Contraceptive Ring

Contraceptive Ring, small, flexible device inserted in a woman’s vagina that releases low doses of female sex hormones to prevent pregnancy. This clear, colorless ring measures slightly over 5 cm (2 in) in diameter and is made of soft plastic. It contains estrogen and progestin (a synthetic form of progesterone). This hormone combination is similar to that used in some types of birth control pills, and it works in a comparable fashion to prevent pregnancy. When absorbed by the body, these hormones inhibit the ovaries from releasing an egg, thicken the mucus of the cervix (opening of the uterus) to prevent sperm from reaching an egg, and prevent the lining of the uterus from thickening so that a fertilized egg cannot implant. The contraceptive ring, marketed under the brand name NuvaRing, became available by prescription in early 2002. With typical use, this method of birth control is 99 percent effective in preventing pregnancy.

A woman inserts the contraceptive ring in the vagina and leaves it in place for three weeks. At the end of this 21-day period, the woman removes the device and discards it. Within the next few days, her menstrual period should start. Exactly one week after removing the contraceptive ring, the woman inserts a new ring even if she is still bleeding from her period. This three-week in and one-week out pattern is repeated every month with a new ring to provide continuous contraceptive protection.

To insert the contraceptive ring, a woman bends the sides together and then places it deep in the vagina. The ring may be expelled if it is not inserted correctly, when removing a tampon, or when having a bowel movement. If this occurs, the ring should be rinsed immediately with cool water and reinserted. If more than three hours elapse before the ring is replaced a barrier method of birth control, such as a condom, diaphragm, or cervical cap, should be used during sexual intercourse for the next seven days.

The ring is a one-size, easy-to-use device that does not require the use of spermicide. Because it prevents pregnancy for only one month at a time, its effects can be quickly reversed. Regular use of the ring may result in shorter, more regular menstrual periods, while also decreasing premenstrual cramping and menstrual-related iron deficiency and acne.

In some women, the contraceptive ring causes vaginal irritation and discharge. The ring does not protect against sexually transmitted infections, including human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS). Some women experience irregular bleeding, weight gain or loss, breast tenderness, nausea, vomiting, headache, and mood changes during the first two to three months of the ring’s use.

The contraceptive ring increases a woman’s risk of developing blood clots or suffering from a heart attack or stroke. Women over 35 that smoke have a greater chance of developing these conditions and should not use the ring. In addition, women should not use the ring if they have high blood pressure, breast or uterine cancer, liver disease, a history of heart problems, or uncontrolled diabetes. Some medications, including antibiotics and antiseizure, tuberculosis, and migraine drugs, can make the contraceptive ring less effective.