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The Vaginal Ring: An Alternative to Birth Control Pills

IMAGE The vaginal ring is a thin, colorless, flexible ring that is inserted into the vagina for three weeks and is then removed for one week while the woman has her period. Low doses of estrogen and progestin are continuously released from the ring, which is replaced monthly. Like birth control pills, the vaginal ring is 99% effective at preventing pregnancy, though its effectiveness decreases if used improperly.

The Advantages

Advantages of the ring include:
  • Only needs to be changed once a month
  • Is easy to insert and remove
  • Does not require a visit to the doctor for insertion or removal
  • Does not interrupt sexual activity
  • May have less spotting or irregular bleeding compared with birth control pills
  • May reduce the possibility of migraines in some women

The Disadvantages

Disadvantages of the ring include:
  • Does not protect against sexually transmitted infections , including HIV/AIDS
  • Requires a prescription
  • Potential side effects include:
    • Vaginal infections and irritation
    • Weight gain
    • Headaches
    • Lightheadedness
    • Breast tenderness
    • Fatigue
    • Nausea
Some serious side effects of hormonal contraceptives like the vaginal ring include blood clots in the legs, lungs, stroke, and heart attack. Smoking increases these risks. These are similar to many other types of hormonal contraception. Talk to your doctor about all possible side effects.

Precautions

Certain drugs, such as antibiotics, antiseizure drugs, tuberculosis (TB) medications, and migraine medications can affect the effectiveness of the vaginal ring. The herb St. John's Wort can also interfere with effectiveness of this ring. Talk to your doctor about all of the medications and supplements you are taking.
If any of the following symptoms occur while you are wearing the vaginal ring, contact your doctor right away:
  • Severe abdominal pain or headaches
  • Chest pain or shortness of breath
  • Blurred vision
  • Severe leg or arm pain or numbness
  • Redness and swelling in legs
  • Skin appears yellow in color
  • You fail to have a regular period
Do not use the vaginal ring if you might be pregnant or are breastfeeding. It is also not advised for women with the following health concerns:

Other Things You Should Know About Vaginal Rings

  • Storing the ring—The ring should be stored at room temperature (no more than 77°F) and away from direct sunlight.
  • Taking the ring out—If the ring slips out of the vagina, simply wash it off with cold to lukewarm water (not hot) and reinsert it. The ring can be taken out during sex as long as it is not out for more than three hours. In which case, a back up method of birth control should be used for seven days.
  • Pricing—The ring costs about $15-$80 at the pharmacy.
  • Switching from other forms of birth control—You can switch directly to a vaginal ring from other hormonal methods of birth control. Talk to your doctor for details.

RESOURCES

US Food and Drug Administration http://www.fda.gov

Women's Health—US Department of Health and Human Services http://www.womenshealth.gov

CANADIAN RESOURCES

The Canadian Women's Health Network http://www.cwhn.ca

The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org

References

Birth control vaginal ring (NuvaRing). Planned Parenthood website. Available at: http://www.plannedparenthood.org/health-topics/birth-control/birth-control-vaginal-ring-nuvaring-4241.htm. Accessed May 6, 2014.

Contraception. American Congress of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/Departments/Adolescent%20Health%20Care/Teen%20Care%20Tool%20Kit/Contraception.pdf?dmc=1&ts=20120614T1305469301. Published 2010. Accessed May 6, 2014.

Contraceptive patch and vaginal rings. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 14, 2014. Accessed May 8, 2014.

How does it NuvaRing work? Nuvaring website. Available at: http://www.nuvaring.com/Consumer/how-it-works/index.asp. Accessed May 6, 2014.

MacGregor EA. Contraception and headache. Headache. 2013 Feb;53(2):247-276.

Vaginal ring. American Pregnancy Association website. Available at: http://americanpregnancy.org/preventingpregnancy/vaginal-ring/. Accessed May 6, 2014.

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