The vaginal ring is a soft, flexible contraceptive device that is self-inserted into the vagina. This small, plastic ring continuously releases a low dose of two hormones, estrogen and progestin, which are absorbed through the vaginal lining into the bloodstream. These hormones prevent pregnancy primarily by stopping the ovaries from releasing an egg and by thickening cervical mucus to block sperm.
Essential Preparation and Starting Timing
Before handling the vaginal ring, wash your hands thoroughly with soap and water to prevent introducing bacteria. Inspect the ring for any damage, such as tears or breaks, and check the expiration date. Remove the ring from its foil pouch just before insertion, keeping the pouch for proper disposal of the used ring later.
The timing of the initial insertion is important for immediate protection. The “Day 1 Start” involves inserting the ring on the first day of your menstrual period, which provides immediate contraceptive protection without needing a backup method. If you begin on any day other than Day 1, you must use a backup barrier method, like condoms, for the first seven days. The “Sunday Start” requires insertion on the first Sunday after your period begins, and also requires seven days of backup contraception.
Detailed Insertion Methods
Choosing a comfortable body position, similar to inserting a tampon, makes the process easier. Users often find it helpful to stand with one leg elevated, squat down, or lie down on their back. Experimenting will help determine the position that provides the best leverage and comfort.
The flexible ring must be compressed before insertion to reduce its diameter. Two main folding techniques are used. The “taco” fold involves pinching opposite sides together, creating a narrow, compressed shape. The “figure-eight” fold requires squeezing the sides inward, bending the ring into an “8” shape for easier entry.
Gently insert the folded ring’s tip into your vagina and use your index finger to push it further upward. Guide the ring toward your tailbone, similar to inserting a tampon. Push the ring as high as it will comfortably go into the vaginal canal. It does not need to cover the cervix, as its contraceptive effect comes from the released hormones.
Confirming Placement and Troubleshooting
Once inserted, you should not be able to feel the ring during normal daily activities; it should reside high up in the vagina. To confirm placement, insert a clean finger and feel for the ring. The ring cannot travel past the cervix or become lost inside your body.
If you experience discomfort after insertion, the ring may not be pushed in far enough or may be resting at an awkward angle. Use your finger to gently push the ring further up. Alternatively, remove the ring entirely, refold it, and reinsert it until it feels comfortable.
The ring may occasionally slip out during a bowel movement, strenuous exercise, or sexual intercourse. If the ring comes out, immediately rinse it with cool or lukewarm water, avoiding soap, and reinsert it as soon as possible. If the ring has been out for less than three continuous hours, contraceptive protection is maintained. If it has been outside the vagina for longer than three hours, reinsert it, but use a backup method of contraception for the next seven days.