About the Birth Control Ring

What Is the Birth Control Ring?

The birth control ring is a soft, flexible ring. Hormones in the ring help prevent pregnancy. It is inserted into the vagina, where it slowly releases the hormones through the vaginal wall into the bloodstream.

How Does the Birth Control Ring Work?

The combination of the hormones progestin and estrogen in the birth control ring prevent ovulation (the release of an egg from the ovaries during a woman's monthly cycle). If an egg isn't released, a woman can't get pregnant because there's no egg for a male's sperm to fertilize.

The hormones in the ring also thicken the cervical mucus (made by cells in the cervix). This makes it hard 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 patch, a woman 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, where it remains in place for 3 weeks in a row.

At the end of the third week, on the same day of the week it was inserted and about the same time of day, she removes it. Within a few days her menstrual period should start. At the end of the fourth week, on the same day of the week the last ring was inserted, she inserts a new ring and the process begins again. The new ring should be placed on that day, even if a girl still has her period.

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 can be used 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. If it doesn't feel comfortable, it can be pushed further back or removed and reinserted. Most women do not feel the ring after it is in place.

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 risk of pregnancy and an additional form of birth control should be used until the ring has been in place for 7 days.

If the ring is out for more than 3 hours during a woman's third week wearing it, she should call the doctor for advice. The doctor may say to put a new ring in, or not to replace it, so that the period starts early. Either way, an additional form of birth control should be used.

How Well Does the Birth Control Ring Work?

The effectiveness of the vaginal birth control ring seems to be similar to other hormonal methods of birth control, like the patch or the Pill. Over the course of a year, about 9 out of 100 typical couples who use the ring to prevent pregnancy will have an accidental pregnancy. Of course, a woman must use 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 many things. These include whether a woman has any health conditions or is taking any medicine that might affect its use.

Although using the ring means not having to remember to take a pill every day or replace a patch, it still needs to be removed and replaced on time. Otherwise, it loses its effectiveness.

Does the Birth Control Ring Help Prevent STDs?

No. The vaginal ring does not protect against STDs. Couples having sex must always use condoms along with the vaginal ring to protect against STDs.

Are There Any Problems With the Birth Control Ring?

The vaginal ring is a safe and effective method of birth control. Most young women who use the ring have no side effects.

If side effects do happen, they're similar to those of the birth control pill. These may include:

• irregular menstrual bleeding
• nausea, headaches, dizziness, and breast tenderness
• mood changes

Other possible side effects nclude:

• vaginal irritation or infections
• vaginal discharge
• problems with contact lens use, such as a change in vision or inability to wear the lenses

Many of these side effects are mild and tend to disappear after 2 or 3 months.

The birth control ring increases the risk of blood clots. Blood clots can lead to serious problems with the lungs, heart, and brain. Smoking cigarettes while using the birth control ring can increase a girl's risk of blood clots. So young women who use this type of birth control should not smoke.

Who Is the Birth Control Ring Right for?

The vaginal ring may be a good choice for young women who have trouble remembering to take a pill every day or who have trouble swallowing pills. They must feel comfortable inserting the device into the vagina.

Not all women can — or should — use the vaginal ring. Some medical conditions can make using the ring less effective or more risky (for example, severe high blood pressure and some types of cancer). Those who have had unexplained vaginal bleeding (bleeding that is not during their periods) or who might be pregnant should talk to their doctors, stop using the ring, and use another form of birth control in the meantime.

Where Is the Birth Control Ring Available?

A doctor or a nurse practitioner must prescribe the birth control ring, and will probably ask questions about a girl's health and family medical history . He or she may also do a complete physical exam, including a blood pressure measurement and a pelvic exam. If the ring is prescribed, the doctor will also provide instructions on how to use it.

A young woman may have to go back to the doctor a few months after using the ring to get her blood pressure measured and to make sure that there are no problems. After that, a doctor may recommend routine exams once or twice a year or as needed.

How Much Does the Birth Control Ring Cost?

The ring usually costs between $30–$200 a month, although health and family planning clinics (such as Planned Parenthood) might sell them for less. Also, the vaginal ring and doctor's visits are covered by many health insurance plans.

When Should I Call the Doctor?

Someone using the birth control ring should call the doctor if she:

• might be pregnant
• has a change in the smell or color of her vaginal discharge
• has unexplained fever or chills
• has belly or pelvic pain
• has pain during sex
• has heavy or long-lasting vaginal bleeding
• has yellowing of the skin or eyes
• has severe headaches
• has signs of a blood clot, such as lower leg pain, chest pain, trouble breathing, weakness, tingling, trouble speaking, or vision problems