Vaginal Ring – A Birth Control Option

Fertility control medications or devices have been on the market for many years. With time, they have evolved to incorporate new advances in medical science to provide effective and safe birth control. One of the recently developed contraceptive devices for women is the vaginal ring, which has attracted a lot of attention. It is a device that delivers contraceptive hormones into the vagina and offers effective protection against unplanned pregnancy. This article talks about the various aspects of using a vaginal ring in detail.

What is Vaginal Ring?

The vaginal ring, as the name suggests is a ring-shaped structure that is meant for insertion into the vagina. It is made of soft plastic material or silicone and is coated with hormones that prevent women from conceiving. This simple contraceptive device is marketed under various brand names and is easily available in any family planning centre.

How Does it Work?

The vaginal ring works by preventing the process of fertilization. The ring that gets inserted into the vagina is coated with a combination of the hormones, estrogen and progestin. Both these hormones are absorbed into the reproductive system through the lining of the vagina and act in a threefold way to prevent conception.

• Similar to contraceptive pills, these hormones prevent ovulation or the process of formation of the egg.
• It increases the thickness of the mucous layer in the cervix, thereby obstructing the path of the sperm to enter the uterus.
• It thins down the endometrial layer inside the uterus. A thick uterine wall is imperative for a fertilized egg to attach and grow. By preventing the thickening, the vaginal ring also ensures that the fertilized zygote does not implant itself for further differentiation.

Usage Guidelines

The vaginal ring is used throughout the month except for the time when menstruation occurs. This effectively means three weeks of wearing the ring and one week of the ring-free period for allowing menstruation. Once the menstrual cycle gets over, a new ring is inserted back to provide protection from unintended pregnancy.

1. How to Insert

Inserting and using a vaginal ring is very simple. Some precautions to be taken before inserting the ring are to sanitize the hands before opening the ring and also to check if the ring is within its validity period for usage. To insert the vaginal ring, open the sterile packet and squeeze the ring in such a way that the opposite sides touch each other. In this position, tease the ring inside the vagina and release it to take up its circular position.

2. How to Remove

For removal of the ring, insert your sanitized hands inside the vagina and gently tug the ring to dislodge it. Pull it out gently and pack it in the original packing material to dispose of it in the sanitary waste. Flushing the ring down the toilet is not recommended.

3. How to Use the Ring if You Want to Get Periods

The vaginal ring can be used to regulate the menstrual cycle, just like a contraceptive pill. To get your periods, insert your ring for a period of three weeks and remove it on the exact same day of the week you inserted the ring. You will get your periods soon after you remove it. Typically after the period gets over, you can insert a new ring. After insertion of the new ring, if there is mild bleeding, it is ok to retain the ring while using a sanitary pad or tampon. Care must be taken to not use a menstrual cup as it can interfere with the placement of the ring.

4. How to Use the Ring to Skip Your Periods

The vaginal ring gives you the privilege of altering and restructuring your menstrual cycle. The technique is very simple, and you can discuss the details with your doctor. If you wish to avoid periods for a particular month, you can continue to wear the ring for four weeks instead of just three weeks. At the end of the fourth week, on the same day of the week on which you inserted the ring, you can replace it with a new one. Mild spotting or bleeding is usually found when the ring is used to skip the periods and there is no proven harmful effect with this method.

How Effective is the Birth Control Ring?

By far, it is one of the most effective contraceptive methods available in the market with a working effectiveness percentage of about 91%. The crucial aspect of using a ring is the prompt maintenance of the time of insertion and removal.

How to Make the Ring Work Best for You

To make the best of this birth control device, the following aspects need to be kept in mind while using it.

• You should follow the three-week insertion and one-week removal rule diligently to increase the efficiency of the ring as a birth control method.
• Insert and remove the ring on the same day of the week. For example, if you inserted it on a Monday, make sure to remove it on Monday that falls after the completion of three weeks. This way, the cycle is maintained properly.
• Inserting it with sterile hands is important in order to prevent any form of vaginal infection.
• Although there is no perfect position for inserting the ring, a proper insertion deep inside the vagina can prevent accidental slipping of the ring.

Who Can Use the Contraception Ring?

The contraception ring is suitable for use by women of all ethnicities and ages. Unless there are any medical conditions that hinder the use of the ring, everyone can use it without any problem. Women who have given birth to a baby can start using it after the 21^st day of delivery. However, the ring can reduce the flow of breast milk in feeding mothers and hence should be avoided during the first six months of exclusive breastfeeding. It can also be used right after an episode of abortion or miscarriage without any extra contraception.

