Vaginal Ring

Etonogestrel/ethinyl estradiol (NuvaRing)

• Use: The ring is self-inserted into the vagina. Exact positioning is not required for it to be effective. The vaginal ring must be inserted within 5 days of the onset of the menstrual period, even if bleeding is still occurring. During the first cycle, an additional method of contraception, such as male condoms or spermicide, is recommended until after the first 7 days of continuous ring use. The ring remains in place continuously for 3 weeks. The ring is then removed for 1 week. Menstruation should begin during this week. The next ring is inserted 1 week after the last ring was removed.
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• Side effects: Since the ring affects the female reproductive organs directly, side effects such as weight gain and mood changes are avoided. However, other side effects are similar to those of other birth control medications containing both estrogen and progesterone. Additionally, a vaginal ring may not be suitable for women experiencing vaginal irritation or ulcerations. A ring may be accidentally expelled, for example, when it has not been inserted properly, during tampon removal, or while moving the bowels or straining, especially with severe constipation. If this occurs, the vaginal ring can be rinsed with cool to lukewarm (not hot) water and reinserted promptly. If the ring is not replaced within 3 hours of expulsion, then a backup method, such as male condoms and spermicide, should also be used following reinsertion of the ring for at least 7 days.