Vaginal ring

About the vaginal ring

The vaginal ring is a small, soft plastic ring that is placed inside your vagina. It’s about 4mm thick and 5.5cm in diameter. Used correctly, it is over 99% effective but does not protect against STIs.

How it works

The ring releases two hormones (oestrogen and progestogen), similar to those naturally released by the ovaries, this:

• Prevents ovulation (when a woman releases an egg)
• Thickens the mucus at the entrance to the womb, making it hard for sperm to pass and reach an unfertilised egg
• Thins the lining of the womb to make it harder for a fertilised egg to grow

How to use it

You can start using the vaginal ring at any time. However, you will only be protected against pregnancy when it is used correctly and started on the first day of your menstrual cycle. Otherwise, you will need to use additional contraception, such as condoms, for the first seven days.

Once in, leave it for 21 days. On the 22nd day, remove it and leave it out for seven days, during which time you will be protected against pregnancy. You then repeat the cycle. During this seven day break, you will have a bleed.

To insert the ring, (with clean hands) squeeze the ring between your thumb and finger, and gently insert the tip into your vagina. Gently push the ring up into your vagina until it feels comfortable.

To remove the ring, (again with clean hands) put a finger into your vagina and hook it around the edge of the ring. Gently pull the ring out. Put it in the special bag provided and throw it in the bin – don’t flush it down the toilet.

If you forget to remove the ring after 21 days, what you should do depends on how much extra time the ring has been left in.

• Up to seven days extra: remove the ring as soon as you remember. Start your seven day break. Begin a new ring after the your seven day break as normal. You’re still protected against pregnancy
• More than seven extra days: remove the ring as soon as you remember. Put a new ring in straight away and use condoms for the next seven days. If you have had sex without a condom during this time, you may need emergency contraception

If you forget to put a new ring in, put one in as soon as you remember. You’ll need to use additional contraception, such as condoms, for seven days.

If the ring has come out on its own, it’s probably best to talk to your doctor, or nurse, about what to do and whether you’ll be protected against pregnancy. Alternatively, you can follow the link at the bottom of this page for more information on what to do.

Who can use it

You may not be able to use the vaginal ring if you:

• Have had a blood clot in a vein or artery
• Have had heart or circulatory problems, including high blood pressure
• Are 35 or older and smoke, or have stopped smoking in the past year
• Have severe migraines with aura (warning symptoms)
• Have (or have had) breast cancer in the last five years
• Have diabetes with complications
• Are overweight
• Have vaginal muscles that can’t hold a vaginal ring
• Take certain medicines. Your doctor or nurse will confirm this

Advantages

There are many advantages to using a vaginal ring:

• Easy to put in and remove
• You don’t have to think about it every day, or each time you have sex
• Not affected if you vomit, have diarrhoea or any conditions that affect your gut like Crohn’s disease
• May help with mood swings and symptoms that occur before your period
• Monthly bleeding is usually lighter, more regular and less painful
• May reduce the risk of cancer of the ovary, uterus and colon as well as fibroids, ovarian cysts and noncancerous breast disease

Disadvantages

It’s also worth bearing in mind that, with a vaginal ring:

• Spotting and bleeding can rarely occur in the first few months while the ring is inserted
• It may cause temporary side effects including increased vaginal discharge, headaches, nausea, breast tenderness and mood changes
• May cause serious side effects (although not common) including blood clots, heart and stroke
• Some medicines may stop the vaginal ring from working properly. To check, ask your GP, practice nurse or pharmacist or read the patient information leaflet that comes with your medicine
• You and/or your partner may feel the ring during sex. However, most couples report that this enhances their sex lives!

Where to get it

Most types of contraception are free in the UK, and are available to all women and men through the NHS. Places where you can get contraception include:

• Most GP surgeries – talk to your GP or practice nurse
• Sexual health clinics like those run by Virgin Care, which offer both contraceptive and STI services. If you’d like to, you can book an appointment now
• Community contraception clinics
• Some genitourinary medicine (GUM) clinics

You can get a vaginal ring from contraception or sexual health clinics and most GP surgeries.

We do not offer the facility to book vaginal rings online. Please contact your local service on 0300 330 1122 or 0300 303 8565 so that they can assist you with this. Please note, we do not fit vaginal rings during walk in clinics.

Useful links

• The Family Planning Association’s has an excellent Guide to the Vaginal Ring. This contains more information on using it, risks and frequently asked questions
• NHS Choices provide information on all the different contraceptive methods including the vaginal ring
• Brook has more information and advice on contraception written for people under 25, including the vaginal ring