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Birth Control Ring

Reviewed by: Larissa Hirsch, MD

What Is the Birth Control Ring?

The birth control ring is a flexible circular device that goes inside the vagina. It slowly releases hormones through the vaginal wall into the bloodstream. These hormones help prevent pregnancy.

How Does the Birth Control Ring Work?

The combination of the hormones progestin and estrogen in the birth control ring prevent (the release of an egg from the ovaries during a woman's monthly cycle). If an egg isn't released, a woman can't get pregnant because there's no egg for a male's sperm to fertilize.

The in the ring also thicken the cervical mucus (made by cells in the cervix). This makes it hard for sperm to enter the uterus and reach any eggs that may have been released. The hormones in the ring can also sometimes affect the lining of the uterus so that an egg will have a hard time attaching to the wall of the uterus.

Like the birth control pill or patch, the vaginal ring is based on the monthly menstrual cycle:

  • The girl puts a ring into her vagina on the first day of her period or before day 5. Putting in the ring is like putting in a tampon.
  • The ring stays inside the vagina for 3 weeks in a row.
  • When the ring has been in place for 3 weeks, the girl takes it out. She does this on the same day of the week the ring was inserted. So if she put the ring in on a Thursday of the first week, she takes it out on Thursday of the third week, at about the same time of day.
  • Within a few days, a girl's period should start.
  • Exactly a week after taking out the old ring, the girl puts in a new one. The new ring should go in on the same day of the week, even if the girl still has her period.

The hormones in the ring take a while to begin working. So when a girl starts using the ring, couples must use another form of birth control (such as a condom) for 7 days. Even after the ring starts working on its own, using condoms helps protect against sexually transmitted diseases (STDs).

It doesn't matter where the ring is in the vagina as long as it feels comfortable. If it doesn't feel comfortable, it can be pushed further back or taken out and put in again. Most girls don't feel the ring after it's in place.

Vaginal muscles hold the ring in place, so it's unlikely that it will fall out. If it does, it can be rinsed under cool water (not hot) and put back in within 3 hours. If more than 3 hours pass without a ring in the vagina, there's a chance a girl could get pregnant if she has sex. The couple should use a condom or other form of birth control until the ring has been in place for 7 days.

If the ring is out for more than 3 hours during the third week a girl wears it, she should call her doctor for advice. The doctor may say to put a new ring in, or not to replace it, so that her period starts early. Either way, she should use another kind of birth control to avoid pregnancy.

How Well Does the Birth Control Ring Work?

The ring is an effective form of birth control. Over the course of a year, about 9 out of 100 typical couples who use the ring to prevent pregnancy will have an accidental pregnancy. Of course, a girl must use the ring correctly. Not putting the ring in on time or taking it out too soon makes it less effective.

In general, how well each type of birth control method works depends on many things. These include whether a girl has any health conditions or is taking any medicine that might affect its use.

Does the Birth Control Ring Help Prevent STDs?

No. The vaginal ring does not protect against STDs. Couples having sex must always use condoms along with the ring to protect against STDs.

Are There Any Side Effects From the Birth Control Ring?

Most young women who use the ring have no side effects.

If side effects do happen, they may include:

  • irregular periods
  • nausea, headaches, dizziness, and breast tenderness
  • mood changes

Other possible side effects include:

  • vaginal irritation or infections
  • vaginal discharge
  • problems with contact lenses, such as a changes in vision or inability to wear the lenses

Many of these side effects are mild and tend to go away after 2 or 3 months.

The birth control ring increases the risk of blood clots. Blood clots can lead to serious problems with the lungs, heart, and brain. Smoking cigarettes while using the birth control ring can increase the risk of blood clots. if you use a birth control ring or other form of hormonal birth control, don't smoke.

Who Can Use a Birth Control Ring?

The vaginal ring may be a good choice for girls who have trouble remembering to take a pill every day or who have trouble swallowing pills. A girl must feel comfortable inserting the device into her vagina.

Not all girls can — or should — use the vaginal ring. Some medical conditions (such as severe high blood pressure and some types of cancer) can make using the ring less effective or more risky.

Girls who have had unexplained vaginal bleeding (bleeding that is not during their periods) or who might be pregnant should stop using the ring, talk to a doctor, and use another form of birth control in the meantime.

Where Can I Get the Birth Control Ring?

A doctor or a must prescribe the birth control ring, and will probably ask questions about your health and family . He or she may also do a complete physical exam, including a blood pressure measurement and a pelvic exam. If the ring is prescribed, the doctor will give you instructions on how to use it.

You may have to go back to the doctor a few months after using the ring to get your blood pressure measured and to make sure there are no problems. After that, a doctor may recommend routine exams once or twice a year or as needed.

How Much Does the Birth Control Ring Cost?

The ring usually costs between $30–$200 a month. Some health and family planning clinics (such as Planned Parenthood) might sell them for less. Also, the vaginal ring and doctor's visits are covered by many health insurance plans.

When Should I Call the Doctor?

If you are using the birth control ring, call the doctor if you:

  • might be pregnant
  • have a change in the smell or color of your vaginal discharge
  • have unexplained fever or chills
  • have belly or pelvic pain
  • have pain during sex
  • have heavy or long-lasting vaginal bleeding
  • have yellowing of your skin or eyes
  • have severe headaches
  • have signs of a blood clot, such as lower leg pain, chest pain, trouble breathing, weakness, tingling, trouble speaking, or vision problems
Reviewed by: Larissa Hirsch, MD
Date reviewed: July 2018