Contraception - vaginal ring

What is a vaginal ring?

Vaginal rings are sold under the brand name NuvaRing® in Australia.

They are soft plastic rings that contain 2 hormones – oestrogen and progestogen. These are similar to hormones that are produced by the ovaries and used in ‘the ‘pill’ (combined pill).

Effectiveness of vaginal rings

If used correctly a vaginal ring is at least 99% effective at preventing pregnancy.

If you forget to put a new ring in, use it incorrectly or take certain medications, it might only be 93% effective.

How to use a vaginal ring

To use a vaginal ring, you squeeze the ring and insert it into your vagina (like inserting a tampon). It stays in your vagina for 3 weeks.

You then take it out and throw it away and wait 7 days before inserting a new ring.

You will usually have your period (bleeding from your vagina) a few days after removing the ring. You can skip your period by inserting a new ring straight away and missing the 7-day break.

Most people who use a vaginal ring cannot feel the ring once it is in their vagina.

What stops a vaginal ring from working

A vaginal ring may not work if:

• you insert a new ring more than 24 hours late
• you leave the ring out of your vagina for more than 24 hours, during the 3 weeks of use
• you are taking some medications or natural remedies (check with your doctor, nurse or pharmacist).

How a vaginal ring works

A vaginal ring works by stopping your ovaries from releasing an egg each month.

It also thickens the fluid around the cervix (opening to the uterus or womb). This helps to prevent the sperm from entering.

When you start using a vaginal ring for the first time, or after a break, it can take up to 7 days to start working.

Speak with a doctor, nurse or pharmacist about the best way to get started.

Where to get vaginal rings

Your doctor can provide a script for a vaginal ring which you can take to the pharmacy.

You can only get up to 4 vaginal rings at a time.

It is more expensive than some brands of the pill.

Benefits of vaginal rings

A vaginal ring:

• can be used to skip your period
• may make your periods lighter, more regular, and less painful
• may cause acne to improve
• may reduce your risk of getting cancer of the uterus (womb) and ovaries
• can help with symptoms of polycystic ovary syndrome (PCOS) and endometriosis.

Once you stop using a vaginal ring your fertility quickly returns to normal.

Side effects from using a vaginal ring

Possible side effects of using a vaginal ring for a small number of users can include:

• an increase in vaginal discharge (fluid from the vagina)
• irregular vaginal bleeding
• nausea
• sore or tender breasts
• headaches
• bloating
• changes to your skin
• mood changes.

These side effects often settle with time. The vaginal ring has not been shown to cause weight gain.

A small number of people find the vaginal ring uncomfortable. Partners are usually not bothered by the ring during sex.

Vaginal rings and serious health problems

The vaginal ring slightly increases your risk of a deep vein thrombosis (blood clot), heart attack or stroke.

It may also lead to a tiny increase in your risk of breast cancer. The risk of developing breast cancer due to vaginal ring or pill use in people aged under 35 years is 1 in 50,000.

When a vaginal ring is not a good option

A vaginal ring may not be a good option for you if you:

• have certain types of migraine headache (check with your doctor or nurse)
• have a high body mass index (BMI) or are obese
• have a close family member who has had a deep vein thrombosis
• are taking certain types of medication which might stop the ring from working (check with your doctor, nurse or pharmacist)
• have had some health problems such as high blood pressure, heart or liver problems (check with your doctor or nurse)
• are over 35 years and smoke
• have been treated for breast cancer
• are unable to move around for a long time (for example because of surgery or disability).

If you forget to insert a vaginal ring

If you forget to insert a vaginal ring:

• Insert a new ring as soon as you remember.
• Use condoms for the next 7 days after inserting the ring.
• If you have had sex without a condom in the 7 days before missing the ring, you may need emergency contraception, or you may need to skip your next 7-day break from the ring and insert a new ring straight away. What you need to do depends on how many days the ring has been in for (check with your doctor, nurse or pharmacist).

If you get pregnant while using a vaginal ring

A vaginal ring won’t harm a pregnancy.

It is safe to continue the pregnancy (and stop using the vaginal ring) or to have an abortion.

Using a vaginal ring after having a baby

If you are breastfeeding, do not use a vaginal ring until your baby is 6 weeks old as it may reduce your supply of breast milk and may increase your risk of thrombosis.

After 6 weeks you can use a vaginal ring, but other types of contraception might be better choices.

If you are not breastfeeding, you can usually start using a vaginal ring once your baby is 3 to 6 weeks old (check with your doctor, nurse or pharmacist).

Vaginal rings and pregnancy

You can stop using a vaginal ring at any time and your fertility will quickly return.

Further information about vaginal rings

Vaginal rings:

• do not protect you from sexually transmitted infections (STIs). The best way to lessen the risk of STIs is to use barrier protection such as condoms with all new sexual partners
• are safe to use with condoms
• do not need to be taken out for sex.

Write down the date or enter a reminder into your phone for when your ring is due to be removed and the next one inserted.

The vaginal ring is one of many types of contraception. Read more about other types of contraception.

Where to get help

• Your GP (doctor)
• Pharmacist
• 1800 My Options Tel. 1800 696 784 – for information about contraception, pregnancy options and sexual health in Victoria
• Many community health services and some public hospitals will have a family planning clinic, a sexual health clinic or a women’s health clinic providing contraception
• Private clinics offering abortion also offer contraceptive services
• Sexual Health Victoria (SHV) – book an appointment online or call Melbourne CBD Clinic: Tel. (03) 9660 4700, Box Hill Clinic: Tel. (03) 9257 0100 or (free call): Tel. 1800 013 952. These services are youth friendly