What is a Vaginal Ring?
A Vaginal Ring is a thin, transparent, flexible ring that you insert into the vagina yourself to provide contraception protection. Leaving the Vaginal Ring in for 3 weeks, it slowly releases estrogen and progestin hormones into the body. These hormones stop ovulation and thicken the cervical mucus, creating a barrier to prevent sperm from fertilizing an egg. Worn continuously for three weeks followed by a week off, each Vaginal Ring provides one month of birth control. The Vaginal Ring is 92-99.7% effective as birth control. It does not protect against sexually transmitted infections, including HIV/AIDS.

If you are beginning the ring following a pregnancy, you should begin the day of or the day after your abortion, delivery or miscarriage. Otherwise, you may start the Sunday following the beginning of your menstrual cycle. If breastfeeding, consult your health care provider. To reduce the chance of pregnancy and reproductive tract infections, especially during the first week of use, male condoms or spermicide should be used with a Vaginal Ring.

Switching from other Hormonal Methods

You can switch directly to a Vaginal Ring from another hormonal method of birth control without a gap in effectiveness. If you are using:

  •  Combination oral contraceptives (The Pill): Insert a Vaginal Ring within 7 days after the last pill of your pack.
  •  Progesterone-only oral contraceptives (Mini Pill): Insert a Vaginal Ring on any day and discontinue Mini Pills on that day.
  •  Injectable contraceptives (Depo Provera): Insert a Vaginal Ring on the day of your next scheduled injection.
  •  IUD or implant: Insert a Vaginal Ring on the day of your removal.

If you are switching from any of these methods and follow these instructions, the Vaginal Ring should be effective immediately.


Insertion may be awkward at first. However, since the vaginal ring is not a barrier method, incorrect insertion is not usually a problem. You may choose to sit with knees apart, stand with one leg raised, or lie on your back with your knees spread. Squeeze the outer sides of the ring into a tight oval and gently push it into your vagina. Push the ring far enough in so it feels comfortable or so you can’t feel it at all.


A Vaginal Ring remains in the vagina for three weeks. To remove the Ring, hooking it with a finger and pull it out. To dispose, wrap it in the original foil wrapper and dispose in the trash to protect the hormones from being released into the environment. Within the next few days, bleeding from your menstrual period should begin. For another month of birth control, insert a new Vaginal Ring seven days after removal of the last one, even if your period has not ended.


Vaginal rings for future use can be stored at room temperature, no more than 77 degrees Fahrenheit, and away from direct sunlight up to 4months. Rings stored more than 4 months should be refrigerated.


A Vaginal Ring can slip out of the vagina. If this happens, you can wash the ring with cold to lukewarm water (not hot) and reinsert it. If you lose the original ring, insert a new one as soon as possible. If more than three hours pass without the ring in your vagina, there is a chance of becoming pregnant. The Vaginal Ring must be worn continuously for 7 days to regain effectiveness. During this week, you may wish to use a back up method of birth control such as male condoms or spermicide; a Diaphragm is not recommended as a back up method for the Ring.

Missed Periods

Missing a period does not necessarily mean you are pregnant. However, if you miss a period, you may want to consider the likelihood of pregnancy and get a pregnancy test. Pregnancy is more likely if the last ring used was outside the vagina for more than three hours, two periods are missed consecutively, or if a ring was worn for longer than four weeks. If you are pregnant, discontinue use of the Vaginal Ring.

Your Health

Some women may not be able to use the Vaginal Ring because of the risk of serious health problems. Women over 35 who smoke or have any of the following conditions should not use the Vaginal Ring:

  •  History of heart attack or stroke
  •  Chest pain
  •  Blood clots
  •  Unexplained vaginal bleeding
  •  Severe high blood pressure
  •  Diabetes with kidney, eye, or nerve complications
  •  Known or suspected cancer
  •  Known or suspected pregnancy
  •  Liver tumors or liver disease
  •  Headaches with neurological symptoms
  •  Jaundice
  •  Disease of the heart valves with complications
  •  Require long bed rest following surgery
  •  Allergic reaction to the vaginal ring

Women with a family history of breast cancer, diabetes, high blood pressure, high cholesterol, headaches or epilepsy, depression, gallbladder or kidney disease, recent major surgery, easily irritated vagina, dropped uterus, dropped bladder, rectal prolapse, severe constipation, or are breastfeeding may not be able to use a Vaginal Ring. Your clinician or doctor can decide with you.

Side Effects:
  • As the body adjusts to hormonal changes from the vaginal ring, women may experience some minor side effects, including:
  • Vaginal discharge
  • Vaginal irritation
  • Headache
  • Weight gain
  • Nausea
  • Irregular bleeding
  • Breast tenderness
  • Mood changes
Drug Interactions

The effectiveness of a Vaginal Ring is lowered when taken with certain medications, including antibiotics, St. John’s Wort, anti-seizure, tuberculosis, and migraine medications. If you are taking any medications, tell your clinician. When taking medications that may interfere with the Vaginal Ring, consider adding a backup method of birth control, like condoms or spermicide. As with all drugs, it is useful to inform all your medical providers if you are using hormonal birth control.

Danger Signs
  • Women who experience any of the following symptoms while wearing a Vaginal Ring should call the clinic immediately:
  • Abdominal pains (severe)
  • Chest pain or shortness of breath
  • Headaches (severe)
  • Eye problems, such as blurred vision
  • Severe leg or arm pain or numbness
  •  Easy to use.
  •  Can be worn for three weeks.
  •  Affects fertility one month at a time.
  •  Does not interrupt sex play.
  •  Does not protect against sexually transmitted infections, including HIV/AIDS.
  •  Raised risk of heart attack and stroke.
  •  Requires a prescription.
Your Cervix
The cervix is the opening to the uterus where menstrual blood, babies, and sperm pass. It is also the opening through which abortions are performed. Barrier methods of birth control, including the cervical cap, diaphragm, and female condom, work by covering the cervix and preventing sperm from entering the uterus. Hormonal methods of birth control, such as the Vaginal Ring, Contraceptive Patch, Oral Contraceptives (the Pill), and Depo Provera, affect the mucus around the cervix and make the opening more resistant to sperm. Women’s bodies also naturally produce hormones that change the cervix during a menstrual cycle. You can learn more about your cervix using a speculum to perform a self-exam. For instructions and a speculum, ask your clinician or visit the Cedar River Clinics website.
Further References:

NuvaRing (manufacturer): www.NuvaRing.com
Our Bodies, Ourselves, Boston Women’s Health Book Collective, new version in 2005. www.ourbodiesourselves.org
Feminist Women’s Health Center at 404-728-7900


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