|What Is It?
The birth control ring is a soft, flexible, doughnut-shaped ring about
2 inches (5 centimeters) in diameter. It is inserted into the vagina
where it slowly releases hormones - the chemicals that the body makes
to control the organs in the body - through the vaginal wall into
the bloodstream. The hormones in the ring control the ovaries and
How Does It Work?
The combination of the hormones progesterone 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 girl can't get pregnant because there's no egg for a guy's sperm
The hormones in the ring also thicken the cervical mucus (the mucus
produced by cells in the cervix). This makes it difficult 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 the patch, a girl 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 the first Sunday after her menstrual
cycle, where it remains in place for 3 weeks in a row. At the end
of the third week, she removes it and her menstrual period should
start. At the end of the fourth week, she inserts a new ring and
the process begins again.
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.
The exact position of the ring in the vagina is not critical as
long as it feels comfortable. This is because the ring does not
work as a barrier method of birth control. If it doesn't feel comfortable,
a girl can push it further back or remove and reinsert it. Most
girls do not feel the ring once it is in place. It can be left in
place during swimming, bathing, and exercise. It can also remain
in place during intercourse.
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 chance a girl can become
pregnant and she'll need to use an additional form of birth control
until the ring has been in place for 7 days.
How Well Does It Work?
The effectiveness of the vaginal ring is still being studied. So
far results are similar to other hormonal methods of birth control,
like the patch or the Pill. Results show that over the course of
1 year, five to eight out of 100 typical couples who rely on the
ring to prevent pregnancy will have an accidental pregnancy. Of
course, the chance of getting pregnant depends on whether a girl
uses 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 a lot of things. These include whether a person has any health
conditions or is taking any medications that might interfere with
its use. It's important for a doctor to be aware of all medications
and herbal supplements that a girl might be taking. Although using
the ring means a girl does not have to remember to take a pill every
day or replace a patch, it still needs to be replaced every 3 weeks.
If it is not replaced on time, it loses its effectiveness. Abstinence
(the decision to not have sex) is the only method of birth control
that always prevents pregnancy and sexually transmitted diseases
Protection Against STDs
The vaginal ring does not protect against sexually transmitted diseases.
For those having sex, condoms must always be used along with the
vaginal ring to protect against STDs.
Possible Side Effects
The vaginal ring is a safe and effective method of birth control.
Most young women who use the ring have no side effects. Smoking
cigarettes and using the ring can increase a girl's risk of certain
side effects, which is why health professionals advise girls who
use the ring not to smoke.
The side effects that some women have while using the ring are
similar to those experienced with the birth control pill. These
- irregular menstrual bleeding
- nausea, weight gain, headaches, dizziness, and breast tenderness
- mood changes
- blood clots (rare in women under 35 who do not smoke)
Other possible side effects seen in ring users include:
- vaginal irritation or infections (mainly yeast infections)
- vaginal discharge
- problems with contact lens use, such as a change in vision or
inability to wear the lenses
These side effects are usually mild and tend to disappear after
2 or 3 months.
Who Uses It?
The vaginal ring may be a good choice for young women who find it
difficult to remember to take a pill every day or who have difficulty
swallowing pills. They must feel comfortable enough with their bodies
to be able to insert a device into the vagina.
Not all women can - or should - use the vaginal ring. In some cases,
medical or other conditions make the use of the ring less effective
or more risky. For example, it is not recommended for women who
have had blood clots, high blood pressure, certain types of cancers,
certain types of migraine headaches, or uncontrolled diabetes. It's
recommended that women who have had unexplained vaginal bleeding
(bleeding that is not during their periods) or who suspect they
may be pregnant should talk to their doctors, stop using the ring,
and use another form of birth control in the meantime.
Girls who are interested in learning more about the possible health
benefits and risks of different types of birth control, including
the ring, should talk to a doctor or other health professional.
How Do You Get It?
A doctor or a nurse practitioner must prescribe the ring. He or
she will probably ask questions about 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 doctor or
nurse recommends the ring, he or she will write a prescription and
provide instructions on how to use it. Those who start using the
ring may be asked to return within several months for a blood pressure
measurement and to ensure that there are no problems. After that,
a doctor may recommend routine pelvic exams once or twice a year
or as needed.
How Much Does It Cost?
The ring usually costs between $30 and $35 a month, although health
and family planning clinics (such as Planned Parenthood) might sell
them for less. In addition, the vaginal ring and doctor's visits
are covered by many health insurance plans.