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Contraceptive Vaginal Ring

Table of Contents

Contraceptive Vaginal Ring

Birth Control Vaginal Ring

A contraceptive vaginal ring is thin, flexible, and approximately 2 inches in diameter. It delivers a combination of ethinyl estradiol and a progestin when inserted into the vagina. There are two brands of birth control rings available in the U.S.: Annovera (yearly) and NuvaRing (monthly). Learn more about contraceptive vaginal rings.

Hormone Replacement Therapy Vaginal Ring

Image by TheVisualMD

Vaginal Ring

A medical illustration depicting the application of a vaginal ring.

Image by BruceBlaus

A medical illustration depicting the application of a vaginal ring.

A medical illustration depicting the application of a vaginal ring.

Image by BruceBlaus

Vaginal Contraceptive Ring

What is it?

It is a flexible ring that is about 2 inches around.
It releases two hormones (progestin and estrogen) to stop the ovaries from releasing eggs.
It also thickens the cervical mucus, which keeps sperm from getting to the egg.

Vaginal Contraceptive Ring - How Do I Use It?

You put the ring into your vagina.
Keep the ring in your vagina for 3 weeks and then take it out for 1 week. Your menstrual period should start during this ring-free week.
If the ring falls out and stays out for more than 3 hours, replace it but use another method of birth control, like a condom and spermicide, until the ring has been in place for 7 days in a row.

How do I get it?

You need a prescription from a healthcare provider.

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

Out of 100 women who use this method, about 9 may get pregnant.

Some Side Effects and Risks

Vaginal discharge, discomfort in the vagina, and mild irritation.
Headache
Mood changes
Nausea
Breast tenderness

Some Less Common Risks

It is not common, but some women who take the pill develop high blood pressure.
It is rare, but some women will have blood clots, heart attacks, or strokes.

Does it protect me from sexually transmitted infections (STIs)?

No.

Source: FDA Consumer Health Information

Additional Materials (3)

Vaginal Ring

A silicone vaginal ring identical to those used in the ASPIRE trial.

Image by NIAID

Dapivirine vaginal ring and tablets of oral PrEP medication

A clinical trial has begun to examine the safety and use of two HIV prevention tools—oral pre-exposure prophylaxis (PrEP) and a vaginal ring—in adolescent girls and young women in southern Africa. Funded by the National Institutes of Health, the trial is designed to contribute to the delivery of safe, effective and desirable choices of HIV prevention methods for adolescent girls and young women, who are disproportionately affected by the HIV epidemic.

Image by National Institutes of Health (NIH)

A medical illustration depicting the application of a vaginal ring.

A medical illustration depicting the application of a vaginal ring.

Image by BruceBlaus

Vaginal Ring

NIAID

Dapivirine vaginal ring and tablets of oral PrEP medication

National Institutes of Health (NIH)

A medical illustration depicting the application of a vaginal ring.

BruceBlaus

Instructions on Contraceptive Vaginal Ring

A medical illustration depicting the application of a vaginal ring.

Image by BruceBlaus

A medical illustration depicting the application of a vaginal ring.

A medical illustration depicting the application of a vaginal ring.

Image by BruceBlaus

Instructions on Contraceptive Vaginal Ring

Information for Contraceptive Vaginal Ring

The contraceptive ring contains both estrogen and progestin. The contraceptive ring is 98 percent to 99 percent effective when used correctly.

BENEFITS:

Fewer menstrual cramps and bleeding
Improvement in acne
Regular periods
Weight neutral
Less pain at ovulation
Reduced PMS symptoms

DECREASED RISK OF:

Ovarian or Endometrial cancer
Benign breast tumors or ovarian cysts
Ectopic pregnancy
Anemia

RISKS/SIDE EFFECTS:

Vaginal infections and irritation
Vaginal discharge/discomfort
Mood changes/depression (NuvaRing)
Spotting between periods
Nausea/Vomiting
Breast tenderness
Headaches
Decreased milk supply (if breastfeeding)
Worse acne (NuvaRing)
Change in libido

Cigarette smoking increases the risk of serious cardiovascular side effects from combination oral contraceptive use. This risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in women over 35 years of age. Women who use combination hormonal contraceptives, including NuvaRing, should be strongly advised not to smoke.

To decrease your chances of serious problems, you need to go to an emergency room, doctor, or clinic if you have any of the following symptoms:

A Abdominal pain (severe)

C Chest pain or shortness of breath

H Headaches (severe)

E Eye problems (blurred vision, flashing lights, or blindness)

S Severe leg pain (calf or thigh)

ALTERNATIVES: You have received written information about the other methods of birth control. For situations of suspected contraception failure, emergency contraception is available and offers a second chance to reduce the risk of unintended pregnancy.

INSTRUCTIONS: You have received information about the vaginal ring and how to use it. The vaginal ring does not protect against STIs (sexually transmitted infections) and HIV.

DECISION TO STOP USING: You may stop using the vaginal ring at any time. A woman is most likely to become pregnant if she or her partner does not use a method of birth control.

QUESTIONS: You may ask questions about the ring at any time and may contact the clinic with further questions.

Instructions for Contraceptive Vaginal Ring

Before the use of either vaginal ring and during the use of ANNOVERA, store unused vaginal rings at room temperature and out of direct sunlight.

After use, do not flush vaginal rings down the toilet. One ANNOVERA vaginal ring is designed to be used for one year and should be stored in the provided case in between insertions.

Speak to your medical provider about the proper timing of initial insertion/use and if you will need to use a backup method for 7 days.

No special accuracy is required for ring placement; absorption is fine anywhere in the vagina.

With clean hands, press the sides of the ring together between the thumb and the first (index) finger.

Press and hold the sides of the vaginal ring together for easier insertion into the vagina.

Choose a position that is comfortable to you for insertion. Helpful positions to ease insertion may include squatting or standing with one leg up.

Gently insert the folded vaginal ring into the vagina and use your index finger to push the ring in as far as it goes. When properly inserted, the ring should be entirely in the vagina and behind the pelvic bone.

The date and time of insertion should be noted so that the ring can be removed 21 days later at about the same time

When it is due for removal, wash and dry your hands and choose the position that is most comfortable for you. Place one finger into the vagina to hook the vaginal ring and then gently pull downward to remove it. The used vaginal ring should be disposed of in the trash; do not flush in the toilet.

NUVARING: The vaginal ring is inserted into the vagina, left in place for 3 weeks (21 days), and then removed for a “ring-free” week (7 days). At the end of the “ring-free” week, a woman inserts a new vaginal ring. Speak to your medical provider about insertion and removal timing to determine if “continuous cycling” is right for you. If you leave the ring in your vagina longer than 4 weeks, remove the ring, contact your medical provider for further direction, and check if you are pregnant.

