What is the contraceptive vaginal ring?

The contraceptive vaginal ring is a soft plastic ring that you insert into your vagina to stop yourself getting pregnant.

The ring releases the hormones oestrogen and progestogen. These are the same hormones used in the combined oral contraceptive pill, but at a lower dose.

How does the vaginal ring work?

You can insert and remove a vaginal ring yourself. You will need to start using the vaginal ring at the correct time during your menstrual cycle. Your doctor can help you determine the correct day on which to start.

Once inserted properly, the ring sits high in your vagina. You leave it in place for 3 weeks to release the oestrogen and progestogen. Don’t remove the ring during sex or exercise – it should be left in place.

The hormones stop your ovaries from releasing eggs. They also thicken the mucus at the entrance to your uterus (womb), and change the lining of the uterus to prevent any fertilised eggs from attaching and developing.

After 3 weeks, you should remove the ring for a week so you can have your period, and then you should insert a new vaginal ring. If you forget to remove your ring after 3 weeks, but you take it out before 4 weeks have passed, it will still protect you from pregnancy. If you leave your ring in place for more than 4 weeks, then there’s a greater possibility of you becoming pregnant. In this case, you should use alternative contraception and speak to your doctor before starting a new ring.

Types of vaginal rings

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

How well does the vaginal ring work?

The vaginal ring works fairly well at preventing pregnancy. If 100 women use the vaginal ring for a period of 1 year, about 9 will still likely become pregnant.

The ring won't work at all if you forget to put it in, or don't take it out at the right time.

The vaginal ring can't protect you against sexually transmitted infections (STIs) - only condoms do that, and even condoms won't protect you against every kind of STI.

Advantages and disadvantages of the vaginal ring

The main advantages of the vaginal ring are that it:

• is safe for most women to use
• doesn't need to be fitted by a doctor
• has few side effects
• allows control of your periods
• allows your fertility to return quickly when the ring is removed.

The main disadvantages are that:

• you need to remember to replace it at the right time
• it is more expensive than the pill
• it can cause some side-effects such as headaches and blood clots (or thrombosis).

What could go wrong?

If the ring accidentally comes out, rinse it with water and put it back in straight away.

The vaginal ring won't protect you from getting pregnant if:

• you leave it in for longer than 4 weeks
• your ring is out for more than 3 hours (unless it's for the one-week break)
• your one-week break stretches past one week.

If any of this happens, put in a new ring and use another type of contraception such as condoms for the next week. If you have unprotected sex during this time, you might consider taking emergency contraception, available from your doctor, chemist, health centre or family planning centre.

More information

See Family Planning NSW and Jean Hailes for Women's Health.