Vaginal ring

NuvaRing.

A flexible, plastic ring placed inside the vagina that releases 2 hormones (oestrogen and progestogen).

The NuvaRing is the only type of vaginal ring available in Australia.

Some of the more common uses of the vaginal ring include:

• preventing pregnancy
• skipping periods
• regulating periods
• reducing period pain
• reducing heavy period bleeding
• reducing excessive hair growth
• improving acne

The vaginal ring works by:

• stopping ovulation (eggs being released from the ovaries)
• thickening cervical mucus so sperm can’t get through to the fallopian tubes (where eggs are fertilised)
• thinning the lining of the uterus so if an egg is fertilised, it is less likely to implant to start a pregnancy

The vaginal ring can start working quickly to prevent pregnancy, but the timing depends on when you start using it in your menstrual cycle.

If you first use the vaginal ring within the first 5 days of your period starting, you are protected straight away.

If you first use the vaginal ring more than 5 days after your last period started, it will take 7 days before you are protected. Use backup contraception (e.g. condoms) or avoid having sex for those first 7 days to prevent pregnancy.

Typical use: 93% effective.

Perfect use: 99.7% effective.

There are two options for using the vaginal ring:

• Keep the vaginal ring in your vagina for 3 weeks.
• After 3 weeks, take the ring out and dispose of it. Leave it out for 1 week (7 days). During this week you will have a bleed like a period.
• Put in a new ring exactly 7 days later. Remember what time it was taken out, as a new ring needs to be inserted within 3 hours of the time it was removed the week before.

Or, if you would like to skip the bleed in between rings:

• Keep the vaginal ring in your vagina for 3 weeks.
• After 3 weeks, take the ring out and dispose of it.
• Put in a new ring immediately.

It does not need to be removed for sex or exercise. However, if for any reason you remove the ring during the 3-week period, do not leave it out for more than 3 hours at a time.

If the ring accidentally falls out, rinse it with water and place it back into the vagina straight away.

The vaginal ring is less effective if:

• a new ring is used more than 7 days after your last ring was removed
• your ring has been removed from the vagina for more than 3 hours
• the same ring has been left in your vagina continuously for 4 weeks or longer (and not replaced with a new one)
• the vaginal ring is not placed in the vagina correctly (it may also feel uncomfortable)

The information sheet that comes in the vaginal ring packet will give you instructions on what to do if this happens. In these instances, you may need to use another form of contraception (e.g. condoms) to prevent pregnancy, or avoid having sex, until you’re back on track.

Some medicines reduce the effectiveness of the vaginal ring, including some epilepsy medications. It is best to check with a healthcare professional if any new or current medications or supplements you take will decrease the effectiveness of the vaginal ring.

No.

Internal and external condoms are the only types of contraception that protect against STIs.

The vaginal ring is placed in the vagina for 3 weeks and then removed and disposed of. You then have 7 days without a ring before a new ring is inserted. Alternatively, if you want to skip the bleed in between rings, insert a new ring immediately (do not wait 7 days).

It is possible that a partner may feel it during sex. It is also possible someone might notice the packet or find the vaginal ring in the bin once disposed of.

As with all medications, some people may experience side effects.

Some possible side effects include:

• nausea
• headaches
• sore breasts
• spotting (light bleeding that is not your period)
• mood changes
• decrease in libido (less interest in sex)
• small brown patches or freckles on your face (called melasma)

• increase in vaginal discharge

Side effects vary between different people. Some people experience no side effects or experience positive changes while using the vaginal ring. Side effects can settle after a few months. If the side effects of the vaginal ring bother you, you may want to try a different type of contraception.

Some common health conditions and lifestyle factors that may stop you from using the vaginal ring include:

• over 50 years of age
• current Body Mass Index (BMI) over 35kg/m2
• smoker aged 35 years or older (includes vaping)
• blood clots
• migraine headaches
• high blood pressure
• history of stroke
• heart disease (current or past)
• breast cancer (current or past)
• severe liver disease or liver cancer

It is important to talk with a healthcare professional about your full medical history when deciding which contraception option is the safest and most suitable for you.

You will need a prescription. You can get one from a doctor (either a GP or relevant specialist, e.g. a gynaecologist), nurse practitioner or pharmacist (in some states and territories). They should ask you questions about your medical history and might do some tests to ensure that the ring is a safe option for you before prescribing.

It is possible to get a prescription at:

• a GP clinic
• a specialist appointment
• a telehealth appointment (online or over the phone)
• sexual health clinics
• family planning clinics
• pharmacies (in some states and territories)

Once you have a prescription, the vaginal ring can be bought at most pharmacies, including online pharmacies.

You can insert and remove the vaginal ring yourself.

The vaginal ring is listed on the Pharmaceutical Benefits Scheme (PBS), which makes it cheaper for those who hold a current Medicare card.

Each repeat of a prescription usually lasts for 3 months (includes 3 rings). Costs for each repeat are:

• PBS price: up to $25
• PBS price for concession card holders: up to $7.70
• Private prescription: between $120–140

Although some healthcare professionals bulk bill (which means you won’t pay anything to see them), some may charge out-of-pocket costs for the appointment needed to get your prescription.

No, the vaginal ring has no impact on long-term fertility.

Your fertility should return to normal soon after you stop using the ring, but your menstrual cycle might take a little while to settle.

If you are breastfeeding, you will need to wait until your baby is at least 6 weeks old to use the vaginal ring. If you are not breastfeeding, you may be able to use the vaginal ring once your baby is 3 to 6 weeks old.

It is important to check with a healthcare professional what is safest and most suitable for you.