The contraceptive vaginal Ring
Description
NuvaRing is a flexible ring about two inches (5.4 cm) in diameter that is inserted into the vagina once a month.
How it Works
The ring slowly releases a combination of contraceptive hormones (estrogen and progesterone). Just like the pill, it mainly prevents ovulation.
Effectiveness
When used correctly, it is 99% effective, like the pill.
Cost
A ring costs approximately $24. Private insurance plans will usually cover the cost and it is covered by Quebec's prescription drug insurance plan (Régime d'assurance-médicaments du Québec).
Before starting NuvaRing
An appointment with a health professional is required to determine whether you have any medical conditions that could prevent you from using the ring. The contraindications are the same as for the pill.
When should I start using NuvaRing?
It is recommended that you start to use the ring within the first five days of your period. This way, protection against pregnancy is immediate. You may also start to use NuvaRing at any time during your cycle, in which case, a back-up method of birth control, such as condoms, is necessary for the first seven days.
How do I use the ring?
Once you insert the ring into your vagina, it is kept in place for three weeks. On the fourth week, you must remove it for seven days. This is when you will get your period, which will begin two or three days after the ring is removed. After a seven-day break, you must insert a new ring for the next 21 days repeating the same cycle.
You will be protected against pregnancy even during the week when you are not using the ring. It is important to insert a new ring after seven days, even if you are still on your period.
How do I insert it?
Step 1: After washing and drying your hands, remove the ring from its wrapper.
Step 2: Choose a position that is comfortable. You may lie down, squat or stand with one leg raised while bending your knee.
Step 3: Hold the ring between your thumb and index finger and press the sides of the ring together. This will be easy to do, because the ring is very flexible.
Step 4: Gently push the ring deep into your vagina. The exact position of NuvaRing is not important for it to be effective. If you feel any discomfort, the ring has probably not been inserted far enough into the vagina. Use your finger to push it further in: there is no danger of the ring being pushed too deeply into the vagina.
How do I remove it?
After 21 days, you must remove the ring for seven days. Hook your index finger under the rim or grasp the ring with your thumb and index finger and pull it out. Throw the ring into the garbage.
Possible side effects
The most common side effects of NuvaRing are nausea, headaches and vaginal secretions, which may increase.
Like the pill, side effects are more common during the first three months of use and generally disappear or lessen after that. If they persist or bother you, continue to use the NuvaRing and contact your doctor.
Despite the presence of side effects, the ring remains just as effective as long as you follow the instructions for use.
Advantages of NuvaRing
- This method of contraception is very effective and reversible.
- It makes the menstrual cycle regular.
- It reduces the frequency of:
-menstrual pain and bleeding
-pre-menstrual syndrome
-ovarian cancer
-cancer of the endometrium (inner lining of the uterus)
-colon cancer
-benign breast tumours
-ovarian cysts
-salpingitis(infection of the Fallopian tubes)
-ectopic pregnancies (pregnancy in the Fallopian tubes)
-the symptoms of endometriosis
Forgetting to insert a ring
- If the ring was removed for a period of less than 3 hours: reinsert the ring as soon as possible. Keep the ring in place until the next ring removal day.
- During the first week:
If the NuvaRing was removed for more than 3 hours or if you forget to insert a new ring after the seven day break, insert one as soon as possible. Keep it in place until the next ring removal day. Use a backup method of contraception (e.g. a condom) for the next seven days. Emergency oral contraception (morning after pill) is recommended if you have had sexual relations in the preceding 5 days. - During the second or third weekIf the ring was removed for a period of less than 3 days: reinsert the ring as soon as possible. Keep the ring in place until the next ring removal day. Begin a new cycle with a new NuvaRing without taking a seven day break. You will not have a period that month.
If the ring has been out of the vagina for more than three days: reinsert the ring as soon as possible and keep it in place until the next ring removal day. Begin a new cycle with a new NuvaRing without taking a seven day break. Use a backup method of contraception (e.g. a condom) for the next seven days. Emergency oral contraception (morning after pill) is recommended if you have had sexual relations in the preceding 5 days. You will not have a period that month.
Complications
Like with oral contraceptives(the pill), complications are very rare and occur mainly in women with health problems or women who smoke.
In any of the above cases, consult a physician immediately.
These complications are:
- severe chest pain with difficulty breathing
- severe headaches
- serious vision problems (sudden decrease or loss of vision)
- serious pain in the thigh or calf and/or swelling in the legs
- persistent numbness and/or weakness on one side of the body
Special Situations
- If NuvaRing slips out of the vagina: The ring should be rinsed with cool to lukewarm (never hot) water and reinserted immediately. This occurs rarely because the muscles of the vagina help to keep the ring in place.
- Partner discomfort: Your partner may feel the ring during sexual intercourse. If this discomfort is significant, you may remove the ring for up to three hours a day without decreasing its effectiveness. Remember to reinsert the ring after rinsing it with cold or lukewarm water.
- NuvaRing and antibiotics: The ring’s effectiveness should not be diminished.
- NuvaRing and pregnancy: Pregnancy becomes possible as soon as you stop using the ring. There may be a delay of a few months before your cycles return to normal. Your fertility remains the same, regardless of how many years you use NuvaRing.
- NuvaRing and perimenopause: Women in good health, who do not smoke, can use the ring until menopause.
- NuvaRing and surgery: If you need to undergo surgery that requires immobilization (bed rest), tell your surgeon that you are using NuvaRing.
- NuvaRing and smoking: Smoking increases the risk of heart disease in women who are on the pill. The same risk exists for women who use NuvaRing. The risk increases with age. Why not use this opportunity to stop smoking now?
- NuvaRing, STI (STDs) and HIV (AIDS):The ring does not offer any protection against sexually transmitted infections. You must use a condom if you are at risk of contracting an STI.