Contraceptive Ring

What is a contraceptive ring?

The contraceptive ring is a round, plastic, flexible pessary device which releases two hormones over a monthly period. The vaginal ring can provide safe and effective contraception without needing to take tablets every day.

About the ring

The contraceptive ring contains two hormones, an oestrogen and a progestogen, which are similar to the naturally produced hormones by the ovaries. The circular ring is flexible, making it easy to insert and remain comfortable during use. The ring can be easily moved to a comfortable position. It can be felt whilst having sexual intercourse, but most people do not consider it to be uncomfortable or unpleasant. It is highly unlikely to harm you or your partner.

The ring provides over 99% contraceptive effectiveness when used correctly.

How does it work?

Similarly to the combined oral contraceptive pill, it releases oestrogen and progestogen to the bloodstream through the vaginal wall. It can provide contraception through three mechanisms:

• Thickens the mucus in the cervix, making it difficult for sperm to pass to the womb
• Reduces the thickness of the uterus lining, stopping any eggs from embedding into this lining
• Preventing ovulation from occurring

Advantages of the contraceptive ring

There are certain benefits the contraceptive ring has over traditional hormonal contraceptive pills. A few advantages are detailed below. If you have further queries or require assistance, please don't hesitate to contact the Doctor or the Sexual Health clinics for expert advice.

• Insertion and removal are easy
• Inserted once a month
• Lower chances of side effects
• Can reduce acne breakouts
• Periods are lighter, more regular and less painful
• Can reduce pre-menstrual symptoms

Disadvantages of the contraceptive ring

There are also certain disadvantages to using the ring.

• Insertion and removal can be uncomfortable.
• Breakthrough bleeding can occur during use.
• Increased risk of blood clots.
• Does not prevent Sexually Transmitted Diseases - use a condom to prevent this.

Risks associated with using the contraceptive ring

There are certain conditions which carry increased health risks while using hormonal contraceptives, such as the contraceptive ring.

Your risk of blood clotting is increased, especially if you have a predisposing condition or engage in certain lifestyle activities.

• Have or had heart conditions (e.g. Angina)
• Have had blood clots (thromboembolism) of any kind before
• Have Hypertension or Diabetes
• Are over the age of 35 and a smoker
• Obesity

The risk of blood clots is higher for the first year of using the ring, and it is important to understand what to look out for to ensure you remain safe while using the contraceptive ring.

• Unexplained swelling and pain in the chest or legs, or constant pins and needles type sensation and pain in the arms or legs
• Difficulty breathing or sudden loss of breath
• Severe Migraines or headaches
• Unexplained Eyesight problems
• Jaundice (yellowing of the skin)

The FPA (sexual health charity) and the NHS have also stated that research shows a slight increase in the risk of:

• Cervical Cancer - unexplained stomach and hip pain should be reported to the Doctor
• Breast Cancer - Unexplained lumps, severe pain or changes in the nipple should be reported to the Doctor

Frequently Asked Questions

How do I know if the contraceptive ring is in place?

There is no specific position; it should be inserted until it is comfortable for you. If there is discomfort, adjust the position until it becomes comfortable. Most women do not feel the ring. The muscles of the vagina will keep it in place and prevent it from moving around or falling out. If you cannot feel the ring or it constantly falls out, contact your doctor or a health clinic for further advice.

What do I do if the Ring is expelled?

If the ring is expelled for less than 3 hours, rinse with cool water and reinsert immediately.

If it is expelled for longer than 3 hours, or if you are unsure of its duration, your protection may be reduced. Reinsert the ring (if in week one or two) and use additional contraceptive methods for seven days. If it is week three of the cycle, then insert a new ring or delay for 7 days to allow the withdrawal bleed, then insert a new ring.

What do I do if the ring has broken?

If you find that the ring has broken, you do not need to worry. It will not harm you; however, you should safely remove the ring, insert a new ring and carry on with your current cycle as normal.

The 7-day pill-free interval ended, but I forgot to insert a new ring immediately.

If the insertion is delayed after the 7-day interval by more than 24 hours, you may not be protected against infection. Insert the new ring immediately and ensure you use additional methods of contraception, such as condoms, for seven days.

What if I forgot to remove the ring on the 21st day of my cycle?

If you forget to remove the ring on a normal day, you will still be protected. The 7-day ring-free break should be observed, and a new ring should be inserted.

I experience bleeding whilst the ring is inserted?

This is known as breakthrough bleeding and is a common occurrence, especially within the first few months of use. It is usually transient and diminishes with prolonged use of the ring. You can use a tampon or pad, which will not affect the effectiveness of the ring.

I didn't experience my period during the pill-free interval.

This is highly unusual if you have used the ring correctly, and it is essential to rule out pregnancy. Take a pregnancy test; if you are not pregnant, then continue with your regular regimen. If you are pregnant, please contact your doctor or the health clinic for further advice. Our Doctors are available to provide expert one-to-one consultation if you require information or assistance.

I've just had a baby. Can I use the Ring?

You can safely use the ring 21 days after childbirth. You will be immediately protected. If you insert the ring 23 or more days after childbirth, you will not be immediately protected, and so it is advised to use additional methods for seven days

I have had a miscarriage/abortion. Can I use the ring?

You can use the ring safely immediately if needed, and you will be fully protected.

How can I buy a contraceptive ring?

Our doctors can prescribe a contraceptive ring called NuvaRing. Further information is given under the heading above. Our doctors will determine your suitability for this ring by reviewing your medical form. It is advised to fill in the form as accurately as possible and inform our doctor of your current medical circumstances to ensure the ring is safe for you to use.