Contraception
Contraceptive Methods
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Vaginal Ring (NuvaRing)
What is it?
The vaginal ring (NuvaRingT) is a new birth control method that is now available in Canada. This soft, flexible, clear plastic ring measures 54mm in diameter and is inserted into a woman's vagina where it slowly releases two female hormones (estrogen and a progestin) for three weeks.
How does it work?
These hormones enter into the woman's bloodstream and prevent pregnancy mainly by stopping the ovaries from releasing an egg. They may also thicken the cervical mucous and make the uterine lining thin. The ring's method of action is very similar to the combined oral contraceptive pill. The ring does not provide a physical barrier to sperm and it does not prevent sexually transmitted infections.
The ring comes in only one size, and does not need to be in a particular position in the vagina to be effective. It is held in place by the walls of the vagina and a woman usually cannot feel the ring once it is in. The woman inserts and removes the ring herself and most women find this easy to do. Remember, the vagina is a closed space and there is no way for the ring to get "lost" or go anywhere else.
The ring is worn inside the vagina for three weeks, followed by a one-week (seven day) ring-free interval. When the ring is removed, a woman usually has a period within a few days. At the end of the ring-free week, the woman inserts another ring to begin a new cycle.
The ring should be left in place during sex. Most men and women do not notice it during intercourse, and even for those who do, it is not usually bothersome.
Effectiveness
The ring is at least as effective as the birth control pill, and it may be more effective if a woman has trouble remembering to take her pill (remember, the pill won't work if a woman forgets to take it!).
Benefits
In addition to preventing pregnancy, the ring has the added benefit of making a woman's periods more regular, lighter, and possibly less crampy. It is thought to have similar benefits as the birth control pill, such as treating PMS, endometriosis and acne, and preventing ovarian and endometrial cancers but these haven't been studied. It is completely reversible. When a woman stops using the ring, her body resumes its normal cycle and fertility returns quickly.
Side Effects
Side effects reported were uncommon but included headaches, vaginal irritation, discomfort or discharge, nausea, and breast tenderness.. Breakthrough bleeding (bleeding between periods) occurred in about 5% of women, especially in the first few months. The ring does NOT cause weight gain, nor does it increase vaginal infections.
Contraindications
Women who cannot take the birth control pill for medical reasons cannot use the ring either. This includes women who have had a blood clot, heart attack, stroke or breast cancer, as well as women with active liver disease or women over 35 years old who smoke. See your doctor to decide if the ring is right for you.
How to get it
You will need a prescription from your doctor and you pick it up at a pharmacy.
Troubleshooting
What to do if the ring falls out?
If the ring falls out, it should be rinsed off and replaced as soon as possible. If it has been out for less than three hours, you should still be protected against pregnancy. If it has been out for more than 3 hours, a back-up method of birth control is needed for the next seven days. The ring must stay in for at least 7 more days after being out for longer than 3 hours; this may mean that you wear it for more than 21 days in total that month. Following this, a one-week ring-free interval can occur and the next ring inserted.
What to do if you forget to take the ring out?
If it has been in for less than 28 days (that is, up to one week too long) remove it, have a seven-day ring-free interval, then insert the next ring. You are still protected against pregnancy. If the ring has been in for more than 28 days, immediately remove it, insert a new ring and use a back-up method of birth control for the next 7 days. You may have irregular bleeding, or no period that month.
What to do if you forget to insert the ring after the week off?
Insert the ring as soon as you remember and use a back-up birth control method for 7 days. If you have unprotected sex after the ring has been out for more than one week, consider using emergency contraception. You should not have more than 7 days without wearing a ring or you risk getting pregnant. Talk to your doctor or pharmacist if in doubt.
Last Modified: January 23, 2007
