Overview

The ring is used to prevent pregnancy. It's a soft plastic ring that you put into your vagina. It's also called the vaginal ring. It gives you a regular dose of the hormones estrogen and progestin.

The ring protects against pregnancy for 1 month at a time. You wear one ring for 3 weeks in a row and then go without a ring for 1 week. During this week, you have your period. Or you may use the ring continuously. This means you don't take the ring out for a week each month. With this method, you won't have your period.

How to use a ring

Talk to your doctor about what day to start using a vaginal hormonal ring (Figure 1). Usually, a ring is started during one of the first 5 days of the menstrual cycle. The ring is replaced with a new one every 4 weeks.

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.

Note the day that you insert a new vaginal ring, then follow these steps.

1. Use your fingers to tuck the vaginal ring into your vagina.

   The ring can't be inserted the wrong way. It's not a barrier contraceptive, so its exact position in the vagina isn't critical for it to work. The ring is left in place during sexual intercourse.

2. Leave the ring in place for 3 weeks.
3. Remove the ring 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.
   • To remove it, use your fingers to hook or grasp it and pull it out.
4. 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. You may need a pregnancy test.

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. You can rinse the ring and insert it again.

If a ring is out of your 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 you can. Follow the same schedule as described above.

The best day to start using your ring

When you start using the vaginal ring depends on what method of birth control you were using before.

Did not use hormonal birth control last month

1. Count the first day of your menstrual period as Day 1.
2. Insert the vaginal ring between Day 1 and Day 5. Insert it 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, shot, or IUD

• Mini-pill: Insert the vaginal ring on any day of the month. But don't skip any days between your last pill and the first day of ring use.
• Shot: Insert the vaginal ring on the same day your next shot 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 abortion

• Insert the vaginal ring within 5 days of a miscarriage or 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 birth control last month" section above.

Figure 1 - Hormonal Methods of Birth Control

Birth control pills, skin patches, and vaginal rings contain estrogen and progestin. There are also progestin-only birth control pills, implants (such as Nexplanon), and shots (such as Depo-Provera). Hormonal methods of birth control prevent eggs from being released from the ovaries, thicken cervical mucus to prevent sperm from entering the uterus, and thin the lining of the uterus to prevent implantation.

Hormone pills come in packs. Most packs contain 3 weeks of hormone pills. During the fourth week, when you do not receive hormones, you have a menstrual period. Some packs of pills have hormone pills for the fourth week instead of sugar pills (non-hormone pills). Taking hormones for the entire month eliminates or reduces the number of periods you have.

The hormone patch releases estrogen and progestin through your skin for 7 days. Over a 4-week period, you use 1 patch per week for 3 weeks, then no patch for 1 week. During this week, you have a menstrual period. You can wear the patch on your lower abdomen, upper torso (not breasts), buttocks, or upper arm.

The hormone vaginal ring is placed in the vagina for 3 weeks. This gives you continuous birth control for the month. On the first day of the fourth week, you remove the ring. You then have a menstrual period. The exact position of the ring in the vagina is not critical for the ring to work.

Current as of: April 30, 2024

Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.