Vaginal Contraceptive Ring

One of the newest developments in hormonal contraceptives is the vaginal contraceptive ring, also known as the Ring and sold under the brand name Nuva Ring. Each ring provides continuous protection against pregnancy for up to one month. It is available through a prescription.

How it Works

The Nuva Ring is a small, transparent ring that is inserted into the vagina, near the cervix and worn for three weeks. During this time, it slowly releases estrogen and progesterone into your body. Like the combination birth control pill, the hormones work to suppress ovulation and thicken cervical mucus (thereby creating a natural barrier for sperm).

Like the birth control pill, the vaginal ring may also change the uterine lining thereby impeding the implantation of a fertilized egg. A new vaginal ring needs to be inserted every month. Once inserted, the Ring is worn for three consecutive weeks before it is removed for one week. During the week that the Ring is not worn, menstruation occurs. Each ring provides one months worth of birth control. However, the Ring does not protect against any sexually transmitted diseases (STDs).

First time users of the Ring will start this method of birth control during the first five days of their menstrual period. Because it takes seven days for the Ring to become effective, it will be necessary to use an additional form of birth control during the first week. However, if you have already been using another form of hormonal birth control, then the Ring should be effective as soon as you switch.

Benefits of Using the Ring

Many women like the convenience of only having to worry about their contraception once a month. Women also like the fact that using a vaginal ring can cause their menstrual periods to be lighter and shorter with fewer cramps. Other benefits of the Ring are similar to the birth control pill and include:

  • Decreased PMS symptoms
  • Decrease in the appearance of acne
  • Some protection against pelvic inflammatory disease and etopic pregnancy
  • Decreased risk of endometrial and ovarian cancers

Complications and Side Effects of the Ring

As with all hormonal birth control methods, there are a variety of side effects associated with the use of vaginal contraceptive rings. The most common ones include:

  • Yeast infection
  • Increased vaginal discharge or irritation
  • Upper respiratory tract infection
  • Sinus infection
  • Weight gain
  • Nausea
  • Spotting or breakthrough bleeding
  • Headaches
  • Tender breasts
  • Mood swings

Although rare, there are also a number of more serious health complications associated with the use of the Ring. These include an increased risk of:

  • Blood clots in the legs, lungs, heart and brain
  • Stroke
  • Heart attack
  • Gallbladder disease
  • Possibly a slightly increased risk of breast cancer and cervical cancer, although evidence has been conflicting

Vaginal ring users who smoke are more at risk of these complications than other users. Because this is a new method of birth control, the long-term effects have not been properly studied or documented.


The efficiency of the Ring has not been accurately evaluated yet although it is assumed to be at least as effective as the birth control pill. The Ring's efficacy has been found to decrease if it is used in combination with certain medications, including some antibiotics, St. John's Wort, and certain anti-seizure, tuberculosis and migraine drugs. Unused vaginal rings need to be stored away from heat and direct sunlight. They should be kept in rooms that are no warmer than 77ºF (25ºC).

Wearing a vaginal contraceptive ring for less than or more than three weeks can decrease its effectiveness. Although it is not common, the Ring can slip out of the vagina. If it has been outside of the body for less than three hours, you can rinse the ring with cold to lukewarm water (never hot) before reinserting it.

If more than three hours have passed since it fell out, you can still rinse and reinsert it. However, your risk of pregnancy will be increased. Therefore it is necessary to use an additional method of birth control until the ring has been worn for seven consecutive days.

Who Should Use It

Not every woman will be able to use the Ring. If any of the following conditions apply to you, you may need to use a different form of birth control:

  • History of breast cancer
  • Diabetes
  • High blood pressure
  • High cholesterol
  • Epilepsy
  • Depression
  • Gallbladder or kidney disease
  • Recently had major surgery
  • Sensitive vagina
  • Dropped uterus or bladder
  • Rectal prolapse
  • Severe constipation
  • Breastfeeding
  • Moral objection to hormonal forms of birth control
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