Contraceptive Vaginal Ring: Application, Cons and Pros

What is It?

Hormonal vaginal contraceptive ring is a relatively new method of protection against unwanted pregnancy, which is becoming even more popular than usual oral contraceptives. In contrast to pills, the ring is applied every few weeks, and thus it is less likely to forget to apply it. Moreover, using the ring significantly reduces risk of side effects because hormones are not included in digestive tract, and do not affect liver and stomach.

Hormonal contraceptive ring is a circle 8,5 mm thick. Circle diameter is 55 mm. One ring is used for one menstrual cycle. The form of the contraceptive ring adapts to vagina physiological structure and, therefore, does not cause discomfort. At home, without doctor’s help, it’s easily entered independently. Within three weeks contraceptive ring in vagina by body temperature gives small doses of progestogen and estrogen, which are absorbed through mucosa and penetrate blood. Contraceptive effect of these hormones is to suppress ovulation.

contraception

After 21 days of application, you need to remove the ring for menstruation period. After 7 days you are to apply a new ring. In case when the ring was accidentally removed from vagina for two – three hours, during this time contraceptive effect persists, however, it is necessary to introduce new ring as soon as possible. If it has already been more than three – four hours, it is necessary during the following week to use barrier contraceptives along with hormonal ring, to avoid unwanted pregnancy.

If the ring was removed for more than three hours, during 14th – 21st day of application, it is necessary to extend its use for more than three weeks (seven days after its re-introduction). If the means was inside for more than 21 days but less than 28, then a woman must take a 7-days break, and then apply a new one.

If contraceptive ring acts for more than 28 days in the body, then its efficiency is reduced. Body’s ability to conceive is fully restored one month after the ring cancellation.

This type of contraception is convenient in that women’s activity is not limited: she can play sports, take baths, etc. Before sexual intercourse gynecologists recommend to remove the ring, but often this recommendation is not followed, because it does not interfere with sex, does not reduce libido and sensitivity.

The main advantage of this means of protection is no negative effect on blood coagulability and liver function (unlike oral contraceptives).

Before using hormonal rings, you need to consult a gynecologist.

It is worth remembering that contraceptive ring can’t protect from sexually transmitted infections. Lack of sexual infections and constant partner are mandatory conditions for using hormonal contraception.

In case of hypersensitivity, a woman may feel some discomfort when foreign body is in vagina.

Efficiency

Vaginal rings are considered a highly effective contraception, if carefully follow rules of their application. Failure rate at their application is comparable with failure rate at oral contraceptives reception. Statistics show that of 1000 women who correctly apply this means of protection, only three observe pregnancy. Among women who violate terms of ring insertion and removal, 8 out of 1000 get pregnant.

After Abortion

After abortion hormonal circle can be used immediately. No additional contraceptive measures are required.

After Childbirth

After giving birth hormonal vaginal circle can be used only if a woman is not breastfeeding – from fourth week after labor. If a woman starts to apply the ring from 5 – 6 weeks, then she will need to use barrier methods of protection during the following week.

If, however, before the circle introduction there has already appeared sexual intercourse without condom, then hormonal contraception should be postponed until menstruation comes. It is advisable to immediately confirm absence of pregnancy – some highly sensitive tests can show positive result on the first 7 days of pregnancy.

Continuous use of hormonal ring can be carried out during a year. Then it is necessary to undergo preventive examination by gynecologist. In case if doctor did not reveal any adverse change, vaginal ring use can be extended.

Contraindications:

  • diabetes;
  • hepatic diseases (hepatitis, tumors);
  • breast cancer;
  • blood clotting violations;
  • thrombosis;
  • neurological disorders, migraines;
  • blood stroke, heart attacks in anamnesis;
  • age up to 18 years;
  • pregnancy;
  • lactation period.

It is undesirable to use contraceptive rings for women older than 35 years that smoke a lot. With great caution they are used at uterine cervix prolapse, obesity, chronic constipation.

Disadvantages:

  • contraceptionchanges in menstrual discharge nature;
  • lactation suppression;
  • dizziness, nausea;
  • breast pains;
  • protection from pregnancy only, but not against sexually transmitted diseases.

Advantages:

  • used only once every few weeks, instead of every day;
  • simple and easy administration without doctor’s help;
  • no effect on libido, sensitivity, sensations during sexual intercourse;
  • vomiting or diarrhea will not affect contraceptive ring effectiveness;
  • PMS relief;
  • reduced risk of uterus, ovaries, colon oncological diseases;
  • reduced risk of ovarian cysts, fibroids, benign thoracic glands tumors.

