An intravaginal ring is a flexible, circular device designed for placement inside the vagina, serving as a form of hormonal birth control. This small, soft ring steadily releases hormones that are absorbed through the vaginal walls into the bloodstream, working to prevent pregnancy. It offers a continuous and reliable method of contraception for individuals seeking an alternative to daily pills or other methods.
How Intravaginal Rings Work
The effectiveness of an intravaginal ring stems from its continuous release of synthetic hormones, specifically estrogen and progestin. These hormones are absorbed directly into the bloodstream through the vaginal lining. The primary mechanism involves preventing ovulation, which is the monthly release of an egg from the ovaries.
The hormones also thicken the cervical mucus, creating a barrier that makes it difficult for sperm to travel through and reach any potential egg. They can also thin the lining of the uterus, making it less receptive to a fertilized egg. This multi-pronged approach significantly reduces the chance of pregnancy.
Types of Intravaginal Rings and Their Use
Different types of intravaginal rings are available, each with specific usage instructions and replacement schedules.
NuvaRing and Generic Versions
NuvaRing and its generic versions, such as EluRyng, are designed for monthly replacement. A new ring is inserted and remains in place for three weeks (21 days), then removed for a ring-free week (7 days) to allow for withdrawal bleeding. After this break, a new ring is inserted, ideally on the same day and at the same time of day as the previous insertion. Some users may choose to insert a new ring immediately after removal to skip their period, a practice to discuss with a healthcare provider.
Annovera
Annovera is another type of intravaginal ring, notable for its extended use. This ring can be used for up to one full year, or 13 cycles. Like NuvaRing, it is worn for three weeks (21 days) and then removed for a one-week (7 days) ring-free interval. During this ring-free week, the Annovera device is cleaned with mild soap and lukewarm water, patted dry, and stored in its provided case. After the break, the same Annovera ring is reinserted for the next cycle. This reusability offers convenience compared to monthly replacement rings.
Insertion and Removal
For insertion, individuals should wash their hands and find a comfortable position, such as squatting, lying down, or standing with one leg elevated. The ring is squeezed between the thumb and index finger and gently pushed into the vagina as far as it comfortably goes. It does not need to be in a specific spot to be effective, as long as it feels comfortable and remains entirely inside.
To remove the ring, a clean finger is inserted to hook around the edge, allowing it to be gently pulled out. If a ring accidentally slips out, it should be reinserted within a specified timeframe (e.g., within 3 hours for NuvaRing or 2 hours for Annovera) to maintain contraceptive protection; otherwise, backup birth control, such as condoms, may be needed for seven days.
Benefits and Potential Considerations
Intravaginal rings offer several advantages for contraception. They are highly effective in preventing pregnancy when used correctly, with typical use resulting in a pregnancy rate of about 7% per year. Their once-a-month or yearly replacement schedule provides convenience compared to daily birth control methods. This reduced frequency of attention can improve adherence, contributing to its effectiveness.
Beyond contraception, these rings can make periods more predictable and lighter, and may help reduce menstrual cramps. Some individuals also experience a reduction in acne and a lowered risk of ovarian cysts, and endometrial and ovarian cancers.
Individuals may experience common side effects, particularly during the first two to three months as the body adjusts. These can include irregular bleeding or spotting between periods, headaches, nausea, and breast tenderness. Some users might also notice an increase in vaginal discharge or vaginal irritation.
Certain medical conditions or lifestyle factors may make an intravaginal ring less suitable. For example, individuals over 35 who smoke should not use combined hormonal contraceptives due to an increased risk of serious cardiovascular events, such as blood clots, heart attack, or stroke. Individuals with a history of blood clots, certain types of migraines with aura, uncontrolled high blood pressure, specific liver diseases, or certain cancers (like breast cancer) may also not be suitable candidates. It is important to have a comprehensive discussion with a healthcare provider to review one’s medical history and determine if an intravaginal ring is an appropriate birth control option.