Who Should Avoid Using Birth Control Ring?

Although suitable for most women, the use of the vaginal ring should be avoided by women who have the following conditions:

• a cardiac problem
• a clot in the veins or arteries
• a habit of smoking and have crossed the age of 35
• Breast cancer
• Diabetes
• Obesity issues
• A vagina that is either too big or small for the ring to fit

Advantages of Vaginal Ring

The vaginal ring, apart from providing effective contraception, also has some other benefits, like:

• Helping in reducing menstrual cramps and pre-menstrual syndromes
• Lighter menstrual bleeding
• No serious side effects
• Reduced risk of some cancers

It is very easy to insert and does not require any day to day follow up. It also does not interfere with sexual pleasure, making it a very convenient device for birth control.

Risks and Side Effects of Vaginal Ring

As the ring is a hormone-based birth control method, it also entails some side effects just like oral contraceptives. Some reported side effects are:

• Nausea
• Breast tenderness
• Mood swings
• Vaginal discharge
• A headache
• Fatigue and weight gain

Some risk factors associated with the ring are rare instances of a blood clot in the arteries or vein and a slight increase in the risk of breast cancer.

What If You Forget to Remove the Ring?

In case you forget to remove the ring, you may expose yourself to the risk of being unprotected, as the hormones would have outlived their active time period. If you forgot the ring anytime, remove it immediately as soon as you remember. If you kept the ring inside for less than seven days after the third week, remove the ring and give a break of 7 days for your menstrual cycle and then reinsert a new ring. In the case where the ring remains for more than a week after the third week, remove it immediately and put on a new ring right away. During the period where you forgot to remove the ring if you have had any intercourse, immediately take emergency contraceptive pills to avoid unintended pregnancy. Also, remember to take additional precaution while having sex during the following week.

What If the Ring Comes Out On Its Own?

Sometimes, there are chances for the ring to detach and come away during intercourse or otherwise when it is not fitted properly. Depending on the time elapsed after it was inserted and the number of hours it was exposed outside, anyone of the following steps can be adopted.

• If the ring is exposed out for less than a time frame of 3 hours, then wash it with cold or slightly warm water and reinsert it carefully.
• If the ring is exposed for more than three hours, especially in the first or second week after insertion, then wash it with cold or lukewarm water and reinsert it. Additionally, as a precaution take contraceptive tablets for seven days. If your ring accidentally detaches soon after intercourse, then immediately take emergency contraceptive pills to avoid pregnancy.
• If the ring gets exposed for more than three hours during the third week after insertion, you can remain ring-free to complete your menstrual cycle or insert a new ring if you wish to avoid it.

Does Vaginal Ring Provide Protection Against Sexually Transmitted Diseases (STDs)?

The vaginal ring does not offer protection against sexually transmitted diseases. The use of a condom is compulsory if there is any scope for the transmission of such infections.

Vaginal Ring With Other Medicines

Some of the following medicines slightly seem to interfere with the functioning of the ring and bring down its efficiency. You can speak to your doctor before taking these medications if you are using the vaginal ring.

• Medications like antibiotics (rifampicin, rifamate, rifampin)
• Medications given for HIV
• Antifungal griseofulvin
• Some anti-epileptic medications
• John’s Wort

FAQs

1. When does the vaginal ring start working?

The vaginal ring offers effective protection seven days after insertion. If you insert it during the first day of your menstrual cycle, it offers protection from the day you insert it. When inserted on any other days, it has to be backed by an additional contraceptive for the first 7 days.

2. When can I use the vaginal ring after childbirth?

You can use the ring 21 days after your delivery. However, if you wish to breastfeed your baby, then it is advisable to start using the ring after at least 6 months postpartum, as the hormones in the ring reduce the milk flow.

3. When can I use the ring after an abortion or miscarriage?

You can use the vaginal ring immediately after a miscarriage or abortion.

4. Can I use the ring when breastfeeding?

Although it’s not harmful to use it while breastfeeding, the ring is known to hamper with the breast milk supply. Therefore, it is advisable to not use it until at least six months after delivery.

The vaginal ring is undoubtedly an effective contraceptive tool if used with diligence and proper care. You can talk to your gynaecologist to find out more about the ring and how you can start using it for preventing unintended pregnancy.

Also Read: Natural Birth Control Methods