Vaginal Ring
The vaginal ring is a combined hormonal contraceptive, which has in its composition estrogen and progestogen of gradual and regular release and which are absorbed by the blood vessels that are found in the vagina.
The ring is a contraceptive placed by the woman herself, so it does not depend on any medical procedure. Its malleable and flexible feature, as well as its size of only 5cm in diameter, allows it to be easily inserted into the vagina once a month.
The vaginal ring is a method for women who do not want an oral contraception, seek a better option in terms of problems with forgetfulness and regularity of taking and who wish to simplify their contraceptive option. It has a proven efficacy of 99%, also to the pill.
Any healthy woman looking for an effective method of contraception can opt for the vaginal ring, and should always consult her doctor or health care professional for personalized advice.
Acting
The ring acts through the two hormones present in the method, etonogestrel (progestin) and etinilestradiol (estrogen), which are released daily into the bloodstream on a regular and daily basis. This is an ovulation inhibitor method, i.e. prevents the release of ovaries and therefore fertilization.
Placement
The effectiveness of the vaginal ring depends on its placement in the vagina by the woman. Many women claim that placement is simple and easy, and it is only necessary to push the ring with your fingers to the inside of the vagina. Given its texture and flexibility, it glides easily and allows the woman not to feel it on the top of the vagina. Efficacy is not compromised by the position of the ring, which adapts to the woman’s body.
When you start using the ring, you should take into account the time and type of contraception you had done so far:
The ring should be inserted on the first day of menstruation, and in this case there is immediate efficacy.
At the latest, ring placement should be done until the next day after the pill-no-pill interval.
At the latest, the use of the ring shall be initiated until the next day after the interval without the system.
You can stop taking any day by starting the ring the next day. In the first 7 days of the exchange of methods, you should use a second method of contraception.
The ring can be placed on the day of injection, or on the very day of implant removal or SIU. In the first 7 days of the exchange of methods, you should use a second method of contraception.
In postpartum or abortion, you should always consult your doctor or health care professional for better advice.
From its placement, the ring remains in the vagina for 3 weeks, and is subsequently optimally removed on the same weekday and at the same time as it was placed. Like a cap, to remove the ring just insert one or two fingers into the vagina to find it and pull it.
During the fourth week, without the ring, vaginal bleeding occurs, that is, menstruation. After 7 days, exactly the same day of the week and time it was removed, a new ring should be introduced. During this week, the effectiveness of the contraceptive ring is maintained, so if the use of the ring is correct, it will be protected against pregnancy.
Retire o Anel da saqueta
Comprima o Anel
Escolha uma posição confortável
Introduza o anel na vagina com uma mão (4A). Se necessário, os lábios vaginais podem ser afastados com a outra mão. Empurre o anel para o interior da vagina até estar bem ajustado (4B). Deixe o anel assim colocado durante 3 semanas (4C).
O anel pode ser removido prendendo o dedo indicador no bordo do anel ou agarrando o anel entre os dedos indicador e médio e puxando o anel para fora.
Advantages and disadvantages
The vaginal ring is now understood as a method of contraception of high efficacy and very convenient for women who do not want to be on a daily dose regimen. There is no inconvenience in the day-to-day presence of the ring in the vagina over 3 weeks, and it is considered a hygienic method that does not even interfere with sexual activity.
In the following summary table you can easily see the advantages and disadvantages of the contraceptive ring:
| Advantage | Disadvantage |
| Easy to use | Does not protect against Sexually Transmitted Infections |
| It does not require a daily dose, so there is a lower probability of forgetting | It is not indicated for women who cannot take oestrogens |
| Regulates and controls the menstrual cycle | |
| Improves dysmenorrhea (menstrual pain) | |
| Since it is a method that does not depend on the digestive system, its effectiveness is not affected by vomiting or diarrhoea | |
| It is not ingested and is a good option for women with digestive system disorders | |
| Fertility returns from the moment it is removed | |
| Does not interfere with sexual intercourse | |
| Its effectiveness is not interfered with by other medicinal products, notably some antibiotics |
Frequently Asked Questions
Even if you forget to remove the ring, the effectiveness is maintained for 4 weeks. You can remove the ring and take the 1-week break by putting on a new one 7 days later.
If it passes 4 weeks, it is important to contact a doctor as you are no longer protected from pregnancy. With the certainty that you are not pregnant as soon as possible you can put a new vaginal ring, accompanied by a second method for 7 days.
The ring should not be felt on a day-to-day stand and should not be a nuisance for the woman.
No, usually the ring is not felt and should not cause pain.
The ring does not leave the vagina unless it is expelled or removed. The expulsion of the ring happens only in specific situations, such as with its poor placement or during sexual intercourse. If it leaves the vagina, it can be washed only with cold water and introduced again. It is important to note that the ring may not be more than 3 hours outside the vagina as it loses its effectiveness.
The ring should not be removed, even during sexual intercourse. If by accident the ring comes out, it can be washed with cold water and put back up to 3 hours after expulsion, and never after, as it will already have its effectiveness compromised.
It is not necessary to remove the vaginal ring for a gynecological examination.
No. On the contrary, estrogen promotes the increase of microorganisms that balance the vaginal flora.
Yes, there is no incompatibility of using both at the same time. If there is a possibility that the ring comes out with the removal of the cap, just wash it only with cold water and reinsert it into the vagina.
No, since the ring does not easily leave the vagina, when properly placed, there is no incompatibility between the vaginal ring and physical exercise.
The connecting channel between the vagina and the uterus is only 1 mm in diameter, so the ring cannot pass through this channel.
Side Effects
See Anette’s package leaflet.
More Information
For further clarification, contact a healthcare professional or your pharmacy.
More information about the vaginal ring can be found on the APF website or in this leaflet.
Editorial Note: This page and all other contents presented in lifewell.pt are prepared and reviewed by medical experts in Portugal.
