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The Combined Vaginal Ring

Find out all you need to know about the combined vaginal ring

The Combined Vaginal Ring

The combined contraceptive vaginal ring is a small soft ring that you insert into your vagina. It contains two hormones, progestogen and oestrogen, similar to the hormones in your body.

The hormones primarily prevent an egg from being released each month. They also make it difficult for sperm to get to an egg and thin the uterus (womb) lining to make it difficult for a fertilised egg to implant there. The ring is kept in the vagina continuously night and day for three weeks and then taken out for a week if you want to have a monthly bleed. A new ring needs to be inserted immediately after a week to maintain contraceptive protection.

Video - The Combined Vaginal Ring

Would you like to find out everything you need to know about the ring? We've created this short explainer video, filled with information about the ring:

  • What it is
  • How effective it is in protecting against pregnancy
  • Advantages
  • Disadvantages
  • Risks
If you do not have a routine and think you may forget to replace the ring every three-four weeks, you may wish to consider a LARC (Long-Acting Reversible Contraception) method.

How to use the combined vaginal ring

In your first appointment with a doctor or clinician, you will discuss a range of contraceptive methods to find the one that suits you. Often, you will talk about your lifestyle, preferences, needs and medical history, and the clinician will assess the risks and benefits of contraceptive methods for the individual, considering all alternatives.

With clean hands, squeeze the ring between your thumb and finger and use one hand to insert it into your vagina. If necessary, spread your labia (vaginal lips) with your other hand. Push the ring into your vagina until it feels comfortable.

The ring needs to be replaced with a new one every 3-4 weeks depending on whether you want to have a withdrawal bleed that month.

Users of the vaginal ring have the option to have a monthly bleed or to skip or shorten their monthly bleed.

Do you know about LARC contraceptive methods?

If you really don’t want to get pregnant, say for the next year at least, it’s worth thinking about a LARC method: LARC stands for long acting reversible contraception, such as the implant, coil and injection. Once these methods are fitted you can forget about them!

Effectiveness of the combined vaginal ring

The vaginal ring works well at preventing pregnancy. However, its ability to stop a pregnancy largely depends on a person using it properly.

With typical use up to 7 out of 100 users will become pregnant

If you think you will not be able to remember to replace the ring once every 3-4 weeks, it may not be the right method for you.

The combined vaginal ring and your period

One advantage of using the combined vaginal ring is that it can make your periods regular, lighter and less painful.

The combined vaginal ring also gives you more control over your periods: you can choose not to have a period, or to delay your period.

Advantages, Disadvantages and Risks Associated With the Combined Vaginal Ring

As with all contraceptive methods, there are a range of advantages, disadvantages and potential risks when using the combined vaginal ring.

Advantages of the combined vaginal ring

  • It can make your periods regular, lighter, and less painful.
  • It gives you the choice not to have a monthly bleed or control when you have a bleed.
  • One ring provides contraception for a month, so you don’t have to think about it every day.
  • It is not required to be used just before sex so will not affect spontaneity of sex.
  • It doesn’t interrupt sex, because you can have sex with the ring in place.
  • Your fertility will return to normal immediately after the you stop using the ring.
  • Unlike contraceptive pills, the ring remains effective even if you have vomiting or diarrhoea.
  • It helps protect against some forms of cancer (ovary, uterus (womb) and colon).
  • It reduces the risk of getting fibroids, ovarian cysts and non-cancerous breast disease.
  • It may reduce acne and improve your skin.

Disadvantages of the combined vaginal ring

  • It may not be suitable if you don’t feel comfortable inserting or removing it from your vagina.
  • Spotting and irregular bleeding while the ring is in your vagina can occur in the first few months.
  • The ring has to be left inside the vagina continuously for most of the month. Taking it out and forgetting to put it back within 3 hours (for sex or cleaning) could make it fail.
  • If you are breastfeeding, talk to your medical provider to see if it is safe to use the vaginal ring.
  • The most common side effects are disturbances in monthly bleeding in the first few months. You can also have headaches, breast tenderness, nausea, mood changes, vaginal irritation and vaginal discharge.
  • Use of some medications, such as those for seizures, some HIV medicines or those for tuberculosis, can stop the ring from working.  Check with your medical provider if your medications are compatible with use of the ring.
  • The ring can sometimes come out on its own, but you can rinse it in warm water and put it back in as soon as possible. You will need additional protection if the ring has been out for more than 3 hours. 
  • Condoms are the only contraceptive method which protect against sexually transmitted infections. To ensure protection from both pregnancy and infection, we recommend "dual protection". This means using a male or female condom in addition to the contraceptive method of your choice to prevent pregnancy.

Risks associated with the combined vaginal ring

The combined vaginal ring is associated with some rare risks. For most people, the benefits of taking the combined pill outweigh the possible risks, but it is essential that our clients have access to quality advice and information when it comes to contraception.

Some of the rare risks associated with combined contraceptive methods include the development of a blood clot in your leg or lungs, a heart attack, or a stroke.

Your clinician or contraception provider will ask you questions to check whether you could be at a higher risk, for example, if you smoke, have high blood pressure, are overweight, take certain medicines or have a certain family medical history.

Where can I get the combined vaginal ring?

In the UK, you can get the combined vaginal ring for free from sexual health clinics, some GP surgeries and some young people's services.

At MSI UK, we primarily offer contraception services as part of your abortion care. We also recently launched new contraception-only clinics in a number of areas, meaning you can access LARC (Long-Acting Reversible Contraception, such as the IUD, the IUS, the implant and the injection) with us without having had a termination of pregnancy. Follow the link to find out more: MSI UK Contraception Clinics

 

Try our Digital Contraception Counsellor "Choice"

It’s important to know more about different contraceptive options so that we can support you as best we can. Our digital counsellor "Choice" helps you find the best contraceptive options for you. Fill out a questionnaire about your lifestyle, preferences, needs and medical history, and you'll see a list of the most appropriate contraception options for you.