Contraceptive ring

The contraceptive ring is a flexible plastic ring that is inserted into the vagina where it releases hormones, an artificial estrogen and progestin, for contraception

The hormones in the contraceptive ring inhibit ovulation

© Your Photo Today / Phanie

What is the contraceptive ring?

The contraceptive ring, known in technical jargon as the vaginal release system, is an elastic plastic ring about five centimeters in diameter. It is usually inserted into the vagina on the first day of your normal menstrual period, practically like a tampon.

The ring is only available in one size, as it adapts to the woman's body. Precision to the millimeter is not important, after inserting the woman should not feel anything. The ring stays in the vagina for three weeks. There it continuously releases small amounts of a certain estrogen (ethinylestradiol) and a gestagen (etonogestrel, a derivative of the synthetic progestogen desogestrel).

Uterus, vagina (schematic)

© W & B / Ulrike Möhle

Ultimately, the contraceptive ring works like the pill

The hormones enter the blood through the vaginal walls. Main effect: They inhibit ovulation. In other words, the vaginal ring ultimately works in a similar way to the pill. However, there is more choice here.

After three weeks, the woman will remove the ring herself and then dispose of it (ideally put it in the residual waste in the sealable original bag). Menstruation occurs in the following seven days. A new ring is inserted on the eighth day, i.e. on the same day of the week on which the previous ring was removed a week before, and if possible at the same time. Even in the ring-free week, the previously released hormones offer protection against pregnancy.

Important: the conversation with the doctor

Before the gynecologist prescribes the contraceptive ring, he will ask the woman about current and previous illnesses (anamnesis). He also asks about illnesses in the family. He will also examine the woman carefully. Finally, it provides information about the advantages and disadvantages, risks and side effects of the contraceptive method and possible alternatives.

Pregnancy should be ruled out. The doctor explains to the woman how she uses the ring and sets an appointment for a check-up with her. In the event of side effects, she should see a doctor immediately (see below).

Advantages of the contraceptive ring

In contrast to the pill, women do not have to think about taking the homon ring every day. The hormones are not absorbed through the gastrointestinal tract, but through the vagina. Therefore, the effect of the vaginal ring is not in question, for example, even when vomiting. Rules strength and duration can decrease. If the ring interferes with sexual intercourse, it can be removed for a maximum of three hours (clean with lukewarm water and store hygienically).

After childbirth, the contraceptive ring is suitable as soon as the uterus has regressed (but not during breastfeeding, see section "Contraindications" below).

Disadvantages of the contraceptive ring

If the ring has been out of the vagina for more than three hours, contraceptive protection may be impaired. Then an additional protective measure, such as a condom, is recommended. If in doubt, the person concerned should contact the gynecologist.

It cannot be completely ruled out that the contraceptive ring will be expelled, for example in the case of a sagging uterus or severe constipation. However, the gynecologist will consider these restrictions in advance if possible. To be on the safe side, the user should check at regular intervals whether the ring is still there.

It can very rarely break, which can also lead to injuries. Remove the broken ring as soon as possible and, if there are no identifiable problems, insert a new ring. In addition, a barrier method such as the male condom should be used for the next few days.

If the ring is missing or defective, there is also a risk of pregnancy. Here, as of course, in the event of an injury, those affected should contact their doctor immediately.

Interactions are possible with some drugs. Among other things, they can influence the safety of contraception. You will find detailed information on the problems mentioned in the instructions for use.

Side effects and risks

Similar to the pill, headaches, nausea and increased vaginal infections can occur. Side effects such as acne, breast pain, weight gain, mood swings, decreased desire for sex (changes in libido) and depression are also possible.
Note: Warning notices have been included for the technical and user information on hormonal contraceptives (hormonal contraceptives, here: the contraceptive ring) that draw attention to an increased risk of suicide as a possible consequence of depression. Women who experience mood swings and symptoms of depression while using a contraceptive should seek medical advice quickly from their doctor, even if the drug has only recently been used.

Another important issue is the risk of thrombosis. In a thrombosis, a blood clot blocks a vessel, such as a vein in the leg. If the clot is washed away with the blood and blocks another section of the vessel, it is an embolism, for example in the lungs.

The risk of such a venous thromboembolism is higher with the contraceptive ring compared to low-dose combination pills that contain, in addition to estrogen, a progestin such as levonorgestrel (more on the risk of thrombosis with hormonal contraception in the article "The Pill"; see note at the bottom). One of the reasons for this is that the hormones from the contraceptive ring continuously enter the blood. Apparently they can stimulate clotting factors in the liver.

Even if thromboses occur somewhat more frequently under hormonal contraception, they only rarely occur in this context. Factors such as age, predisposition to an increased tendency to thrombosis or pregnancy are comparatively even more important for the risk of thrombosis. Nevertheless, you should get precise advice from the doctor about the individually suitable contraception methods and then decide on them in peace.

Thromboses can also develop in the arteries. The possible consequences include heart attacks and strokes. This risk increases over the age of 35, with disorders of lipid metabolism and high blood pressure. Smoking also increases the risk of cardiovascular diseases, especially after the age of 35. If a woman has such risks, the doctor will carefully weigh up whether a hormonal method of contraception such as the vaginal ring is really suitable for her.

Do you need a prescription for the birth control ring?
The doctors at Zava can help you quickly and easily - you can use the Zava website to request a prescription for your ring using an online questionnaire, 7 days a week. You can often pick up your medication on the same day from a local pharmacy or have it unobtrusively packaged and delivered to the address of your choice.

Request a prescription now

Contraindications of the contraceptive ring

Existing or previous thromboses of any kind and secondary diseases are contraindications. Go to the gynecologist if you experience acute or persistent discomfort while using the contraceptive ring. The doctor will check, among other things, whether it is better to remove the ring.

The hormone ring is also not indicated for severe liver disease or cancers such as breast cancer and uterine cancer, the growth of which can be stimulated by hormones.

The contraceptive ring is not suitable for breastfeeding women.

What else should you watch out for?

The contraceptive ring does not protect against HIV / AIDS and other sexually transmitted diseases.

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