Vaginal ring: what it is, how to use it, advantages and side effects

The vaginal ring is a type of contraceptive method in the form of a 5 cm ring, which is made of flexible silicone and which is inserted into the vagina, in order to prevent ovulation and pregnancy through the gradual release of hormones.

This method must be used for 3 consecutive weeks and, after that time, it must be removed, taking a break of 1 week, before putting on a new ring. When used correctly, this contraceptive method is more than 99% effective, similar to condoms, in preventing unwanted pregnancies.

The contraceptive ring is very comfortable, as it is made of a flexible material that adapts to the contours of the region, positioning itself in a less sensitive portion of the vagina, even during intimate contact.

Price and where to buy

This type of contraceptive method can be purchased at conventional pharmacies, without the need for a prescription, and its price varies between 40 and 70 reais. One of the most well-known trade names of the vaginal ring is Nuvaring, there are other brands like Circlet, for example.

How it works

The vaginal ring is made of a type of silicone that contains synthetic versions of the female hormones progesterone and estrogen. These two hormones are released over 3 weeks and cause the ovaries not to produce a new egg, avoiding fertilization and, consequently, a possible pregnancy.

After the 3 weeks of wearing the ring, it is necessary to take a break of 1 week to allow menstruation to start, before putting on the new ring.

How to put the vaginal ring

The vaginal ring should be inserted into the vagina on the first day of menstruation. For this, the following steps must be followed:

Check the expiry date of the ring packaging; Wash your hands before opening the package and holding the ring; Choose a comfortable position, such as standing with one leg higher and the foot resting, or lying down, for example; Hold the ring between your forefinger and thumb, squeezing it until it is shaped like an "8"; Insert the ring gently into the vagina and push lightly with the index finger.

The exact location of the ring is not important for its operation, so each woman should try to position it in the place that is most comfortable.

After 3 weeks of use, the ring can be removed by inserting the index finger into the vagina and gently pulling it out. Then it must be placed in the packaging and thrown in the trash.

When to replace the ring

The ring needs to be removed after 3 weeks of continuous use, however, it should only be replaced after 1 week of rest. So, this method needs to be put on every 4 weeks.

A practical example is: if you put the ring on a Saturday, around 9 pm, you must remove it 3 weeks later, that is, also on a Saturday at 9 pm. The new ring must be placed exactly 1 week later, that is, next Saturday at 9 pm.

If more than 3 hours pass after the time for placing the new ring, it is recommended to use another contraceptive method, such as a condom, for 7 days, as the effect of the ring may be reduced.

Main advantages and disadvantages

The vaginal ring is one of several contraceptive methods available and, therefore, it has advantages and disadvantages that must be evaluated by each woman when selecting a contraceptive:

Benefits	Disadvantages
It is not uncomfortable and does not interfere with sexual intercourse.	It has side effects like weight gain, nausea, headache or acne.
It only needs to be placed once a month.	It does not protect against sexually transmitted diseases, such as condoms.
It allows up to 3 hours to be forgotten, to replace the ring.	It is important to insert the ring at the same time so as not to impair the effect.
Helps to regulate periods and reduce menstrual pain.	It cannot be used in several cases, such as liver problems or high blood pressure.

What to do if the ring comes off

In some cases the vaginal ring may be expelled involuntarily to the panties, for example. In these cases, the guidelines vary according to how long the ring has been out of the vagina:

Less than 3 hours

The ring should be washed with soap and water and then replaced inside the vagina. Up to 3 hours, the effect of this method continues to protect against possible pregnancy and, therefore, it is not necessary to use another contraceptive method.

More than 3 hours in the 1st and 2nd week

In these cases, the effect of the ring may be compromised and, therefore, in addition to washing and replacing the ring in the vagina, another contraceptive method, such as a condom or spermicide, should be used for 7 days. If the ring comes off during the first week, and an unprotected intimate relationship has occurred, there is a risk of possible pregnancy.

More than 3 hours in the 3rd week

In this case, the woman must throw the ring in the trash and then must choose one of the following options:

Start using a new ring, without taking a 1 week break. During this period the woman may not experience bleeding from her period, but may experience irregular bleeding. Take a 7-day break and insert a new ring after the break. During this period the woman is expected to have her period. This option should only be selected if, before this period, the ring has been in the vaginal canal for at least 7 days.

If you forget to put the ring on after pausing

If there is forgetfulness and the break is longer than 7 days, it is advisable to put on the new ring as soon as you remember and start the 3 weeks of use from that day. It is also important to use another method of contraception for at least 7 days to avoid pregnancy. If unprotected intimate contact has occurred during the break, there is a risk of pregnancy, and a gynecologist should be consulted.

Possible side effects

Like any other hormone remedy, the ring has side effects that may arise in some women:

Belly pain and nausea; Frequent vaginal infections; Headache or migraine; Decreased libido; Increased weight; Painful menstrual periods.

In addition, there is an increased risk of problems such as high blood pressure, urinary tract infection, fluid retention and clot formation.

Who should not use the ring

The contraceptive ring should not be used by women who have diseases that affect blood clotting, are bedridden due to surgery, have suffered a heart attack or stroke, suffer from angina pectoris, have severe diabetes, high blood pressure, high cholesterol, some type of migraine, pancreatitis, liver disease, liver tumor, breast cancer, vaginal bleeding without cause or allergy to ethinylestradiol or etonogestrel.

Thus, it is advisable to consult the gynecologist before using this contraceptive method, to assess the safety of its use.