The birth control ring contains the hormones estrogen and progestin, which enter a person’s body via absorption through the vaginal lining.
These hormones do the following:
- stop ovulation, so the ovaries do not release eggs
- thicken the cervical mucus, making it more difficult for sperm to travel
- thin the uterine lining, making it difficult for a fertilized egg to implant
How long does the birth control ring take to begin working?
According to the United Kingdom’s National Health Service (NHS), the birth control ring should begin working straight away if a person starts using it from day 1 to 5 of their period.
A person will need to use other forms of contraception, such as condoms, for 1 week if they begin using the ring after day 5 of their period.
NuvaRing
The NuvaRing contains ingredients called etonogestrel and ethinyl estradiol.
A person wears the ring continually for 3 weeks and then removes it for 1 week. During the week-long break, a withdrawal bleed can occur. A person will then replace the ring with a new one.
A person can also wear the NuvaRing to safely skip a withdrawal bleed if they would like to.
Annovera
The Annovera ring contains segesterone acetate and ethinyl estradiol.
A person wears this ring continuously for 21 days and then removes it for a 1-week interval. During this time, a withdrawal bleed may occur. A person can do this for 13 cycles before needing to replace the ring with a new one.
It is important for a person to gently cleanse the vaginal ring with mild soap and water after they remove the ring and before they reinsert it.
When a person uses it correctly, the birth control ring is highly effective at preventing conception.
The NHS states that if a person follows the instructions exactly and consistently, the estimated efficacy rate is 99%. If not, the estimated efficacy rate is 91%.
What can make the birth control ring less effective?
In addition to not following the instructions, other factors that can make using the birth control ring less effective include:
- using certain medications and herbal remedies
- leaving the ring out for too long
- forgetting to re-insert a new ring
- exposing the birth control ring to high temperatures or direct sunlight
- not reinserting the ring soon enough if it falls out
The following are steps for using a birth control ring:
- Check the package to ensure the ring has not expired.
- Wash the hands with soap and water.
- Remove the ring from the wrapper.
- Squeeze the sides of the ring together so that it forms an oval shape.
- Insert the ring deep into the vagina.
The exact placement of the ring is not important. However, if the person can feel the ring when they walk, they have not inserted it deep enough.
To remove the ring, hook a finger through it and pull it out.
The ring will not become lost in the vagina, and it can remain in place during any physical activity, including sex.
What to do if a person makes a mistake using the birth control ring
Common birth control ring mistakes include:
- leaving the ring out of the vagina for more than 2 hours at a time
- removing the ring often enough that the removal time adds up to more than 2 hours during the 21 days for which a person should wear it
- forgetting to insert a ring after the ring-free week
In these cases, a person can use backup birth control until their birth control ring has been in place for 7 days. If intercourse has occurred during this time, a person can consider emergency contraception.
There may also be an increased risk of breast cancer for people using contemporary hormonal contraceptives, according to a
When to seek medical help
A person should seek emergency medical help if they experience:
- pain in the back of the lower leg
- crushing, sharp, or sudden chest pain or heaviness
- shortness of breath
- sudden and severe headache, dizziness, diarrhea, or vomiting
- fainting or feeling faint upon standing
- problems speaking
- limb weakness or numbness
- vision changes
- dark patches on the chin, lip, cheek, or forehead
- skin or eye yellowing
- appetite loss
- dark urine
- pale stool
- extreme fatigue
- weakness
- sudden high fever
- rash, hives, or itching
- muscle aches
- swelling of the hands, feet, lower legs, or ankles
- mood or sleep changes
It also suggests people should not use the birth control ring if they have previously experienced or currently have the following medical conditions:
A birth control ring requires a prescription, which a person can then bring to pharmacy or drug store.
What to discuss with a doctor
Before issuing a prescription for a a birth control ring, a doctor or nurse will conduct an exam and review a person’s medical history to determine whether this method of contraception is suitable for them.
Anyone interested in trying the birth control ring can ask their doctor for information regarding:
- suitability
- efficacy
- side effects
- risks
- usage instructions
Knowing what to expect can make it easier for a person to use a new birth control method and make them aware of when they may need to contact their doctor about possible problems.
When discussing the birth control ring with a doctor, a person will also need to make the doctor aware of the following:
When to call after insertion
A person may need their doctor’s guidance after they have started using the birth control ring. Reasons to speak with a doctor after insertion include:
- absence of expected menstruation
- unexpected, persistent, or intolerable side effects
- removal of the ring for longer than 2 hours during the time when the person is meant to wear it
If a person is in doubt, a doctor can offer clarification and help manage any issues that may arise.
Most insurance plans cover the cost of birth control rings.
- $0 to $200 every 5 weeks for the NuvaRing
- $0 to $2,200 each year for Annovera
There may also be government programs or Planned Parenthood health centers a person can access for help with cost reduction.
When can a person use the vaginal birth control after giving birth?
A person can use the birth control ring 21 days after giving birth. However, the birth control ring can affect a person’s milk supply, so it is important to not use this form of contraception if a person is considering nursing.
When do fertility levels return to “normal”?
A person’s fertility levels usually return to their previous levels within 1 to 3 months after they stop using the ring.
Can the ring fall out on its own?
A birth control ring can fall out in various situations, such as during sexual intercourse, bowel movements, and tampon removal. It can also fall out if it breaks.
What should I do if the vaginal ring falls out?
A person can rinse and reinsert their birth control ring if they notice it has slipped out. However, if the ring has been out of the vagina for longer than 2 hours, the person will need to wear backup contraception for 1 week.
Can my sexual partner feel the ring?
A person should not be able to feel the ring during sexual intercourse. However, if either person can feel the ring, they can move it around until it feels comfortable.
If this is bothersome, the person can remove it, then rinse and reinsert it immediately afterward. It is important to not leave the ring out of the vagina for more than 2 hours.
Does the birth control ring protect against STIs?
Neither Annovera nor the NuvaRing prevent a person from contracting STIs. However, a person can use an STI-protective barrier method such as a condom while using a birth control ring.
Vaginal rings that offer STI protection may be available in the future. A 2022 phase I clinical trial tested intravaginal rings (IVRs) that contained both contraceptives and antiretrovirals as a type of multipurpose prevention technology (MPT).
The findings suggested that there is a demand for MPT IVRs that prevent both contraception and STIs.
Is the ring better than the pill?
Whether the ring is “better” than the pill depends on a person’s personal preferences. Both types use hormones to prevent pregnancy and are equally effective.
A birth control ring may be a good option for people who do not want to have to remember to take a daily pill. However, progestin-only oral contraceptives can be useful for people who do not want to take estrogen.
The birth control ring is a thin, flexible plastic ring a person inserts into their vagina that contains hormones to prevent pregnancy. These rings are highly effective at preventing conception. However, they do not protect against STIs.
The hormones in the birth control ring can produce side effects, and this type of birth control is not suitable for everyone. A person’s doctor can review their medical history to determine whether the birth control ring is safe for them.
Most insurance plans cover the cost of the birth control ring. Anyone wishing to try the birth control ring can get one at a pharmacy with a prescription from their doctor.