NUVARING: Ring removal during intercourse is not recommended; however, women who want to remove it during intercourse may do so without having to use a backup method as long as it is not removed for longer than three hours. If the vaginal ring is out of your body for more than three hours during the 3-week period, contact your medical provider for direction.

NUVARING: Ring breakage has occurred when using a vaginal lubricant or treatment for infection. Talk to your medical provider about vaginal products and Nuvaring before use.

ANNOVERA: The vaginal ring is inserted into the vagina, left in place for 3 weeks (21 days), and then removed for a “ring-free” week (7 days). At the end of the “ring-free” week, a woman inserts her same vaginal ring as used before. One vaginal ring is used for one year (13 cycles). See proper cleaning instructions below.

ANNOVERA: Ring removal during intercourse is not recommended; however, women who want to remove it during intercourse may do so without having to use a backup method as long as it is not removed for longer than two hours. If the vaginal ring is out of your body for more than two hours during the 3-week period, contact your medical provider for direction.

ANNOVERA: Do not use any vaginal lubricants that have silicone or oil in them. Water-based lubricants are ok to use.

ANNOVERA Cleaning Instructions: Wash the vaginal ring with mild soap and lukewarm water, pat it dry, and store in the case provided. At the end of the ring-free interval, the vaginal system should be cleaned prior to being placed back in the vagina for another 21 continuous days (3 weeks).

Why is my vaginal ring uncomfortable?
Although some women may be aware of the vaginal ring in the vagina, most women do not feel it once it is in place. If you feel discomfort, the vaginal ring is probably not inserted back far enough in the vagina. Remove and reattempt insertion to ensure the vaginal ring is pushed into the vagina far enough. Use your finger to push the vaginal ring further into your vagina gently There is no danger of the vaginal ring being pushed too far up in the vagina or getting lost. The vaginal ring can be inserted only as far as the end of the vagina, where the cervix (the narrow, lower end of the uterus) will block the vaginal ring from going any further. Your medical provider can ensure proper placement before leaving the clinic if you desire.

Source: North Dakota Department of Health and Human Services

Estradiol Vaginal Ring

Estradiol Vaginal Ring

Also called: Estring®

Estring (estradiol vaginal ring) is a prescription vaginal ring that provides a low, continuous dose of estrogen for 90 days to help relieve vaginal dryness and inflammation due to menopause.

Estradiol Vaginal Ring

Also called: Estring®

Estring (estradiol vaginal ring) is a prescription vaginal ring that provides a low, continuous dose of estrogen for 90 days to help relieve vaginal dryness and inflammation due to menopause.

Estrogens increase the chance of getting cancer of the uterus.
Report any unusual vaginal bleeding right away while you are using Estring. Vaginal bleeding after menopause may be a warning sign of cancer of the uterine (womb). Your healthcare provider should check any unusual vaginal bleeding to find out the cause.
Do not use estrogens with or without progestins to prevent heart disease, heart attacks, strokes, or dementia.
Using estrogens with or without progestins may increase your chance of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with or without progestins may increase your risk of dementia, based on a study of women age 65 years or older.
You and your healthcare provider should talk regularly about whether you still need treatment with Estring.
Do not start using Estring if you:
- Have unusual vaginal bleeding
- Currently have or have had certain cancers. Estrogens may increase the chance of getting certain types of cancers, including cancer of the breast or uterus. If you have or had cancer, talk with your healthcare provider about whether you should use Estring.
- Had a stroke or heart attack in the past year
- Currently have or have had blood clots
- Currently have or have had liver problems
- Are allergic to any of the ingredients in Estring
- Think you may be pregnant
Tell your healthcare provider:
- If you are breastfeeding. The hormone in Estring can pass into your breast milk.
- About all of your medical problems. Your healthcare provider may need to check you more carefully if you have certain conditions, such as asthma (wheezing), epilepsy (seizures), migraine, endometriosis, lupus, or problems with your heart, liver, thyroid, kidneys, or have high calcium levels in your blood.
- About all the medicines you take. This includes prescription and nonprescription medicines, vitamins, and herbal supplements. Some medicines may affect how Estring works. Estring may also affect how your other medicines work.
- If you are going to have surgery or will be on bed rest. You may need to stop taking estrogens.
Side effects are grouped by how serious they are and how often they happen when you are treated.
Serious but less common side effects include:
- Breast cancer
- Cancer of the uterus
- Stroke
- Heart attack
- Blood clots
- Dementia
- Gallbladder disease
- Ovarian cancer
- High blood pressure
- Liver problems
- High blood sugar
- Enlargement of benign tumors of the uterus ("fibroids")
Some of the warning signs of these serious side effects include:
- Breast lumps
- Unusual vaginal bleeding
- Dizziness and faintness
- Changes in speech
- Severe headaches
- Chest pain
- Shortness of breath
- Pains in your legs
- Changes in vision
- Vomiting
- Yellowing of the skin, eyes or nail beds
Call your healthcare provider right away if you get any of these warning signs, or any other unusual symptom that concerns you.
Less serious but common side effects include:
- Headache
- Breast pain
- Irregular vaginal bleeding or spotting
- Stomach/abdominal cramps, bloating
- Nausea and vomiting
- Hair loss
- Fluid retention
- Vaginal yeast infection
These are not all the possible side effects of estrogens. For more information, ask your healthcare provider or pharmacist.
- Follow carefully the instructions for use.
- Talk with your healthcare provider regularly about whether you should continue using Estring.
- See your healthcare provider right away if you get vaginal bleeding while using Estring.
- If you have fever, nausea, vomiting, diarrhea, muscle pain, dizziness, faintness, or a sunburn-like rash on face and body, remove Estring and contact your healthcare provider.
- Contact your healthcare provider if you have difficulty removing the vaginal ring.
- Have a breast exam and mammogram (breast X-ray) every year unless your healthcare provider tells you something else. If members of your family have had breast cancer or if you have ever had breast lumps or an abnormal mammogram, you may need to have breast examinations more often.
- If you have high blood pressure, high cholesterol (fat in the blood), diabetes, are overweight, or if you use tobacco, you may have higher chances for getting heart disease. Ask your healthcare provider for ways to lower your chances for getting heart disease.
1. ESTRING (ESTRADIOL) RING [accessed on Jul 29, 2019]

These FAQs provide a summary of the most important information about Estradiol Vaginal Ring. If you would like more information or have any questions, talk to your healthcare provider.

Ethinyl Estradiol and Etonogestrel Vaginal Ring

Ethinyl Estradiol and Etonogestrel Vaginal Ring

Also called: NuvaRing®

NuvaRing is a hormonal birth control (contraceptive) device for women. It consists of a vaginal ring and two hormones (ethinyl estradiol and etonogestrel).

Ethinyl Estradiol and Etonogestrel Vaginal Ring

Also called: NuvaRing®

NuvaRing is a hormonal birth control (contraceptive) device for women. It consists of a vaginal ring and two hormones (ethinyl estradiol and etonogestrel).

