Vaginal Ring: How to Use – Benefits, Uses and Side Effects

The vaginal ring is the ideal method of contraception for women who tend to forget to take their pill every day. This plastic ring is inserted into the vagina and must be replaced every month. However, the ring has some drawbacks: first, this expensive contraceptive is not covered by social security. In addition, like the mini-dose pill, it contains estrogen and suffers from many contraindications.

L'intravaginal ring also called vaginal ring is a flexible porous plastic ring approximately 5 cm in diameter and 4 mm in section. This contraceptive inserted into the vagina in which he releases female hormones (in contact with body heat) which then pass into the bloodstream. Once the ring is in place, you cannot get pregnant.

Just like for the combined pill (also called a mini-pill or combination pill), the ring contains both estrogens (and more precisely of the ethinylestradiol) and the progesterone (and more precisely of the etonogestrel). Due to the low amount of hormones released, it is considered a low-dose hormonal contraceptive.

As you can see, the first disadvantage of the vaginal ring is that it therefore suffers from same contraindications as mini-dose pills third generation: “with an increased risk of venous and arterial thromboembolic diseasesThe vaginal ring should therefore be avoided in women who have a history of this type or who have certain cardiovascular risk factors including high blood pressure, diabetes and active smoking in particular,” warns the expert.

The vaginal ring is inserted into the vagina and must be replaced every 4 weeks.

The vaginal ring should be inserted as deep as possible into the vagina.

If this is your first time wearing the ring, the ideal is towait until the first day of your period. The ring is then effective immediately.

If you put the ring in between the second and fifth day of your period, it is best to use a condom for 7 days to avoid any risk of pregnancy.

Pinch the ring between your thumb and forefinger and insert it like a tampon.. Once in the vagina you should no longer feel it. If it bothers your partner during intercourse, you can remove it for the duration of intercourse only. Rinse it with water before reinserting it.

You must remove the ring after three weeks (21 days). During the three weeks you wear the ring, the hormones released block ovulation and you cannot get pregnant.

Your period will come in the fourth week. during which you are still protected against the risk of unwanted pregnancy. At the end of the fourth week (i.e. at the end of the 28th day), you will need to insert a new ring.

It is possible to keep the ring for the full 4 weeks if you do not want to have your period. You will then replace this ring with another one.

The contraceptive ring presents an excellent theoretical efficiency of 99.7%. However, usage errors bring down this 91% effective in practice.

– carefully follow the instructions for use as well as the dates for inserting and removing/replacing the ring. If the ring is expelled more than 3 hours outside the vaginait is necessary to:

*put the ring back if you are located during the first two weeks of your cycle.

*use a new ring if you are located during the third week of your cycle. Then use a condom for 7 days to avoid any risk of unwanted pregnancy.

– use the morning after pillif you have had any sexual intercourse inthe 7 days preceding the expulsion of the ring.

– do not insert the ring more than4 months after the date of purchase (which must be written by the pharmacist on the box), and in all cases before the expiration date.

The most commonly reported side effects are:

· Repeated vaginal infections;

· Increased vaginal discharge;

· Abdominal pain;

· Painful periods;

· Depression ;

· Decreased libido;

· Headaches, migraine;

· Breast tension;

· Weight gain ;

· Discomfort related to the ring;

· Expulsion of the ring (especially when passing stool in the event of pushing effort).

Just like the Third generation combined pillsthe ring induces an increased risk ofobstruction by a blood clot in the veins or arteries. Your gynecologist will therefore not prescribe contraception if you have cardiovascular risk factors (history of thrombosisofpulmonary embolismofStroke or ofheart attack, smoking, hypertension, obesity…).

Just like the estrogen-progestin pill, the ring also increases the risk of some cancers (such as breast or liver cancer) and some kidney, digestive or liver diseasesThe gynecologist will therefore have to check that you are not exposed to these diseases.

According to the drug's leaflet, it should not be used in the following cases:

• arterial thromboembolic accident (imyocardial infarctionhascerebrovascular accident…) or venous (phlebitis, pulmonary embolism…) old or occurring during contraception;
• diseases increasing the risk of thrombosis (diabetes with vascular lesions, severe high blood pressuresignificant excess of lipids in the blood);
• known blood clotting disorder (protein C deficiency or in protein S…);
• pancreatitis associated with a significant excess of triglycerides in the blood;
• history of severe migraines accompanied by neurological signs (paralysis, etc.);
• hormone-dependent cancer (breast cancer) ;
• liver diseaseserious or recent, including liver tumor ;
• intermittent genital bleeding (the origin of this bleeding must be determined by examinations before starting treatment);

Other situations that could be considered risky:

· A age over 35 years (especially if associated with other risk factors);

· THE active smoking ;

· a severe or acute renal failure ;

· THE postpartum or thebreastfeeding.

This medicine should not be combined with herbal products containing St. John's Wort (risk of reduced effectiveness or even cancellation of the contraceptive effect). It should also not be taken at the same time as hepatitis c treatments (dasabuvir or of theombitasvir/paritaprevir) at the risk of increasing the liver toxicity of these drugs.

You can obtain the contraceptive ring upon presentation of the gynecologist's prescription and with your vital card.

THE Nuvaring® price (Etoring in generic) is freely set by the pharmacy. The rings are sold in boxes of 1 or 3 with applicator(s). Its unit price is on average16 euros either 48 euros for 3 rings.

The contraceptive ring is not covered by Social Security.