by many health insurance plans.
Reviewed by:
Larissa Hirsch, MD
Date reviewed: February 2007
Originally reviewed by:
James J. Fitzgibbon, MD
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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