Do not use NuvaRing if you smoke cigarettes and are over 35 years old. Smoking increases your risk of serious cardiovascular side effects (heart and blood vessel problems) from combination hormonal contraceptives (CHCs), including death from heart attack, blood clots or stroke. This risk increases with age and the number of cigarettes you smoke.
Hormonal birth control methods help to lower the chances of becoming pregnant. They do not protect against HIV infection (AIDS) and other sexually transmitted infections.
Do not use NuvaRing if you:
- smoke and are over 35 years old
- have or have had blood clots in your arms, legs, eyes, or lungs
- have an inherited problem with your blood that makes it clot more than normal
- have had a stroke
- have had a heart attack
- have certain heart valve problems or heart rhythm problems that can cause blood clots to form in the heart
- have high blood pressure that medicine can't control
- have diabetes with kidney, eye, nerve, or blood vessel damage
- have certain kinds of severe migraine headaches with aura, numbness, weakness, or changes in vision, or have any migraine headaches if you are over age 35
- have liver disease, including liver tumors
- take any Hepatitis C drug combination containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir. This may increase levels of the liver enzyme "alanine aminotransferase" (ALT) in the blood
- have unexplained vaginal bleeding
- are pregnant or think you may be pregnant. NuvaRing is not for pregnant women.
- have or have had breast cancer or any cancer that is sensitive to female hormones
- are allergic to etonogestrel, ethinyl estradiol or any of the ingredients in NuvaRing. See the list of ingredients in NuvaRing at the end of this leaflet.
Hormonal birth control methods may not be a good choice for you if you have ever had jaundice (yellowing of the skin or eyes) caused by pregnancy or related to previous use of hormonal birth control.
Tell your healthcare provider if you have ever had any of the conditions listed above. Your healthcare provider can suggest another method of birth control.
Before you use NuvaRing tell your healthcare provider if you:
- have any medical conditions
- smoke
- are pregnant or think you are pregnant
- recently had a baby
- recently had a miscarriage or abortion
- have a family history of breast cancer
- have or have had breast nodules, fibrocystic disease, an abnormal breast x-ray, or abnormal mammogram
- use tampons and have a history of toxic shock syndrome
- have been diagnosed with depression
- have had liver problems including jaundice during pregnancy
- have or have had elevated cholesterol or triglycerides
- have or have had gallbladder, liver, heart, or kidney disease
- have diabetes
- have a history of jaundice (yellowing of the skin or eyes) caused by pregnancy (also called cholestasis of pregnancy)
- have a history of scanty or irregular menstrual periods
- have any condition that makes the vagina become irritated easily
- have or have had high blood pressure
- have or have had migraines or other headaches or seizures
- are scheduled for surgery. NuvaRing may increase your risk of blood clots after surgery. You should stop using NuvaRing at least 4 weeks before you have surgery and not restart it until at least 2 weeks after your surgery.
- are scheduled for any laboratory tests. Certain blood tests may be affected by hormonal birth control methods.
- are breastfeeding or plan to breastfeed. Hormonal birth control methods that contain estrogen, like NuvaRing, may decrease the amount of milk you make. A small amount of hormones from NuvaRing may pass into your breast milk. Consider another non-hormonal method of birth control until you are ready to stop breastfeeding.
- have (or have ever had) an allergic reaction while using NuvaRing, including hives, swelling of the face, lips, tongue, and/or throat causing difficulty in breathing or swallowing (anaphylaxis and/or angioedema).
Tell your healthcare provider about all medicines and herbal products you take, including prescription and over-the-counter medicines, vitamins and herbal supplements.
Some medicines and herbal products may make hormonal birth control less effective, including, but not limited to:
- certain anti-seizure medicines (such as barbiturates, carbamazepine, felbamate, oxcarbazepine, phenytoin, rufinamide and topiramate)
- medicine to treat fungal infections (griseofulvin)
- certain combinations of HIV medicines, (such as nelfinavir, ritonavir, darunavir/ritonavir, (fos)amprenavir/ritonavir, lopinavir/ritonavir, and tipranavir/ritonavir)
- certain hepatitis C (HCV) medicines (such as boceprevir and telaprevir)
- non-nucleoside reverse transcriptase inhibitors (such as efavirenz and nevirapine)
- medicine to treat tuberculosis (such as rifampicin and rifabutin)
- medicine to treat high blood pressure in the vessels of the lung (bosentan)
- medicine to treat chemotherapy-induced nausea and vomiting (aprepitant)
- St John's wort
Use an additional barrier contraceptive method (such as a male condom with spermicide) when you take medicines that may make NuvaRing less effective. Since the effect of another medicine on NuvaRing may last up to 28 days after stopping the medicine, it is necessary to use the additional barrier contraceptive method for that long to help prevent you from becoming pregnant. While using NuvaRing, you should not use certain female barrier contraceptive methods such as a vaginal diaphragm, cervical cap or female condom as your back-up method of birth control because NuvaRing may interfere with the correct placement and position of a diaphragm, cervical cap or female condom.
Some medicines and grapefruit juice may increase the level of ethinyl estradiol in your blood if used together, including:
- the pain reliever acetaminophen
- ascorbic acid (vitamin C)
- medicines that affect how your liver breaks down other medicines (such as itraconazole, ketoconazole, voriconazole, fluconazole, clarithromycin, erythromycin, and diltiazem)
- certain HIV medicines (atazanavir/ritonavir and indinavir)
- non-nucleoside reverse transcriptase inhibitors (such as etravirine)
- medicines to lower cholesterol such as atorvastatin and rosuvastatin
Hormonal birth control methods may interact with lamotrigine, a medicine used for seizures. This may increase the risk of seizures, so your healthcare provider may need to adjust your dose of lamotrigine.
Women on thyroid replacement therapy may need increased doses of thyroid hormone.
Ask your healthcare provider if you are not sure if you take any of the medicines listed above. Know the medicines you take. Keep a list of them to show your doctor and pharmacist when you get a new medicine.
- Read the Instructions for Use at the end of this Patient Information that comes with your NuvaRing for information about the right way to use NuvaRing.
- Use NuvaRing exactly as your healthcare provider tells you to use it.
- NuvaRing is used in a 4-week cycle.
- While using NuvaRing, you should not use certain female barrier contraceptive methods such as a vaginal diaphragm, cervical cap or female condom as your back-up method of birth control because NuvaRing may interfere with the correct placement and position of a diaphragm, cervical cap or female condom.
