What Is the Birth Control Ring?

The birth control ring is a flexible circular device that goes inside the vagina. It slowly releases hormones through the vaginal wall into the bloodstream. These hormones help prevent pregnancy.

How Does the Birth Control Ring Work?

The combination of the hormones progestin and estrogen in the birth control ring prevent ovulation (the release of an egg from the ovaries during the monthly menstrual cycle). If an egg isn't released, pregnancy can't happen because there's no egg for the sperm to fertilize.

The hormones in the ring also thicken the cervical mucus (made by cells in the cervix). This makes it hard 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 patch, the vaginal ring is based on the monthly menstrual cycle. To use the ring:

• Put the ring into your vagina on the first day of your period or before day 5. Putting in the ring is like putting in a tampon.
• The ring stays inside the vagina for 3 weeks in a row.
• When the ring has been in place for 3 weeks, take it out. Do this on the same day of the week the ring was inserted. So if you put the ring in on a Thursday of the first week, take it out on Thursday of the third week, at about the same time of day.
• Within a few days, your period should start.
• Exactly a week after taking out the old ring, put in a new one. The new ring should go in on the same day of the week, even if you still have your period.

The hormones in the ring take a while to begin working. So when someone starts using the ring, couples must use another form of birth control (such as a condom) for 7 days. Even after the ring starts working on its own, using condoms helps protect against sexually transmitted diseases (STDs).

It doesn't matter where the ring is in the vagina as long as it feels comfortable. If it doesn't feel comfortable, you can push it farther back or take it out and put in again. Most girls don't feel the ring after it's in place.

Vaginal muscles hold the ring in place, so it's unlikely that it will fall out. If it does, it can be rinsed under cool water (not hot) and put back in within 3 hours. If someone has sex when more than 3 hours have passed without a ring in the vagina, there's a chance of pregnancy. The couple should use a condom or other form of birth control until the ring has been in place for 7 days.

If the ring is out for more than 3 hours during the third week of wearing it, call your doctor for advice. The doctor may say to put a new ring in, or not to replace it, so that your period starts early. Either way, use another kind of birth control to avoid pregnancy.

How Well Does the Birth Control Ring Work to Prevent Pregnancy?

The ring is an effective form of birth control. Over the course of a year, about 9 out of 100 typical couples who use the ring to prevent pregnancy will have an accidental pregnancy. Of course, the ring must be used correctly. Not putting the ring in on time or taking it out too soon makes it less effective.

In general, how well each type of birth control method works depends on many things. These include whether a girl has any health conditions or is taking any medicine that might affect its use.

Does the Birth Control Ring Help Prevent STDs?

No. The vaginal ring does not protect against STDs. Couples having sex must always use condoms along with the ring to protect against STDs.

Are There Any Side Effects From the Birth Control Ring?

Most people who use the ring have no side effects.

If side effects do happen, they may include:

• irregular periods
• nausea, headaches, dizziness, and breast tenderness
• mood changes

Other possible side effects include:

• vaginal irritation or infections
• vaginal discharge
• problems with contact lenses, such as a changes in vision or inability to wear the lenses

Many of these side effects are mild and tend to go away after 2 or 3 months.

The birth control ring increases the risk of blood clots. Blood clots can lead to serious problems with the lungs, heart, and brain. Smoking cigarettes while using the birth control ring can increase the risk of blood clots. If you use a birth control ring or other form of hormonal birth control, don't smoke.

Who Can Use a Birth Control Ring?

The vaginal ring may be a good choice for someone who has trouble remembering to take a pill every day or who has trouble swallowing pills. A girl must feel comfortable inserting the device into her vagina.

Some medical conditions (such as severe high blood pressure and some types of cancer) can make using the ring less effective or riskier.

Anyone who has had unexplained vaginal bleeding (bleeding that is not during their periods) or who might be pregnant should stop using the ring, talk to a doctor, and use another form of birth control in the meantime.

Where Can I Get the Birth Control Ring?

A doctor or a nurse practitioner must prescribe the birth control ring, and will probably ask questions about your health and family medical history . They may do an exam, including a blood pressure measurement and, possibly, a pelvic exam. If the ring is prescribed, the doctor will give you instructions on how to use it.

You may have to go back to the doctor a few months after using the ring to get your blood pressure measured and to make sure there are no problems. After that, a doctor may recommend routine exams once or twice a year or as needed.

How Much Does the Birth Control Ring Cost?

The ring usually costs between $30–$200 a month. Some health and family planning clinics (such as Planned Parenthood) might sell them for less. Also, the vaginal ring and doctor's visits are covered by many health insurance plans.

When Should I Call the Doctor?

If you are using the birth control ring, call the doctor if you:

• might be pregnant
• have a change in the smell or color of your vaginal discharge
• have unexplained fever or chills
• have belly or pelvic pain
• have pain during sex
• have heavy or long-lasting vaginal bleeding
• have yellowing of your skin or eyes
• have severe headaches
• have signs of a blood clot, such as lower leg pain, chest pain, trouble breathing, weakness, tingling, trouble speaking, or vision problems