The choices Contraceptive ring

Contraceptive ring

What is it?

The ring is a flexible transparent plastic ring that contains low dose estrogen and a progestogen. It sits in the vagina and is self-inserted once-monthly. It should be inserted on the first day of your period and left in place for three consecutive weeks. After a one week, ring-free interval, during which a withdrawal bleed occurs, a new ring is inserted. Exact positioning is not critical for it to work.

How does it work?

The release of the hormones in the ring is activated when the ring comes into contact with the vagina. The walls of the vagina then absorb the hormones and distribute them into the bloodstream in the same way as the combined pill. The ring works by:

• Stopping your ovaries releasing mature eggs
• Thickening the mucus of the cervix to act as a barrier to sperm
• Stopping the egg settling by keeping the lining of the womb thin

How effective is it?

The ring is 99% effective when used correctly, just like ‘the Pill'.

What are the benefits?

• You do not have to remember to take a pill every day
• You are protected against pregnancy for up to a month
• Does not interrupt sex
• Hormones do not have to go through the stomach so protection is not affected by sickness or diarrhoea
• For those who wish to become pregnant, the method is easily reversible
• Good cycle control with regular cycles

Who may not be able to / may not want to use it?

Women who:

• Are over 35 years old and stopped smoking less than a year ago
• Are overweight (BMI of 30 kg/m or over)
• Have or have had blood clots in a vein or artery
• Have had circulatory disease, or a heart abnormality or high blood pressure
• Suffer from migraines with aura
  
• Have diabetes complications or have had diabetes for over 20 years
• Have breast cancer or have had it within the last five years
• Have active liver or gall bladder disease
• Take certain medicines that interfere with the effectiveness of the contraceptive ring
• Have vaginal prolapse that can't hold a vaginal ring
• Have current cervical, ovarian, vaginal or uterine cancer
• Might be pregnant
• Have unexplained vaginal bleeding

Possible side-effects?

Not all women will experience side-effects

• Breakthrough bleeding
• Potential increase in the chance of breast tenderness, headaches, nausea and mood changes
• Temporary increase in vaginal discharge or infections
• May increase blood pressure
• Very small increased risk of blood clots
• A small increase in risk of being diagnosed with breast cancer / cervical cancer

What if:

I forget to put it back in / it falls out?

• If the ring is out for less than three hours it will still protect you from pregnancy. You can rinse the ring with cold to lukewarm water (do not use hot water) and put it back in
• If the ring has been out of the vagina for more than three hours during the first and second week, it may not protect you from pregnancy. Put the ring back in the vagina as soon as you remember, and leave the ring in place without interruption for at least seven days (also using a condom if you have sex). If you are in your first week and you had sex contact your doctor or nurse as there is a possibility you may become pregnant
• If the ring has been out of the vagina for more than three hours in the third week it may not protect you from pregnancy. Discard the ring and either insert a new one (starting a new three week cycle) or have your period and restart the cycle no later than seven days from when the previous ring fell out/was removed. Only choose this option if you have used the ring continuously during the previous seven days

I want to become pregnant?

If you decide to try for a baby, it is best to take the ring out at the end of a cycle (three weeks). Ideally you should wait for one period before trying to get pregnant. Waiting means the pregnancy can be dated more accurately and you can start pre-pregnancy care, such as taking folic acid and stopping smoking.

This method does not protect you against sexually transmitted infections, so you may need to use a condom as well.

Remember: Contact your doctor or nurse if you have any concerns or are worried/unsure about anything to do with your contraception.