- Ring breakage has occurred when also using a vaginal product such as a lubricant or treatment for infection. Use of spermicides or vaginal yeast products will not make NuvaRing less effective at preventing pregnancy.
- Use of tampons will not make NuvaRing less effective or stop NuvaRing from working.
- If NuvaRing has been left inside your vagina for more than 4 weeks (28 days), you may not be protected from pregnancy and you should see your healthcare provider to be sure you are not pregnant. Until you know the results of your pregnancy test, you should use an extra method of birth control, such as male condoms with spermicide, until the new NuvaRing has been in place for 7 days in a row.
- Do not use more than 1 NuvaRing at a time. Too much hormonal birth control medicine in your body may cause nausea, vomiting, or vaginal bleeding.
Your healthcare provider should examine you at least 1 time a year to see if you have any signs of side effects from using NuvaRing.
Some women miss periods on hormonal birth control, even when they are not pregnant. Consider the possibility that you may be pregnant if:
1. you miss a period and NuvaRing was out of the vagina for more than 3 hours during the 3 weeks (21 days) of ring use
2. you miss a period and waited longer than 1 week to insert a new ring
3. you have followed the instructions and you miss 2 periods in a row
4. you have left NuvaRing in place for longer than 4 weeks (28 days)
See "What is the most important information I should know about NuvaRing?"
NuvaRing may cause serious side effects, including:
Blood clots. Like pregnancy, combination hormonal birth control methods increase the risk of serious blood clots, especially in women who have other risk factors, such as smoking, obesity, or age greater than 35. This increased risk is highest when you first start using a combination hormonal birth control method or when you restart the same or different combination hormonal birth control method after not using it for a month or more. Talk with your healthcare provider about your risk of getting a blood clot before using NuvaRing or before deciding which type of birth control is right for you.
In some studies of women who used NuvaRing, the risk of getting a blood clot was similar to the risk in women who used combination birth control pills.
Other studies have reported that the risk of blood clots was higher for women who use combination birth control pills containing desogestrel (a progestin similar to the progestin in NuvaRing) than for women who use combination birth control pills that do not contain desogestrel.
It is possible to die or be permanently disabled from a problem caused by a blood clot, such as heart attack or stroke. Some examples of serious blood clots are blood clots in the:
To put the risk of developing a blood clot into perspective: If 10,000 women who are not pregnant and do not use hormonal birth control are followed for one year, between 1 and 5 of these women will develop a blood clot. The figure below shows the likelihood of developing a serious blood clot for women who are not pregnant and do not use hormonal birth control, for women who use hormonal birth control, for pregnant women, and for women in the first 12 weeks after delivering a baby.
Call your healthcare provider right away if you have:
- legs (deep vein thrombosis)
- lungs (pulmonary embolus)
- eyes (loss of eyesight)
- heart (heart attack)
- brain (stroke)
- leg pain that does not go away
- sudden shortness of breath
- sudden blindness, partial or complete
- severe pain or pressure in your chest
- sudden, severe headache unlike your usual headaches
- weakness or numbness in an arm or leg, or trouble speaking
- yellowing of the skin or eyeballs
Other serious risks include:
- Toxic Shock Syndrome (TSS). Some of the symptoms are much the same as the flu, but they can become serious very quickly. Call your healthcare provider or get emergency treatment right away if you have the following symptoms:
  sudden high fever
  vomiting
  diarrhea
  a sunburn-like rash
  muscle aches
  dizziness
  fainting or feeling faint when standing up
- allergic reaction, including hives, swelling of the face, lips, tongue, and/or throat causing difficulty in breathing or swallowing (anaphylaxis and/or angioedema)
- liver problems, including liver tumors
- high blood pressure
- gallbladder problems
- accidental insertion into bladder
- symptoms of a problem called angioedema if you already have a family history of angioedema
The most common side effects of NuvaRing are:
- tissue irritation inside your vagina or on your cervix
- headache (including migraine)
- mood changes (including depression, especially if you had depression in the past). Call your healthcare provider immediately if you have any thoughts of harming yourself.
- NuvaRing problems, including the ring slipping out or causing discomfort
- nausea and vomiting
- vaginal discharge
- weight gain
- vaginal discomfort
- breast pain, discomfort, or tenderness
- painful menstrual periods
- abdominal pain
- acne
- less sexual desire
Some women have spotting or light bleeding during NuvaRing use. If these symptoms occur, do not stop using NuvaRing. The problem will usually go away. If it doesn't go away, check with your healthcare provider.
Other side effects seen with NuvaRing include breast discharge; vaginal injury (including pain, discomfort, and bleeding) associated with broken rings; and penis discomfort of the partner (such as irritation, rash, itching).
Less common side effects seen with combination hormonal birth control include:
- Blotchy darkening of your skin, especially on your face
- High blood sugar, especially in women who already have diabetes
- High fat (cholesterol, triglycerides) levels in the blood
There have been reports of the ring becoming stuck to the vaginal tissue and having to be removed by a healthcare provider. Call your healthcare provider if you are unable to remove your NuvaRing.
Tell your healthcare provider about any side effect that bothers you or that does not go away. These are not all the possible side effects of NuvaRing. For more information, ask your healthcare provider or pharmacist. Call your healthcare provider for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
- Store NuvaRing at room temperature between 68°F to 77°F (20°C to 25°C).
- Store NuvaRing at room temperature for up to 4 months after you receive it. Throw NuvaRing away if the expiration date on the label has passed.
- Do not store NuvaRing above 86°F (30°C).
- Avoid direct sunlight.
- Place the used NuvaRing in the re-closable foil pouch and properly throw it away in your household trash out of the reach of children and pets. Do not flush your used NuvaRing down the toilet.
Keep NuvaRing and all medicines out of the reach of children.
1. NuvaRing® (etonogestrel/ethinyl estradiol vaginal ring) [accessed on Jul 28, 2019]
2. Ethinyl Estradiol and Etonogestrel Vaginal Ring. MedlinePlus/AHFS® Drug Information. [accessed on Oct 29, 2018]

