Vaginal ring: learn more about this contraceptive method

The vaginal ring is a combined hormonal contraceptive method just like the contraceptive pill and, despite being a small object that must be inserted through the vaginal canal, it is not a barrier method like the diaphragm and female and male condoms.

Like the pill, the vaginal ring depends on the woman to achieve its high contraceptive efficacy. What differentiates the ring and the pill is the way in which the hormones are released and the likelihood of making mistakes during use. We consulted Murilo de Lima Brazan, gynecologist and obstetrician at Hospital das Clínicas de Porto Alegre (CRM-SP: 161709), to provide more details about this method.

What is the vaginal ring?

The vaginal ring is a silicone ring, flexible, transparent, with a smooth surface and without porosity and therefore non-absorbent. Its shape and size are designed to facilitate its insertion into the vaginal canal, as it must be handled and inserted by the woman herself – they are about 5 cm in diameter and 4 mm thick.

It is a hormonal contraceptive method, that is, it works by releasing hormones in the woman’s body. Gynecologist and obstetrician Dr. Murilo de Lima Brazan explains that the ring is considered a combined method because it combines the use of two female hormones: progesterone and estrogen, both found in contraceptive pill formulas.

How does the vaginal ring work?

The ring works by releasing the hormones progesterone and estrogen directly into the bloodstream. This prevents the woman from ovulating and increases the thickness of cervical mucus, thus making it difficult for sperm to rise. Just like the contraceptive pill, the ring releases hormones for 21 days (however, some contraceptive packs may contain 24 active pills) and asks for a break – which may or may not be respected – of 7 days, during which the woman removes the ring and replace it with a new one.

Dr. Brazan ratifies that the use of the ring does not dispense with the use of condoms, as the method does not prevent the transmission of sexually transmitted infections, STIs, such as HIV, HPV, Hepatitis B and C, syphilis, etc. It also states that the ring is recommended only for women who have already had sexual intercourse with vaginal penetration, as it is inserted in a similar way to a tampon.

Understanding how the method works is the best way to know if it is right for you. When in doubt, always consult a gynecologist.

How to use the vaginal ring?

For the first use, it is advisable to instruct a gynecologist on the best day to insert the ring. To place the ring, simply press it between your thumb and forefinger, forming an image similar to an 8, and insert it vertically into the vaginal canal until you reach a flexible and very little sensitive region just below the cervix, which will prevent discomforts.

The ring must remain in this position for 21 days. After this period, it must be removed. The woman then has two options: replace it with a new one immediately, inhibiting menstruation; or replace after 7 days, creating the interval at which she will menstruate.

The appearance of the vaginal ring is similar to that of the diaphragm, but don’t confuse them! They are completely different methods. Brazan explains that the diaphragm is a barrier method and acts by physically preventing contact between sperm and egg, while the ring acts chemically preventing ovulation. Thus, even in sexual relations without condoms, the possibility of fertilization occurring is very low (0.3%).

The gynecologist also states that there is no need to use another contraceptive method concomitantly with the vaginal ring, except condoms. Because it is highly effective if used correctly, it is not necessary to associate it with barrier methods or spermicides, because the effectiveness of spermicides is one of the lowest among contraceptives.

Advantages and disadvantages

The advantages and disadvantages of using the vaginal ring are quite similar to other hormonal methods with some significant differences.

Benefits

• Cycle control;
• Colic control;
• Menstrual volume control;
• Reduction of PMS symptoms;
• Reduction of oiliness of the skin and hair;
• Lower incidence of spotting – bleeding breaks in the middle of the cycle;
• Reduction of the side effects of taking estrogen orally – such as headaches and nausea;
• Beneficial for bariatric surgery patients, as changes in the digestive tract can affect the absorption of drugs used orally;
• Reduced probability of misuse, as the ring is inserted once a month and does not need to be changed for at least 21 days.

Disadvantages

• Vaginal manipulation (because it can be a hindrance for some women)
• Increased vaginal lubrication (as it can be confused with discharge).

Vaginal ring frequently asked questions

When we deal with the release of hormones in our body, we need to be careful and attentive, after all, both the lack and excess of hormones is harmful. In this process, it is common for doubts to arise. We asked for the help of Dr. Murilo Brazan to answer the most frequent ones:

1. For whom is the vaginal ring contraindicated? For women with a history of deep vein thrombosis, pulmonary embolism, heart attack, stroke, diabetes and uncontrolled hypertension, women with breast cancer or older than 35 years, smokers or serious liver disease, pregnant women and women who are use of anticonvulsant medications.

2. Are there any side effects? The side effects are similar to those of the contraceptive pill because they use the same hormones, they are: headaches, decreased libido, bellyaches and nausea and a higher incidence of vaginal infections.

3. Can the vaginal ring be used while breastfeeding? There is still a lot of controversy in the medical community in this regard, so until studies confirm that there is no risk, it is not recommended to use combined hormonal contraceptive methods for at least 6 months while breastfeeding. However, even without breastfeeding, the woman must respect a minimum period of 42 days to resume contraceptive treatment to reduce the risk of vascular problems.

4. How to remove the vaginal ring? Just hold the rim with one or two fingers and pull it out.

5. How effective is the vaginal ring? If used correctly, its effectiveness is 99.7%.

6. Can the vaginal ring be used during sex? Yea! The ring is positioned just below the cervix, so it does not interfere with sex.

Remember that it is essential to follow up with a gynecologist during treatment with contraceptives, especially hormonal ones. Each organism is different, so whenever you feel the need, consult a specialist. Insist on finding the best method for you, your health is at stake.

The information contained on this page is for informational purposes only. They do not replace the advice and follow-up of doctors, nutritionists, psychologists, physical education professionals and other specialists.