Contraceptive Ring

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What is the contraceptive ring?

The contraceptive ring is a soft, flexible, clear plastic ring that is inserted into the vagina. It slowly releases two female hormones (estrogen and a progestin) over a period of three weeks.

How does the contraceptive ring work?

In a normal cycle, hormones cause the ovaries to release an egg about once a month. The ring slowly releases hormones into the woman’s blood and prevents pregnancy by stopping the ovaries from releasing an egg. The hormones also cause the mucus in the cervix to thicken, making it difficult for sperm to enter the uterus.

How effective is it?

The ring is about 99 per cent effective in preventing pregnancy when used correctly. It does not protect against sexually transmitted infections (STIs). You need to use condoms every time you have sex to help protect you from STIs.

How do I use the ring?

• You insert and remove the ring yourself. Most women find this easy to do. There is no way for the ring to get “lost” or go anywhere else, because the vagina is a closed space.
• You should insert the ring between day one and day five of your menstrual cycle (count the first day of bleeding in your menstrual cycle as day one). Use backup birth control such as condoms for the first seven days after it is inserted the first time. Once inserted, keep the ring in for three weeks.
• Remove the ring after day 21 (on the same day and time of the week it was inserted). You will usually have a period within a few days. At the end of the seven ring-free days, insert another ring to begin a new cycle, even if you are still bleeding.
• Dispose in the garbage out of the reach of children or pets.

What if the ring falls out?

• Without a ring for less than three hours: rinse it off and reinsert immediately.
• If it has been out for more than three hours or you are late inserting it by more than 24 hours:
  • During week one:
    • Insert the ring as soon as possible, keeping it in until the scheduled ring removal day. Use condoms for the rest of the cycle. If you had unprotected sex within five days, contact the Sexual Health Clinic, your health care provider or a pharmacist to discuss the need for the emergency contraceptive pill (ECP). 
  • During week two or three:
    • Insert the ring immediately, keeping it in until the scheduled ring removal day. Start a new cycle using a new ring without taking a break. Use condoms for the next seven days.
    • Without the ring for three or more days: If you had unprotected sex within five days, contact the Sexual Health Clinic, your health care provider or a pharmacist to discuss the need for ECP.

What if I forget to take the ring out?

• If it has been in for less than 28 days (up to one week too long) remove it and leave it out for seven days. Following this, insert a new ring. You are still protected against pregnancy.
• If the ring has been in for more than 28 days, you could become pregnant. Take it out right away, insert a new ring and use a back-up method of birth control for the next seven days. If you had unprotected sex during this time, contact the Sexual Health Clinic, your health care provider or a pharmacist to discuss the need for the emergency contraceptive pill (ECP).

What if I forget to insert the ring after the week off?

Insert the ring as soon as you remember and use a backup birth control method for seven days. If you have unprotected sex after the ring has been out for more than seven days, contact the Sexual Health Clinic, your health care provider or a pharmacist to discuss the need for ECP.

Are there times when the ring may not be effective?

Yes. Many prescription, non-prescription and even herbal medicines may interfere with the ring. Always check with the Sexual Health Clinic, your health care provider or a pharmacist or  before taking another medication. You may need to use a backup method of birth control such as condoms while you are on the medication and for seven days after you finish taking it.

If you have unprotected sex during a time that the ring is not effective, contact the Sexual Health Clinic, your health care provider or a pharmacist to discuss the need for ECP.

What are the advantages to using the ring?

You may notice lighter and shorter periods and a more regular cycle. You may also experience less menstrual cramping and less acne. You don’t have to remember it daily or weekly because you insert it once a month.

Some benefits occur the longer you are on the ring, such as decreased risk of:

• cancer of the ovaries and lining of the uterus
• pelvic inflammatory disease and endometriosis
• cysts in the ovaries and breasts
• tubal pregnancy
• anemia from low iron levels.

What are the side effects or possible complications?

The most common side effects are nausea, headache, breast tenderness or bleeding at times you don’t expect in your cycle.

Some women may also experience vaginal infections and irritation, vaginal discharge and weight gain.

Serious side effects are rare, but there is a risk of blood clots, stroke or heart attack with any hormonal contraceptive.

Seek medical attention right away if you notice any of the following:

• severe pain in your legs or abdomen
• severe chest pain, cough or shortness of breath
• blurring or loss of vision, speech problems
• breast lump
• depression or jaundice (yellowing of the skin).

What else do I need to know?

• It is important to have a yearly physical while you are using the ring.
• Women who use hormonal contraceptives are strongly advised not to smoke. Cigarette smoking can increase the risk of high blood pressure, heart disease and blood clots. The risk increases with age.