What is the contraceptive ring?
The contraceptive ring is a slow release, soft, flexible, clear plastic ring measuring 54 millimetres in diameter (approximately 2 inches). The contraceptive ring, like other contraceptives that contain both an estrogen and a progestin, is called a combination hormonal contraceptive (CHC).
The ring is a once-a-month regimen that releases 15 micrograms of estrogen in combination with 120 micrograms of the progestin etonogestrel. Because it is once-monthly, you insert it in the vagina and it stays in place for 3 weeks. You then remove it for one week (7 days ring-free).
When you remove the ring, you will usually have your period within a few days. At the end of the ring-free week, you insert a new ring to begin a new cycle. After the ring is inserted, it releases a continuous low dose of hormones into your body.
The ring is administered once-monthly. Some women may find it convenient to include the ring as part of their monthly routine. Incorrect use of any hormonal contraceptive is associated with an increased risk of unintended pregnancy.
How does it work?
Like other CHCs, the contraceptive ring works in two ways:
- By inhibiting the monthly release of an egg by the ovaries.
- By changing the mucus produced by the cervix. This slows the movement of the sperm through the mucus and through the uterus (womb).
The contraceptive ring does not provide a physical barrier to sperm and it will not protect you from sexually transmitted infections (STIs).
Questions about the ring:
Will it fall out?
It is uncommon for the ring to fall out with proper use. Talk to your doctor and see the prescribing information for tips on what to do should this happen.
Will I experience irregular bleeding?
Irregular bleeding occurs in up to 6.4% of cycles and typically consists of spotting. It does not, however, appear to be significantly higher in the first cycle of ring use.
Factors to consider about the ring
- When used as directed, the contraceptive ring provides reliable contraception for a full month
- It delivers a low dose of hormones
- It may cause vaginal discomfort, but this is uncommon
- If the ring is removed and is out of the vagina for more than three hours during the 3 weeks when it should be in place, the effectiveness could be reduced and a back-up method should be used for 7 days after re-insertion
- Use an extra method of birth control (barrier method) such as condoms or spermicides during the first 7 days of contraceptive ring use in the first cycle
- It does not protect against sexually transmitted infections (STIs)
Factors to consider about combined hormonal contraceptives
- They are effective and reversible
- Combined hormonal contraceptives do not protect against sexually transmitted infections (STIs)
- Common side effects associated with combined hormonal contraceptives include: headaches, nausea, breast tenderness, and bleeding between periods
- They may increase the risk of blood clots
Several health advantages other than contraception have been reported for combination hormonal contraceptives:
- a reduction in the incidence of cancer of the endometrium and ovaries
- a reduction in the likelihood of developing benign breast disease
- a reduction in the likelihood of development of functional ovarian cysts
- less menstrual blood loss and more regular cycles, thereby reducing the chance of developing iron-deficiency anemia
- a potential decrease the severity of dysmenorrhea and premenstrual syndrome
- a potential decrease the incidence of acute pelvic inflammatory disease, thereby reducing the incidence of ectopic pregnancy potential beneficial effects on endometriosis
- potential beneficial effects on endometriosis
Inform yourself and talk to your doctor
There are many choices of hormonal contraceptive available. Do your own research and speak with your doctor about the advantages and disadvantages of the different available types of hormonal contraceptive and choose the one that best fits your needs.
For tips on how to get the most out of your doctor’s visit, see Talking to your doctor.
Cigarette smoking increases the risk of serious adverse effects on the heart and blood vessels. This risk increases with age and becomes significant in hormonal contraceptive users over 35 years of age. Women who use hormonal contraceptives are strongly advised not to smoke.