These FAQs provide a summary of the most important information about Ethinyl Estradiol and Etonogestrel Vaginal Ring. The drug should not be used for a condition other than that for which it is prescribed. Do not give it to other people, even if they have the same symptoms that you have. It may harm them. If you would like more information or have any questions, talk to your healthcare provider.

Estradiol Acetate Vaginal Ring

Estradiol Acetate Vaginal Ring

Also called: Femring®

Femring is a prescription vaginal ring that contains estradiol (an estrogen hormone). It is used to relieve hot flashes and vaginal dryness that occurs in some women during menopause.

Estradiol Acetate Vaginal Ring

Also called: Femring®

Femring is a prescription vaginal ring that contains estradiol (an estrogen hormone). It is used to relieve hot flashes and vaginal dryness that occurs in some women during menopause.

- Using estrogen-alone may increase your chance of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are using Femring. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb). Your healthcare provider should check any unusual vaginal bleeding to find out the cause.
- Do not use estrogen-alone to prevent heart disease, heart attacks, strokes or dementia (decline in brain function).
- Using estrogen-alone may increase your chances of getting strokes or blood clots.
- Using estrogen-alone may increase your chance of getting dementia, based on a study of women 65 years of age or older.
- Do not use estrogens with progestins to prevent heart disease, heart attacks, strokes or dementia.
- Using estrogens with progestins may increase your chances of getting heart attacks, strokes, breast cancer, or blood clots.
- Using estrogens with progestins may increase your chance of getting dementia, based on a study of women 65 years of age or older.
- You and your healthcare provider should talk regularly about whether you still need treatment with Femring.
Femring is used after menopause to:
- reduce moderate to severe hot flashes
  Estrogens are hormones made by a woman’s ovaries. The ovaries normally stop making estrogens when a woman is between 45 and 55 years old. This drop in body estrogen levels causes the “change of life” or menopause, the end of monthly menstrual periods. Sometimes both ovaries are removed during an operation before natural menopause takes place. The sudden drop in estrogen levels causes “surgical menopause”.
  When estrogen levels begin dropping, some women get very uncomfortable symptoms, such as feelings of warmth in the face, neck, and chest, or sudden intense episodes of heat and sweating (“hot flashes” or “hot flushes”). In some women the symptoms are mild, and they will not need to take estrogens. In other women, symptoms can be more severe.
- treat moderate to severe menopausal changes in and around the vagina
  You and your healthcare provider should talk regularly about whether you still need treatment with Femring to control these problems. If you use Femring only to treat your menopausal changes in and around your vagina, talk with your healthcare provider about whether a topical vaginal product would be better for you.
You and your healthcare provider should talk regularly about whether you still need treatment with Femring.
Do not start using Femring if you:
- have unusual vaginal bleeding
  Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb). Your healthcare provider should check any unusual vaginal bleeding to find out the cause.
- currently have or have had certain cancers
  Estrogens may increase the chances of getting certain types of cancers, including cancer of the breast and uterus. If you have or have had cancer, talk with your healthcare provider about whether you should use Femring.
- had a stroke or heart attack
- currently have or have had blood clots
- currently have or have had liver problems
- have been diagnosed with a bleeding disorder
- are allergic to Femring or any of its ingredients
  See the list of ingredients in Femring at the end of this leaflet.
- think you may be pregnant
  Femring is not for pregnant women. If you think you may be pregnant, you should have a pregnancy test and know the results. Do not use Femring if the test is positive and talk to your healthcare provider.
Before you use Femring, tell your healthcare provider if you:
- have any unusual vaginal bleeding
  Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb). Your healthcare provider should check any unusual vaginal bleeding to find out the cause.
- have any problems with your vagina or cervix (lower end of your womb)
  Your healthcare provider may need to check you more carefully if your cervix, bladder, or rectum have fallen out of their normal position and into the vagina or through the opening of the vagina. This may make it more difficult for you to keep Femring in place in your vagina.
- have any other medical conditions
  Your healthcare provider may need to check you more carefully if you have certain conditions such as asthma (wheezing), epilepsy (seizures), diabetes, migraine, endometriosis, lupus, angioedema (swelling of face and tongue) or problems with your heart, liver, thyroid, kidneys, or have high calcium levels in your blood.
- are going to have surgery or will be on bed rest
  Your healthcare provider will let you know if you need to stop using Femring.
- are breastfeeding
  The hormones in Femring can pass into your breast milk.
Tell your healthcare provider about all the medicines you take, including prescription and nonprescription medicines, vitamins and herbal supplements. Some medicines may affect how Femring works. Femring may also affect how your other medicines work. Keep a list of your medicines and show it to your healthcare provider and pharmacist when you get a new medicine.
For detailed instructions, see the step-by-step instructions for using Femring at the end of the Patient Information that comes with your medicine.
- Use Femring exactly as your healthcare provider tells you to use it.
- Femring is inserted into your vagina by you.
- Femring should stay in your vagina for 90 days.
- After 90 days Femring should be removed. If you and your healthcare provider decide you should continue using Femring, a new Femring can be inserted.
- You and your healthcare provider should talk regularly (every 3 to 6 months) about the dose of medicine you are using and whether you still need treatment with Femring.
- toxic shock syndrome (TSS)
  Toxic shock syndrome is a rare but serious illness caused by a bacterial infection that may cause death. Remove your Femring immediately and call your healthcare provider right away if you have any of the following symptoms:
  ° fever
  ° nausea or vomiting
  ° diarrhea
  ° muscle pain
  ° dizziness
  ° feel faint
  ° a sunburn rash on your face or body
- attachment to your vaginal wall
  Contact your healthcare provider right away if you have difficulty removing Femring.
- accidental placement in your bladder
Side effects are grouped by how serious they are and how often they happen when you are treated.
Serious, but less common side effects include:
- heart attack
- stroke
- blood clots
- dementia
- breast cancer
- cancer of the lining of the uterus (womb)
- cancer of the ovary
- high blood pressure
- high blood sugar
- gallbladder disease
- liver problems
- changes in your thyroid hormone levels
- enlargement of benign tumors of the uterus (“fibroids”)
Call your healthcare provider right away if you get any of the following warning signs, or any other unusual symptoms that concern you:
- new breast lumps
- unusual vaginal bleeding
- changes in vision or speech
- sudden new severe headaches
- severe pains in your chest or legs with or without shortness of breath, weakness and fatigue
Less serious, but common side effects include:
- headache
- breast tenderness or pain
- irregular vaginal bleeding or spotting
- stomach or abdominal cramps, bloating
- nausea and vomiting
- hair loss
- fluid retention
- vaginal yeast infection
- reactions from inserting Femring such as burning, irritation, and itching
These are not all the possible side effects of Femring. For more information, ask your healthcare provider or pharmacist. Tell your healthcare provider if you have any side effects that bother you or does not go away.
- Talk with your healthcare provider regularly about whether you should continue using Femring.
- If you have a uterus, talk with your healthcare provider about whether the addition of a progestin is right for you. The addition of a progestin is generally recommended for a woman with a uterus to reduce the chance of getting cancer of the uterus (womb). See your healthcare provider right away if you develop vaginal bleeding while using Femring.
- Have a pelvic exam, breast exam and mammogram (breast x-ray) every year unless your healthcare provider tells you something else.
- If members of your family have had breast cancer or if you have ever had breast lumps or an abnormal mammogram (breast x-ray), you may need to have breast exams more often.
- If you have high blood pressure, high cholesterol (fat in the blood), diabetes, are overweight, or if you use tobacco, you may have a higher chance for getting heart disease.
  Ask your healthcare provider for ways of lowering your chances for getting heart disease.
- Store at room temperature 68º F to 77º F (20º C to 25º C).
KEEP FEMRING and all other medicines out of the reach of children.
1. Femring® (estradiol acetate vaginal ring) [accessed on Jul 29, 2019]

These FAQs provide a summary of the most important information about Estradiol Acetate Vaginal Ring. The drug should not be used for a condition other than that for which it is prescribed. Do not give it to other people, even if they have the same symptoms that you have. It may harm them. If you would like more information or have any questions, talk to your healthcare provider.

