Vaginal Ring - Types, Advantages, and Risks

Introduction:

Unprotected sex during any time has the chance of pregnancy. Birth control or contraception is the process of preventing pregnancy. Various birth control methods include intrauterine devices (IUD), birth control pills, condoms, vasectomy, and others. A vaginal ring is a suitable option for birth control in women with a uterus who do not want to get pregnant. It is a low-maintenance option for birth control as it has to be inserted only once a month, unlike birth control pills that must be taken daily.

What Is a Vaginal Ring?

The vaginal ring is a convenient and safe hormonal birth control method. A soft plastic ring is inserted into the vagina to prevent pregnancy by releasing hormones into the body. It is also known as the birth control ring. A vaginal ring is about two inches round. The vaginal ring contains two hormones, estrogen, and progestin, similar to the hormones produced by the ovaries and is also found in oral contraceptive pills. The ring releases both hormones (estrogen and progestin) through the vaginal lining into the body. A vaginal ring is a prescription-only method of contraception.

What Are the Types of Vaginal Rings?

As approved by the U.S. Food and Drug Administration (FDA), there are two types of vaginal rings. They are as follows:

• NuvaRing: These rings are for one-time use. A NuvaRing is worn for three weeks (21 days) and removed for the next seven days (one week) to allow bleeding. After the seventh day, a new ring is again inserted into the vagina, and a new cycle is started. Each NuvaRing contains hormones lasting up to 35 days (five weeks). Hence, women who want to delay their periods by one or two weeks can wear the ring for four to five weeks.

• Annovera Ring: Annovera vaginal ring is reusable as a single ring lasts about one year (13 cycles). Annovera rings are usually worn for three weeks (21 days) and then taken out for one week (seven days). Once the ring is removed from the vagina at the end of 21 days, it is washed with water and mild soap and safely stored in the case with it. The Annovera ring is inserted back into the vagina at the end of the seven ring-free days. Annovera rings contain hormones that can last up to one year. However, the ring should not be kept continuously inside the vagina for one year as it is advised to be taken out once every three weeks.

How to Insert a Vaginal Ring?

The steps used in inserting a vaginal ring are as follows:

• The person should squat, lie down, or stand with one leg on the chair.

• The vaginal ring is removed from the foil packet using washed hands.

• The ring should be held between the index finger and thumb.

• The ring should be squeezed using fingers so that the sides of the ring touch each other and the ring becomes narrow.

• The narrowed ring is inserted deep inside the vagina using fingers.

• The ring does not need to cover the cervix to work.

How to Remove a Vaginal Ring?

The steps involved in removing a vaginal ring are as follows:

• After washing hands, a clean finger (usually the index finger) is inserted into the vagina.

• Once the ring has been found, the finger should be hooked through the ring or under the edge of the ring and gently pulled out.

• The used ring should be placed in the original bag or foil packet and disposed of in the bin. Care should be taken not to flush down the ring in the toilet.

• Removing the vaginal ring should be painless. Any signs of bleeding or pain should be reported to the doctor.

How Does Vaginal Ring Prevent Pregnancy?

• The vaginal ring continuously releases synthetic estrogen and progestin.

• The body absorbs the released hormones through the vaginal lining and reaches the bloodstream.

• Estrogen prevents the monthly release of eggs by the ovaries. This leads to the unavailability of the egg to be fertilized with the sperm.

• Progestin causes the thickening of the mucus around the cervix, which makes it hard for the sperm to get inside and reach the egg.

• The hormones also lead to thinning of the uterus lining, which prevents the fertilized egg from implanting itself.

What Are the Advantages of Vaginal Ring?

The advantages of using a vaginal ring are as follows:

• Easy to use.

• Flexible enough to fit inside all vaginas.

• Reduced side effects than oral contraceptives.

• Helps in making the periods lighter, shorter, regular, and easily predictable. The hormones present in the ring help in reducing menstrual cramps.

• It can reduce the severity or prevent conditions like ectopic pregnancy, iron deficiency anemia, cysts in the ovaries and breast, premenstrual syndrome (PMS), and ovarian cancers.

• It can be removed at any time and tried for pregnancy.

• Helps with the symptoms of endometriosis and polycystic ovary syndrome (PCOS).

What Are the Disadvantages of Vaginal Ring?

The disadvantages of a vaginal ring are as follows:

• Does not protect against sexually transmitted infections.

• Vaginal irritation or infections.

• Spotting between periods.

• Tender or sore breasts.

• Nausea.

• Increased vaginal discharge.

• Headaches.

• Certain medicines can make the ring less effective.

• Reduced sex drive.

What Are the Risks Associated With Vaginal Rings?

Usage of a vaginal ring increases the risk of the following conditions:

• High blood pressure.

• Heart attack.

• Stroke.

• Blood clots.

• Pulmonary embolism.

• Toxic shock syndrome (TSS).

Who Should Not Use a Vaginal Ring?

The vaginal ring is contraindicated in women with the following conditions:

• History of heart attack and stroke.

• Above 35 years of age.

• Uncontrolled high blood pressure.

• Breast cancer.

• Liver disease.

• Obesity.

• Migraines.

• Uncontrolled diabetes.

How Effective Is a Vaginal Ring?

When used correctly, the vaginal ring can be 99% effective in pregnancy prevention. However, factors like forgetting to place a new ring, incorrect usage, or certain medications can reduce its effectiveness to 93%.

Conclusion:

Vaginal rings are an effective way of preventing pregnancy when used appropriately. However, while many women consider vaginal rings an effective and convenient method of birth control, it has certain disadvantages like any other birth control method. Hence, discussing with the doctor the advantages and disadvantages of the vaginal ring would help decide whether it is the right choice of contraception.