Vaginal ring
The vaginal ring, sometimes called the NuvaRing is a soft plastic ring that you place inside your vagina. The vaginal ring releases a continuous dose of the hormones oestrogen and progesterone, the same as the combined pill. These hormones prevent the release of an egg each month and thicken the cervical mucas making it harder for sperm to travel through. It also thins the lining of the womb so an egg is less likely to implant itself.
The vaginal ring stays inside the vagina for 21 days, after which you take it out for 7 days before replacing it with a new one. You are still protected against pregnancy during the 7 day ring-free period.
How effective is the vaginal ring?
If used correctly, the vaginal ring is 99% effective against pregnancy. If you insert the ring on the first day of your period, it is effective immediately. If you insert it at any other time, you need to wait for seven days or use an additional form of contraception such as condoms.
Who can use a vaginal ring?
There are some women who can’t use a vaginal ring. It may not be suitable if you:
- have had a blood clot in a vein or artery, or a member of your immediate family had a clot before they were 45 years old
- have lupus
- have had heart or circulatory problems, including high blood pressure
- are 35 or older and smoke, or if you stopped smoking in the past year
- get migraines
- have had breast cancer or carry genes associated with breast cancer
- have diabetes
- are overweight
- take certain medication
- are pregnant or are breastfeeding a baby less than six weeks old
- can’t hold the ring in your vagina (for example if your vaginal muscles aren’t strong enough because of giving birth)
If any of these things apply to you, then please book an appointment and come and see us. You may still be able to use a vaginal ring and if not, we can suggest some other forms of contraception that may work better for you.
If you are admitted to hospital or need to have an operation, make sure you tell your doctor that you are using the ring as you may need to stop it to reduce the risk of thrombosis (blood clots).
Where can I get a vaginal ring?
You can get a vaginal ring from your nearest Devon Sexual Health clinic where you can book an appointment.
What happens at the clinic?
A specially trained doctor or nurse will have a chat with you about your sexual history, your health and what contraception will work best for you and your lifestyle.
Are there any side effects?
The vaginal ring may ease premenstrual symptoms and make periods less heavy or painful. Some women may have a temporary increase in vaginal discharge, sore breasts and headaches but these usually pass quite quickly. Very few women have more serious side effects, but these could be the development of a blood clot, or a slightly increased risk of breast cancer or cervical cancer.
Pros & Cons
- 99% effective against pregnancy
- Easy to put in and take out and only needs changing every 3 weeks
- Can make periods less heavy and painful
- You don’t have to remember to put it in before sex
- It isn’t affected if you are sick – it will carry on working
- No long term effect on your fertility
- It does not protect against STIs
- It may cause temporary side effects such as moodiness, nausea, sore breasts, headaches and a change in vaginal discharge
- You need to remember to take it out after 21 days and replace after a further 4-7 days
- You may experience a change in your bleed pattern with some breakthrough bleeding in the first few months of use
- Some medicines can stop it working
Frequently asked questions about
Vaginal Ring
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How do I use the vaginal ring?
To insert the vaginal ring:
- With clean hands remove from the foil pouch squeeze the ring between the thumb and fingers in one hand
- Spread the labia (vaginal lips) with the other hand
- Push the ring into the vagina like a tampon until it feels comfortable – it doesn’t need to be in an exact position
- If it feels uncomfortable push it a little further into the vagina and try to re-position it so it feels comfortable. It cannot get lost inside the vagina, but if you have any concerns or you are unable to feel it see a doctor or nurse
- Keep the resealable foil pouch to use to dispose of the vaginal ring
The vaginal ring should be left in the vagina for 3 weeks (21 days). Following this you can have a ring free interval for 4-7 days. During this time you would be expected to have a withdrawal bleed.
You can omit the 4-7 day break and put a new ring straight back in. You could do this with 2 or 3 rings in a row.
You can also do this indefinitely remembering to change your ring every 3 weeks and then choosing to take a break when you start to bleed (you must have used vaginal rings for at least 21 consecutive days prior to the break).