Segesterone and Ethinyl Estradiol Vaginal Ring

Segesterone and Ethinyl Estradiol Vaginal Ring

Also called: Annovera™

Annovera is a vaginal birth control system used to prevent pregnancy in women. This system consists of a vaginal ring and two hormones (segesterone acetate and ethinyl estradiol).

Segesterone and Ethinyl Estradiol Vaginal Ring

Also called: Annovera™

Annovera is a vaginal birth control system used to prevent pregnancy in women. This system consists of a vaginal ring and two hormones (segesterone acetate and ethinyl estradiol).

- Do not use Annovera if you smoke cigarettes and are over 35 years old. Smoking increases your risk of serious heart and blood vessel (cardiovascular) side effects from hormonal birth control methods, including death from heart attack, blood clots, or stroke. This risk increases with age and the number of cigarettes you smoke.
Annovera does not protect against HIV infection (AIDS) and other sexually transmitted infections (STIs).
Do not use Annovera if you:
- smoke and are over 35 years old.
- have or have had a blood clot in your arms, legs, lungs, or eyes.
- have had a stroke.
- have reduced blood flow to your brain (cerebrovascular disease).
- have reduced blood flow or blockage in 1 or more of the arteries that supply blood to your heart (coronary artery disease).
- have had a heart attack.
- have heart rhythm or heart valve problems that increase your risk of having blood clots, such as an infection of the inner lining of the heart and heart valves or a type of irregular heartbeat called atrial fibrillation.
- have a problem with your blood that makes it clot more than normal.
- have high blood pressure that is not controlled with medicine or have high blood pressure with blood vessel damage.
- have diabetes and are over 35 years old; have diabetes with high blood pressure or problems with your kidneys, blood vessels, eyes, or nerves; or have had diabetes for longer than 20 years.
- have headaches with changes in vision, numbness or weakness, have migraine headaches with aura, or are over age 35 years old and have any type of migraine headaches.
- have liver disease or liver tumors.
- have or have had breast cancer or any cancer that is sensitive to the female hormones estrogen or progesterone.
- have unexplained vaginal bleeding.
- are allergic to segesterone acetate, ethinyl estradiol, or any of the ingredients in Annovera. See the end of this leaflet for a complete list of ingredients in Annovera.
- take any Hepatitis C drug combination medicine containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir. This may increase levels of the liver enzyme alanine aminotransferase (ALT) in the blood.
Before you use Annovera tell your healthcare provider if you:
- have any of the conditions listed above.
- smoke.
- are pregnant or think you are pregnant.
- recently had a baby, miscarriage, or abortion.
- have breast problems such as an abnormal mammogram or breast x-ray, breast nodules, fibrocystic breast disease, or a family history of breast cancer.
- have any medical condition, especially migraine headaches, depression, seizures, diabetes, high blood pressure, high cholesterol or triglycerides, gallblalier disease, liver disease, heart disease, or kidney disease.
- have a family history of blood clots or stroke.
- have yellowing of the skin or eyes (jaundice).
- have a condition that makes your vagina become irritated easily.
- have a history of toxic shock syndrome.
- had gallblalier problems when you were pregnant.
- are scheduled for surgery. The hormones in Annovera may increase your risk of blood clots after surgery. You should stop using Annovera at least 4 weeks before you have surgery and not restart until at least 2 weeks after your surgery.
- are scheduled for any laboratory tests. Certain blood tests may be affected by hormonal birth control methods.
- are breastfeeding or plan to breastfeed. You should not use Annovera if you are breastfeeding. The hormones in Annovera may decrease your milk production. The hormones in Annovera pass into your breast milk. Talk with your healthcare provider about the best birth control method for you while breastfeeding.
Tell your healthcare provider about all medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
Some medicines, vitamins, and herbal supplements make hormonal contraception less effective, such as:
- anti-seizure medicines
- medicine used to treat fungal infections
- combinations of HIV medicines
- Hepatitis C (HCV) medicines
- non-nucleoside reverse transcriptase inhibitors
- medicine to treat tuberculosis
- medicine to treat high blood pressure in the vessels of the lung
- medicine to treat chemotherapy-induced nausea and vomiting
- St. John's wort
Talk to your healthcare provider if you take any of the medicines listed above to see if the specific medicine you take may make hormonal contraceptives less effective. Use a back-up or another birth control method when you take medicine that may make hormonal contraceptives less effective and for 28 days after stopping the medicine.
Do not use any vaginal products such as oil-based suppositories, oil-based creams, or oil-based gels while the vaginal system is in your vagina. Do not use any vaginal lubricants that have silicone or oil in them. Water-based lubricants are ok to use. Be sure to read the ingredients on the label carefully before you buy a vaginal lubricant.
Some medicines and grapefruit juice may increase the level of ethinyl estradiol in your blood if used together, including:
- the pain reliever acetaminophen
- ascorbic acid (vitamin C)
- types of medicines used to treat fungal infections
- HIV medicines
- non-nucleoside reverse transcriptase inhibitors
- medicines to lower cholesterol
Annovera may affect the way that lamotrigine (a medicine used to treat seizures) works and may increase the risk of seizures. Your healthcare provider may need to adjust your dose of lamotrigine.
Females who take thyroid hormone replacement medicine or corticosteroid replacement medicine may need increased doses of their thyroid hormone or cortisol medicines.
Ask your healthcare provider if you are not sure if you take any of the medicines listed above.
Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine. Talk to your healthcare provider before you start taking a new medicine.
Annovera is a hormonal birth control method that is used for 3 out of 4 weeks every month. The same vaginal system is reusable for up to 1 full year (1 year includes 13 cycles; each cycle is 28 days).
- Read the Instructions for Use at the end of this Patient Information that comes with Annovera for information about the right way to insert, remove, clean, store, and dispose of (throw away) Annovera.
- Use Annovera exactly as your healthcare provider tells you to use it.
Annovera can cause serious side effects, including:
- See: “What is the most important information I should know about Annovera?”
- blood clots. Like pregnancy, hormonal contraceptives increase the risk of serious blood clots, especially in women who have other risk factors, such as smoking, obesity, or age greater than 35. This increased risk is highest when you first start taking hormonal contraceptives and when you restart the same or different hormonal contraceptive after not using it for 4 weeks or more.
  It is possible to die or be permanently disabled from a problem caused by a blood clot, such as a heart attack or a stroke.Some examples of serious blood clots are blood clots in the:
  legs (deep vein thrombosis)
  lungs (pulmonary embolus)
  eyes (loss of eyesight)
  heart (heart attack)
  brain (stroke)
  Call your healthcare provider or get emergency medical care right away if you have:
  leg pain that does not go away
  sulien shortness of breath
  sulien changes in vision or blindness
  severe pain or pressure in your chest
  a sulien, severe headache unlike your usual headaches
  weakness or numbness in an arm or leg
  trouble speaking
- toxic shock syndrome (TSS). Some symptoms of TSS are the same as flu symptoms, but they can become serious very quickly. Call your healthcare provider or get emergency medical care right away if you have the following symptoms:
  sulien high fever
  vomiting
  diarrhea
  fainting or feeling faint when standing up
  a sunburn-like rash
  muscle aches
  dizziness
- liver problems, including liver tumors. Tell your healthcare provider right away if you have yellowing of your skin or eyes (jaundice).
- high blood pressure.
- gallblalier problems or worsening of a gallblalier problem you already have. You may have an increased risk of gallblalier problems with the use of Annovera if you had gallblalier problems when you were pregnant.
- changes in the sugar and fat (cholesterol and triglycerides) levels in your blood.
- headache. Tell your healthcare provider if you have new headaches that keep coming back, that do not go away, or are severe. Also tell your healthcare provider if your migraine headaches happen more often or are more severe than normal.
- irregular or unusual vaginal bleeding and spotting between your menstrual periods, especially during the first month of using Annovera, or the absence of menstrual periods (amenorrhea).
- depression.
- possible cancer in your cervix.
- swelling of your skin especially around your mouth, eyes, and in your throat (angioedema). Call your healthcare provider or get emergency medical care right away if you have a swollen face, lips, mouth, tongue, or throat as this may lead to difficulty swallowing or breathing. Your risk of having angioedema is higher if you have a history of angioedema.
- dark patches of skin on your forehead, cheeks, upper lip, and chin (chloasma). Your risk of getting chloasma with the use of Annovera is higher if you had chloasma during pregnancy. Women who tend to get chloasma should avoid spending a long time in sunlight, tanning booths, and under sunlamps while using Annovera. Use sunscreen if you have to be in the sunlight.
The most common side effects of Annovera include:
- headache, including migraine
- nausea/vomiting
- vaginal yeast infection (candidiasis)
- lower/upper abdomen pain
- painful periods
- vaginal discharge
- urinary tract infection
- breast pain/tenderness
- irregular vaginal bleeding
- diarrhea
- genital itching
This is not a complete list of possible side effects. Call your healthcare provider for medical advice about side effects.
No serious problems have been reported from a hormonal contraceptive overdose.
1. ANNOVERA™ (segesterone acetate and ethinyl estradiol vaginal system) [accessed on Jan 29, 2019]
2. FDA Drug Approvals and Databases - Drug Trial Snapshot: ANNOVERA [accessed on Jan 29, 2019]
3. FDA NEWS RELEASE: FDA approves new vaginal ring for one year of birth control [accessed on Aug 13, 2018]

