Ring

THE BASICS

What is it?


The birth control ring is a flexible circle of plastic that you place inside your vagina. The ring gradually releases the hormones estrogen and progestin for 3 weeks. At the beginning of the fourth week, you remove it and get your period.

How well does it prevent pregnancy?


An effective method of birth control, but not as reliable as the implant, hormonal IUD, copper IUD, or sterilization for men or women.

  • NuvaRing: Similar to combined pills — about 7 out of 100 women using that method get pregnant in a year of use.
  • Annovera: About 2 to 4 women out of 100 get pregnant in a year of use.

HOW DOES IT WORK?

Prevents the monthly release of an egg from the ovaries (ovulation) in most women. Progesterone also thickens the mucus in your cervix. This stops sperm from entering the uterus. The lining of the uterus also becomes thinner.

Depending on which type of ring you use, you will need to:

  • Replace it with a new ring every 4 weeks (NuvaRing)
  • Repeat this cycle for a year (Annovera): 3 weeks of use, then washing and storing it for 1 week.

WHAT ARE SOME PRODUCT NAMES?

There are two types of ring available in the United States:

  • NuvaRing lasts for 4 weeks.
  • Annovera lasts for 1 year.

PROS

  • Effective birth control.
  • Sex can be spontaneous.
  • Only need to think about birth control twice a month — when you put in a new ring and when you remove the old one.
  • Usually private (some partners can feel it).
  • Reversible. Stop using the ring if you want to try to get pregnant.
  • You can bathe, swim, exercise, and do other normal activities while using the ring. Tampons, lubricants, and vaginal creams are safe to use.

CONS

  • You need to remember to remove the ring after 3 weeks and then replace it on the same day a week later. If you don’t take it out on time, the ring may still be releasing hormones.
  • You need to check to make sure the ring is in place, especially after sex or a bowel movement. A tampon also can sometimes snag the ring and pull it out. If the ring is out for less than 3 hours, all you need to do is wash it (no hot water) and put it back in.
  • Some partners say they can feel the ring during sex. Doctors don’t recommend removing the ring during sex. But if you do, be sure to replace it within 3 hours.
  • Best to choose another method if you don’t want to put your fingers in your vagina or have problems inserting or removing the ring.
  • Not safe if you are a smoker over age 35.
  • No-go with some health issues and medicines:
    • History of blood clots
    • Breast or endometrial cancer
    • Stroke
    • Coronary artery disease
    • High blood pressure
    • Serious liver disease
    • Migraine with aura
    • Advanced diabetes or certain types of lupus
    • Certain seizure medicines

POSSIBLE CONCERNS

Side effects may include:

  • Breast tenderness
  • Nausea
  • Vaginal discharge
  • Headache

Risks include:

  • Blood clots
  • High blood pressure

EXTRA BENEFITS

  • Can reduce heavy menstrual bleeding, painful periods, and anemia.
  • Probably similar to combined pills, may lower risk for colon, ovarian, or endometrial cancer
  • May improve:
    • Acne
    • Endometriosis
    • Menstrual migraine without aura
    • Irregular periods
Back to my options
Consider keeping emergency birth control (“morning-after pill”) at home to use as backup. It works best to prevent pregnancy if taken as soon as possible after unprotected sex or birth control mishaps, but may work if taken up to 5 days afterward. Brands include Plan B, ella, and others.
Use with condom to avoid getting or spreading sexually transmitted diseases or infections, including HIV.
Lasts 4 weeks or 1 year, depending on type.
It helps to keep an extra ring on hand in case you lose one. And if you forget to take your ring out on time, or if your ring is out for more than 3 hours when you would normally be using it, you’ll need to call your doctor for advice.