The Vaginal Ring

Also called a “hormonal ring”, it is self-inserted into the vagina, and it releases hormones similar to the combined pill for three weeks.

 

EFFECTIVENESS

Practical effectiveness*: 93%
Theoretical effectiveness**: 99%

 

WITH HORMONES

Method based on two hormones: a progestin and an oestrogen

 

REMINDER

Think about it once a month

 

ATTENTION

No protection against STIs

If you forgot it, or if the vaginal ring accidently gets out, contact a pharmacist, a physician or a gynaecologist. 

* Practical effectiveness: when measured under conditions of current use (taking into account omissions, failures, etc.)
** Theoretical effectiveness: when observed under conditions of perfect use (without problems of use and without interaction with other medicine)

Source: effectiveness percentages are taken from WHO (2018) 

HOW DOES IT WORK ?

The vaginal ring works in the same way as a combined contraceptive pill. It also contains 2 different hormones that block ovulation, thicken the cervical mucus (which makes it harder for sperm to pass through) and prevent the endometrial lining from developing to accommodate a possible fertilized egg. After 3 weeks, the ring must be removed. This will trigger menstruation. 

The hormones in the ring do not pass through the digestive system but go directly into the bloodstream (as it does with the patch). You are therefore still protected if you suffer from diarrhea or vomiting.

INTERESTING FIGURES AND DETAILS

HOW TO USE IT ?

STEP 1

Go to a physician or gynaecologist to obtain a prescription, and then to the pharmacy to get the rings. 


STEP 2

Is it the first time you use the vaginal ring? Or maybe you use it again after a break? Insert the vaginal ring on the first day of your period. 

You would like to start using the vaginal ring right away? There are certain conditions to respect. Ask your physician for more information. 


STEP 3

Remove the ring from the package (keep the package for later). After cleaning your hands thoroughly, sit in a comfortable position and flatten the ring between your thumb and your forefinger.

Insert the ring deep inside your vagina. 


STEP 4

After three weeks, remove it by passing your index finger through the ring. This will trigger your menstruation. Put the used vaginal ring in its original packaging and then, in the garbage.  


STEP 5

Insert a new ring 7 days later, even if there is still some bleeding.

If you do not like to insert the ring with your fingers, an applicator (similar to a tampon applicator) is available free of charge at the pharmacy. It is also possible to postpone your period by putting on a new ring directly after the three weeks.

HOW TO GET IT

Pharmacie

At your pharmacist

Vaginal rings cost on average 167€ per year (for 13 cycles, i.e., 13 rings). The CNS reimburses 80% of this contraceptive method for women under 30 years old.

(This price is an average indication which may vary.)

Advantages

  • The vaginal ring is the combined method with the lowest dose of estrogen, even lower than the contraceptive pill, for a similar rate of reliability. 
  • It allows you to postpone or even skip your period.
  • It allows you to have regular, less painful, and less abundant periods. 
  • Episodes of vomiting or diarrhea have no impact on the effectiveness of the ring.
  • You don’t have to think about it every day or every time you have sex.
  • You don’t feel it, even during sex. (If you feel discomfort during sex, take the ring out for a moment, then put it back in. Remove the ring for a while, but never for more than 3 hours. Don’t worry, you’re still protected during this time).

GOOD TO KNOW

  • The vaginal ring does not protect against sexually transmitted infections. Thus, remember to use condoms.
  • With a combined hormonal contraceptive (such as the combined pill or ring), there is an increased risk of venous thrombosis. This is a clot that forms in the veins and can be dangerous. This risk is higher during the first year of using the contraceptive and when you reuse it after a break of more than 4 weeks.
  • You should first consult your physician to obtain a prescription. Among other things, the physician must check if you are at risk for thrombosis.
  • The ring has a limited shelf life. You can only buy one box of 3 rings at a time.

QUESTIONS FREQUENTES

When is the ring effective after it has been inserted?

If you use the ring on the 1st day of your period, it is effective immediately. However, if you start using it on the 2nd day of your period or in the middle of your cycle, it will take 7 days before it is effective. Refer to the package instructions or talk to your physician or gynaecologist.

I have my period at the moment and I have to put on a new ring. What do I put on first: the tampon or the vaginal ring?

The ring because it is the easiest. The tampon must be removed after a few hours, whereas the ring will remain in place for three weeks. When removing the tampon, make sure that you do not inadvertently remove the vaginal ring at the same time. If this happens, rinse the ring with cold water and put it back on immediately. Never rinse the ring with hot water, as the hormones are released through the heat. Rinsing the ring in hot water will cause the hormones to be lost and will shorten the duration of the protection that the ring can provide.

Can I jump on a trampoline if I am wearing a vaginal ring?

Yes, no problem. The inner muscles of the vagina will naturally hold the ring in place. If you are uncertain, you can always check if the ring is in place by inserting your fingers into the vagina. If you can’t feel the ring, contact a health care professional immediately.

Is it possible to skip the week break to avoid having period?

Yes, when you remove your ring after 3 weeks, it is possible to put a new one back on immediately for another 3 weeks and not have your period. This is not dangerous or bad for your health.

Is having my period a proof that I am not pregnant?

No. If you use the ring, you can have your period while you are pregnant even. In fact, under hormonal contraception such as the ring, the bleeding is called “withdrawal bleeding”. This means that they are not real periods. Menstruation under hormonal contraception is  therefore not a reliable indicator of whether or not you are pregnant.

If you forgot to remove or reinsert a ring, you can find information below, see the ring’s instruction  or talk to a health professional.

I forgot to remove my ring after 3 weeks, what should I do?

  • If the ring has been left in between 3 and 4 weeks in total:

Remove the ring to allow the 7-day interval to pass and then put on a new ring. The ring has hormones for 4 weeks, so you are not at risk of pregnancy.

  • If the ring has been inserted for more than 4 weeks in total:

Remove the ring and contact your physician. If you had unprotected sex in the last 5 days,  it is recommended that you take emergency contraception and consult a health professional, as there is a risk of pregnancy.

What if I forgot to put my ring back on at the end of the break week?

If the original day has passed, put on a new ring immediately to start a new cycle and use additional contraception (e.g. condom) for 7 days. If you had unprotected sex in the last 7 days, it is recommended that you use emergency contraception and consult a health professional, as there is a risk of pregnancy.

What should I do if I notice that the ring is no longer present?

If you notice that the ring is no longer present and it has been less than 3 hours, rinse the ring with cold water and reinsert it. Never rinse the ring with hot water, as the hormones are released through the heat. Rinsing the ring in hot water will cause the hormones to leak and will shorten the duration of the protection that the ring can provide.

If you notice that the ring is no longer present, and it has been more than 3 hours:

  • If you forgot to use the ring during the first week of use and you had sexual intercourse in the last 7 days, ask for emergency contraception
  • If you forgot to use the ring during the 3rd week, do not take a break and reinsert a new ring for 3 weeks.

Where and how do I dispose of my ring?

In order to respect the environment, it is important not to throw your used rings in the garbage. Because the used ring still contains a certain amount of active hormonal substances when it is removed, it must be put back into the original packaging before being thrown away. If you no longer have the original packaging, you can return your used patches to the pharmacy or find out about collection points for old medicines at www.sdk.lu.

Can the ring make sexual intercourse difficult?

The ring can indeed be felt during vaginal penetrative sex. However, this is usually not uncomfortable. Some people even report this as a pleasant experience during penetration. When  it comes to sexual pleasure, the most important thing is to communicate with your partner what  you like. There are several types of contraception!