These FAQs provide a summary of the most important information about Segesterone and Ethinyl Estradiol Vaginal Ring. If you would like more information or have any questions, talk to your healthcare provider.

Nuvaring

Vaginal Ring within Vagina

Image by TheVisualMD

Vaginal Ring within Vagina

Three-dimensional visualization reconstructed from scanned human data. Lateral view of vaginal ring; Cross-section of vagina, cervix, uterus, and portions of rectum and bladder are visible. A vaginal ring can be used to deliver birth control or hormone replacement therapy, and might be used in the future to deliver microbicides to prevent HIV and other sexually transmitted diseases.

Image by TheVisualMD

The Vaginal Ring (Nuvaring)

What is the vaginal ring?

The vaginal contraceptive ring (Nuvaring) is a small, flexible, plastic ring that is placed into the vagina to prevent pregnancy.

How does the vaginal ring work and does it work well?

The ring contains the same hormones found in most birth control pills. The hormones stop the ovaries from releasing eggs (ovulation). If no egg is released, you cannot get pregnant. The hormones also cause the cervical mucus to thicken and block sperm from meeting with and fertilizing an egg.

How well does it work?

The ring is 91-94% effective if used the right way.

Source: Alabama Medicaid

Who Should Use

Vaginal birth control device NuvaRing

Image by User:Sakky

Vaginal birth control device NuvaRing

Vaginal birth control device NuvaRing

Image by User:Sakky

The Vaginal Ring (Nuvaring) - Is There Anyone Who Should Not Use the Vaginal Ring?

You should not use the vaginal ring if:

You have high blood pressure
You have ever had a heart attack, stroke or blood clots
You have ever had breast cancer
You have unexplained vaginal bleeding
You have migraines
You are pregnant
You have diabetes with kidney, eye, nerve or blood vessel damage
You have liver disease or liver tumors Smoking increases your risk of serious side effects. Women who use birth control methods with hormones should not smoke. This includes electronic cigarettes.

Source: Alabama Medicaid

Side Effects

NuvaRing in hand

Image by Sakky/Wikimedia

NuvaRing in hand

Vaginal birth control device NuvaRing

Image by Sakky/Wikimedia

What Are the Possible Side Effects of the Vaginal Ring?

Most women can use the ring without having any problems. The most common side effects of the vaginal ring are similar to the birth control pill and include breast tenderness, nausea, headache, vaginal discharge, vaginal irritation and breakthrough bleeding. Serious problems are rare. There is a very slight risk of blood clots, heart attacks, toxic shock syndrome, and strokes.

Source: Alabama Medicaid

Additional Materials (1)

A medical illustration depicting the application of a vaginal ring.

A medical illustration depicting the application of a vaginal ring.

Image by BruceBlaus

A medical illustration depicting the application of a vaginal ring.

BruceBlaus

Problem?

headache

Image by r. nial bradshaw

headache

migraine-headache-pain

Image by r. nial bradshaw

How Do I Know If I Have a Problem From Using the Ring?

If you have any of the warning signs, call your doctor, nurse or clinic right away:

Leg pain, swelling and redness
Weakness or numbness on one side of your body
Bad headache
Vision problems
Chest pain

Source: Alabama Medicaid

Starting Using

Hormone Replacement Therapy Vaginal Ring

Image by TheVisualMD

Hormone Replacement Therapy Vaginal Ring

Three-dimensional visualization reconstructed from scanned human data. Anteriolateral view of female pelvis and reproductive organs, with inserted vaginal ring for delivery of hormone replacement therapy. Estrogen replacement therapy in menopausal women, despite the controversy over its general health effects, does lead to definite improvements in sexual response, particularly by increasing vaginal lubrication and wall thickness. It is available in many forms, from pills and injections to skin patches and vaginal suppositories, gels, and rings. Some of these treatment regimens increase hormone levels throughout the body. Others have a more localized response that can be an advantage for women who are worried about systemic side effects or increase in cancer risk. In general, the recommendations for hormone replacement therapy in men and women are similar. Use them, doctors say, if the symptoms require it, but if you don't need them, it's best to let your body have its way. Many individuals maintain healthy sexual function long after the onset of menopause, but for those who don't, hormone replacement therapy can help to improve the quality of their sexual life.

