Birth Control: How to Use the Vaginal Ring

Topic Overview

The vaginal ring is a highly effective method of birth control when it is used exactly as directed. The ring failure rate is the same as that of birth control pills.

Talk to your doctor about what day to start using the ring. Usually, a ring is started during one of the first 5 days of the menstrual cycle.

See a picture of the vaginal hormonal ring.

The ring cannot be incorrectly inserted. Its exact position in the vagina is not critical for it to work because the ring is not a barrier contraceptive. The ring is left in place during sexual intercourse. It is replaced with a new one every 4 weeks.

• Note the day that you insert a new vaginal ring. Leave the ring in place for 3 weeks.
• To take a 1-week break to have a menstrual period, remove the ring on the same day of the week that you inserted the ring 3 weeks before.
• Insert a new ring on the same day of the week as you did 4 weeks ago.

If you forget and leave the ring in place for more than 4 weeks, remove it and use a barrier method of birth control (such as a condom) until a new ring has been in place for 7 days. Discuss this with your doctor. A pregnancy test may be recommended.

Insertion and removal of the ring is similar to using a diaphragm, except the ring is left in place for 3 weeks. Simply use your fingers to tuck it into your vagina and later to hook or grasp it and pull it out.

What to do if the ring slips out of your vagina

If a vaginal ring slips out and it is out of your vagina for less than 3 hours, you are still protected from pregnancy. The ring can be rinsed and reinserted.

If a ring is out of the vagina for more than 3 hours, you may not be protected from pregnancy. Rinse and reinsert the ring, but use an extra method of birth control until the ring has been back in your vagina for 7 days in a row.

If you lose a vaginal ring, insert a new ring as soon as possible and follow the same schedule as described above.

When you start using the vaginal ring depends on what contraceptive method you were using before.

Did not use hormonal contraception last month

• Count the first day of your menstrual period as Day 1.
• Insert the vaginal ring between Day 1 and Day 5, but no later than Day 5, even if you are still bleeding.

For the first cycle of using the vaginal ring, use an extra method of birth control for the first 7 days of ring use.

Switching from a combination (estrogen plus progestin) pill

• Insert the vaginal ring within 7 days of taking your last pill, but no later than the day you would start a new pill cycle. No extra method of birth control is needed.

Switching from a progestin-only mini-pill, injection, or IUD

• Mini-pill: Insert the vaginal ring on any day of the month, but do not skip any days between your last pill and the first day of ring use.
• Injection: Insert the vaginal ring on the same day your next injection is due.
• IUD: Insert the vaginal ring on the same day you have your IUD removed.

Use an extra method of birth control for the first 7 days of ring use.

After a first-trimester miscarriage or therapeutic abortion

• Insert the vaginal ring within 5 days of a miscarriage or therapeutic abortion. No extra method of birth control is needed.
• If a ring is not inserted within 5 days, start using the ring at the time of your next menstrual period. See the "Did not use hormonal contraception last month" section above.