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revised Friday October 12 2007

Contraceptive Ring

What is it?

The vaginal contraceptive ring is a flexible ring that slowly releases low dose hormones (estrogen and progesterone). These hormones are slowly absorbed through the vaginal lining into the bloodstream. You will need a prescription form a doctor to obtain the ring. One ring is used each month, inserted for three weeks, then removed for the fourth week.

How does the ring work?

The ring works the same as birth control pills by stopping the egg from being released each month (ovulation) and changing the mucous in the cervix. This makes it harder for sperm to enter the uterus.

The ring is 99% effective in preventing pregnancy when used correctly.

When you purchase the ring, it will come from the fridge. You do not need put it in the fridge when you get home, however it must be used within 3 months.

How do you use the ring?

To use the ring for the first time:

  • Insert the ring into the vagina on the first day of bleeding, with your next period. Hold the ring between your thumb and finger, squeeze it together. Push the folded ring gently into the vagina.
  • Leave the ring in place for three weeks.
  • Remove the ring on the 4th week. This week you will have your period.

Inserting the ring is the same as inserting a tampon. You can either lie down, stand with one foot propped on something or squat. The ring is effective immediately if put in on the first say of bleeding. If you want to start the ring on a Sunday, but this was not your first day of your period, you must use a back up method of birth control, such as condoms, for the next 7 days.

The exact position of the ring in the vagina is not important for it to work. Most women don't feel it once the ring is inserted. If it does feel uncomfortable, it may just need to be pushed a little further into the vagina. It cannot be pushed too far, as the cervix (narrow, lower end of the uterus) blocks the ring from going further into your body. Some partners say they can feel the ring, but most were not bothered by it.

Can it fall out?

It is rare for the ring to slip out, but it can accidentally come out when not inserted all the way, while taking a tampon out. (use of tampons on the effectiveness of the ring has not been decided, during sex or with straining to have a bowel movement. If the ring does come out, just rinse it with lukewarm water and put it back in as soon as possible. If it is out longer than 3 hours, a back up method of birth control should be used until the ring has been in place for the next seven days.

Read and follow the instructions that come with the package carefully.

If you have made any mistakes using the ring, you may be able to take the emergency contraceptive pill to help prevent pregnancy.

Are there other benefits to using the ring?

Other benefits can include:

  • fewer menstrual symptoms
  • less painful menstrual periods
  • less menstrual bleeding
  • more regular periods
  • less acne
  • reduced risk of cancer of the ovaries and cervix

When else should I use back up?

You should use a back up method such as condoms for 7 days if:

  • you start the ring on a Sunday and this is not the first day of your period
  • you start the ring more than 24 hours after our period starts
  • you care changing from the pill to the ring and it is not the first day of your period
  • switching from injection to the ring and you are more than the 13th week from your last injection
  • you are taking certain other drugs as they can make the ring not work as well. Check with your health care provider

Are there side effects?

Some women may have some side effects such as:

  • nausea
  • headache
  • breast tenderness
  • weight gain/weight loss
  • mood changes
  • decreased libido
  • break through bleeding or spotting
  • vaginal discomfort
  • increased vaginal discharge
  • sinusitis
  • expulsion of the ring

If you use the ring, you should not smoke. Women who use the ring and smoke have a slightly higher chance of developing a blood clot however it is extremely rare.

Signs of a blood clot include:

  • severe leg pain in calf or thigh
  • severe chest pain, cough, shortness of breath
  • severe headache, dizziness, weakness and numbness
  • eye problems such as vision loss or blurring
  • speech changes such as slurring
  • severe abdominal pain

If you have any of these signs, go to a hospital right away.

Remember: Use condoms every time to help prevent the spread of sexually transmitted infections (STIs), HIV and Hepatitis B.

For more information, call 905-799-7700 and ask for Sexual Health Information.

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Revised: Friday October 12 2007

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