Image by TheVisualMD

How Do You Start and Use the Vaginal Ring?

There are 2 ways to start the ring:

Quick Start: put in your first ring as soon as you get the pack.
Next period: put in your first ring soon after your next period begins.
If you put your first ring in up to 5 days after the start of your period, you are protected against pregnancy right away.
If you put your first ring in more than 5 days after the start of your period, you should use condoms as back up for the first 7 days.

Source: Alabama Medicaid

How to Use

A medical illustration depicting the application of a vaginal ring.

Image by BruceBlaus

A medical illustration depicting the application of a vaginal ring.

A medical illustration depicting the application of a vaginal ring.

Image by BruceBlaus

How Do You Use the Vaginal Ring?

Squeeze the ring between your thumb and index finger and gently push it into your vagina (the exact position inside the vagina is not important). Use back-up birth control (like a condom) for the first seven days after you insert the vaginal ring. Leave the ring in place for three weeks (21 days) and then remove it for one week (7 days). Your period will occur during the week the vaginal ring is out. After the off week, just start over and put a new ring in and leave in for three weeks.

Extended cycling of rings:

Bicycling is using the first ring for three weeks, removing and immediately placing a new ring for three weeks, then removing the ring for cycle on the 7th week.
Tricycling is using the first ring for three weeks, removing and immediately placing a new ring for three weeks, removing and immediately placing a new ring for three more weeks then removing the ring for cycle on the 10th week.

You can leave the ring in place while having sex. If the ring falls out for any reason and you are not able to put it back within three hours, another birth control method will be needed until the ring has been in place for seven days. You will need to use a back up method such as condoms for 7 days.

Source: Alabama Medicaid

Unprotected Sex

Female Pelvis Showing Contraceptive Ring within Vagina

Image by TheVisualMD

Female Pelvis Showing Contraceptive Ring within Vagina

Three-dimensional visualization reconstructed from scanned human data. Anterior view of female pelvis and reproductive organs, showing proper placement of a contraceptive ring within the vagina. A contraceptive ring is a female hormonal contraceptive device that is inserted into the vagina; it releases hormones that stop the ovary from releasing an egg, so that pregnancy does not occur. It also causes the cervical mucous to thicken, making it more difficult for sperm to enter the uterus, and changes the lining of the uterus, preventing implantation of a fertilized egg. The contraceptive ring is only available with a prescription. When used correctly, it has a failure rate of 1 - 2%. It offers no protection against STDs.

Image by TheVisualMD

What If I Stopped Using the Vaginal Ring and Had Unprotected Sex?

Take Emergency Contraception (EC) right away. EC can prevent pregnancy up to 5 days after sex, and it works better the sooner you take it. You can get EC at the pharmacy without a prescription or at your county health department family planning clinic or doctor’s office.

Source: Alabama Medicaid

Where to Get

Contraceptive Ring

Image by TheVisualMD

Contraceptive Ring

Anterior view of a contraceptive ring. A contraceptive ring is a female hormonal contraceptive device that is inserted into the vagina; it releases hormones that stop the ovary from releasing an egg, so that pregnancy does not occur. It also causes the cervical mucous to thicken, making it more difficult for sperm to enter the uterus, and changes the lining of the uterus, preventing implantation of a fertilized egg. The contraceptive ring is only available with a prescription. When used correctly, it has a failure rate of 1 - 2%. It offers no protection against STDs.

Image by TheVisualMD

Where Can I Get the Vaginal Ring?

You need a prescription. You can buy the vaginal ring at your local drug store or get it at the health department clinic.

REMEMBER:

The vaginal ring does not protect against sexually transmitted infections (STIs) or human immunodeficiency virus (HIV). Protect yourself; use a condom every time you have oral, vaginal or anal sex.
Certain antibiotics and herbal medications such as St John’s wort may make the vaginal ring less effective.

Source: Alabama Medicaid

Related HealthJournals

Intrauterine Contraceptive Device

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Oral Contraceptives

Oral contraceptives, or birth control pills, are hormone-containing medications that are taken by mouth to prevent pregnancy. There are two main kinds: combined pills, which contain estrogen and progestin, and mini-pills, which only contain progestin. Learn about the advantages and disadvantages of taking the pill, and how to take it properly.

Teen Sexual Health

Sexual development is a normal part of the teen years. Your teens needs your help in understanding their feelings, peer pressure, and how to say no if they do not want to have sex. If your teens start having sex, they need to know how to prevent pregnancy and sexually transmitted diseases. Learn ways parents can help their teen avoid sexual risk behaviors.

Contraception

Contraception, or birth control, is the use of medicines, devices, or surgery to prevent pregnancy. There are many different types. Some are reversible, while others are permanent. Some types can also help prevent sexually transmitted diseases (STDs). Read about the different options, and their risks and benefits.

Emergency Contraception

Emergency contraception can help prevent pregnancy in women who had sex without using birth control, whose birth control method failed, and who were sexually assaulted. Emergency contraceptives prevent pregnancy by stopping release of the egg from the ovary and by blocking sperm's access to the egg. Read more about emergency contraception.

Vasectomy

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Male Condom

A male condom is a thin sheath that covers the penis to collect sperm and prevent it from entering the woman's body. They can also help protect against sexually transmitted diseases. Male condoms are generally made of latex or polyurethane, but a natural alternative is lambskin (made from the intestinal membrane of lambs). Get the facts on male condoms.

Female Condom

The female condom is a thin, soft, loose-fitting pouch (or sheath) with a flexible soft ring on each end. One end of the female condom fits inside of the vagina to keep it in place, and the other stays outside of the vagina. Learn more about female condoms and how to use it the right way.

Fertility Awareness as Birth Control

Fertility awareness-based methods for birth control, sometimes known as natural family planning or the rhythm method, are a way of finding out the days you are most likely to get pregnant and then not having sex on those days. It means paying close attention to your menstrual cycle to track when your body releases an egg. Learn how it works.

Unplanned Pregnancy

Unplanned pregnancy is common. About 1 in 2 pregnancies in America are unplanned. Ideally, a woman who is surprised by an unplanned pregnancy is in good preconception health and is ready and able to care for a new child. But this sometimes isn't the case. Know your options.

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Contraceptive Vaginal Ring

A contraceptive vaginal ring is thin, flexible, and approximately 2 inches in diameter. It delivers a combination of ethinyl estradiol and a progestin when inserted into the vagina. There are two brands of birth control rings available in the U.S.: Annovera (yearly) and NuvaRing (monthly). Learn more about contraceptive vaginal rings.

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