To remove the vaginal ring:
- With clean hands hook a finger under the ring or grasp it between your thumb and finger to gently pull it out
- Put the vaginal ring in the foil pouch and then put that in a bin. It must not be flushed down the toilet
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Can I use a vaginal ring during my period?
Yes, if you put it in on the first day of your menstrual cycle it will start working immediately. You can safely use tampons or menstrual cups with the ring in place – just be careful not to pull the ring out with the tampon or cup. There are no issues with using pads.
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What happens if I get a bleed in the middle of my cycle?
it is common to get some breakthrough bleeding in the first few months after starting to use a vaginal ring. This should settle down. If it doesn’t then please speak to a doctor or nurse about this.
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Will a vaginal ring protect me against STIs?
No a vaginal ring will not protect you against sexually transmitted infections. If you have a new partner or are unsure about your partner’s sexual history, then you need to use a male or female condom. You could also book a check-up for you both.
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How often should I replace my vaginal ring?
Every 21 days you should take it out and rest for 4-7 days (you can still have sex without getting pregnant), and then replace it with a new one.
You can omit the 4-7 day break and put a new ring straight back in. You can do this for 2-3 rings in a row.
You can also do this indefinitely remembering to change your ring every three weeks and then choosing to take a break when you start to bleed (you must have used vaginal rings for at least 21 consecutive days prior to the break). -
Can I have a bath or go swimming with my vaginal ring in?
Yes. It should stay in place.
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Will my vaginal ring just fall out?
In general, your vaginal muscles will keep the ring in place. Occasionally it may come out on its own (be expelled). This can happen if it isn’t sitting correctly, or it can come out with a tampon/moon cup, during sex or during a bowel movement
If the ring has been out of the vagina for less than 3 hours, rinse the vaginal ring in lukewarm (not hot) water and re-insert it straight away.
If the ring has been out for over 3 hours, and you are in the first 2 weeks of that ring’s use, rinse the vaginal ring in lukewarm (not hot) water and re-insert it straight away. You may need emergency contraception if you’ve had sex in the preceding 5 days. Additional protection would be recommended for 7 days. Contact Devon Sexual Health if you are unsure or need advice.
If the ring has been out for over 3 hours, and you are in the last (third) week of that ring’s use, you could insert a new ring immediately and start a new ring cycle. Or you could have your ring-free interval and then commence a new ring cycle at the end of the 7day breack
If this happens recurrently you may want to consider an alternative form of contraception.
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How soon after fitting my vaginal ring can I have sex?
If you fit the vaginal ring on the first day of your menstrual cycle, you can have sex straightaway. If you fit it at any other time, you need to wait for 7 days or use a different form of contraception for 7 days.
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Will my partner be able to feel the vaginal ring when we have sex?
It’s possible, but it’s soft and is unlikely to cause any harm or discomfort.
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What should I do if I forget to take my vaginal ring out after 21 days?
As long it is less than a week late, just have your 4-7 day break or change to a new ring. If it is 2 weeks late or more, you should miss your break and you may need emergency contraception. Contact Devon Sexual Health if you are unsure or need advice.
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What should I do if I forget to replace my vaginal ring after my 7 day break?
As long as it is less than 48 hours late you should just replace the ring, but if it is more than 48 hours late, you should use extra protection, such as condoms, for 7 days as well and you may need emergency contraception. If you are unsure contact Devon Sexual Health.
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Can I use the vaginal ring after giving birth?
You can use the vaginal ring from 21 days after giving birth if you feel comfortable and are not breastfeeding.
If you start it on day 21 you are protected straightaway. If you start after day 21, then you will need to use additional contraception for another 7 days.
For some people, particularly if you are breastfeeding, it may not be the best contraception method for you so we would advise speaking with a doctor or nurse about your options.
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Can I use the vaginal ring after an abortion or miscarriage?
Yes, you can use the vaginal ring immediately after a first trimester abortion or miscarriage and you will be protected immediately if you start within five days.
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Can I take other medications alongside the vaginal ring?
Yes – always inform anyone prescribing or gving you medications that you have the ring in place. Medicines such as those used to treat HIV, TB, and epilepsy may make it less effective. As may the complementary medication, St John’s Wort.
Thrush treatments do not affect the effectiveness of the vaginal ring.