Risks at Use

Side effects are extremely rare, and these possible disadvantages are easily outweighed by advantages of hormonal contraception.

Very rarely there may be:

  • arterial thrombosis;
  • venous thrombosis;
  • cardiac angina;
  • blood stroke.

Thrombosis in anamnesis is a contraindication to use hormonal circle.

Risk of thrombosis at hormonal vaginal ring application is enhanced by conducting sedentary lifestyle, smoking, diabetes, hypertension, obesity, migraines.

When should You Visit Doctor?

If there are some of the following symptoms, you should immediately consult a doctor:

  • dyspnea;
  • severe fatigue and numbness of extremities;
  • chest pains, worsening at breathing movements;
  • feet swelling;
  • migraines;
  • eyes whites or skin yellowing;
  • severe abdominal pains;
  • sudden blurred vision.

It is possible that these symptoms appearance may be associated with hormonal contraceptive circle usage.

If you are to have surgery, or there was an accident, which limited your ability to move – you should tell your doctor about using hormonal contraceptives. Your doctor will decide whether you need to stop using contraceptives, or simply prescribe a course for thrombosis prevention.

Weight Gain – True or Myth?

Sometimes women complain that while using hormonal contraceptives they gain weight. However, clinical studies have not confirmed this fact. Weight changes are rather possible due to the fact that during menstrual cycle there is fluid retention in the body.

Application Rules

There are a few rules for application that you need to remember: if in course of the last 30 days you did not use hormonal contraception, you will need to introduce vaginal circle on 1st – 5th day of menstruation (even if hemorrhages last more than 5 days, introduction is still should be carried out not later than on the 5th day). In this case, you need to use additional non-hormonal contraception for a week. And in the following cycles extra contraception is not required.

If you previously used oral contraceptives, and now want to switch to hormonal ring, then the first step is to finish pills package. You can start using the ring during a week after taking the last pill, but not later than on the 7th day. Throughout these seven days additional protection is required.

If you previously used products containing progesterone hormone analogues (implants, mini-pills, IUDs, injectables):

  • switch from mini-pills can be performed on any day;
  • switch from injection means is carried out from the next injection;
  • switch from IUD or implants – after their removal.

In all these cases it is necessary to additionally use condoms for 7 days.

Introduction and Removal

contraceptionOptimal physiological position for hormonal circle introduction a woman chooses herself – lying down, standing, squatting on haunches. The circle is soft, elastic and easily amenable to compression with two fingers. After compression, it is necessary to introduce deep inside. It will take the best position itself. If, after introduction, you continue to feel it, so it was not introduced deep enough. In this case it is necessary to push it deeper with finger. If the circle is introduced deep, it ceases to be felt, and does not fall out when walking. It should be pulled out with finger, gently, not to damage mucous with fingernail.

Since hormonal circle is not a barrier method of contraception, its position inside of vagina is not important for its effectiveness.

Advantages and Disadvantages of Contraceptive Methods

For family planning and protection from unwanted pregnancy variety of means can be used, their choice in our time is very wide.

Condom
+ The most simple, reliable and time-tested method of contraception, affordable and accessible. It protects not only against pregnancy but also against sexually transmitted diseases.
It is a barrier protection, when breaks, loses its function, so doesn’t provide 100% guarantee against sexually transmitted infections and pregnancy. It reduces sensitivity. Often «forgetting» effect plays not in favor of condoms.

Interrupted sexual intercourse
+ Applicable if partners do not want to use condom or it simply is not «within reach».
It is an unreliable method, because sperm can enter vagina, not only at the moment of ejaculation, but also during actual intercourse. In addition, it requires skill from men to control themselves.

Oral contraceptive
+ Pills effectiveness is high enough.
Great risk to forget to take a pill. They have a negative impact on liver and blood indicators; their effectiveness is reduced by vomiting.

Intrauterine device
+ It is used as a method of family planning. The coil is put for a very long time, which is convenient (up to 5 years).
It does not protect against sexually transmitted infections. Nulliparous women and women who have more than one partner can’t use it.

Contraceptive ring
+ Convenient use – once every 3 weeks; reduced risk to forget to apply it; high efficiency; no negative effect on liver. No decrease in sensitivity during sexual intercourse.
It does not protect against sexually transmitted infections.