Combined Vaginal Ring

Effectiveness depends on the user: Risk of pregnancy is greatest when a woman is late to start a new ring.

• The combined vaginal ring is new, and research on effectiveness is limited. Effectiveness rates in clinical trials of the vaginal ring suggest that it may be more effective than combined oral contraceptives, both as commonly used and with consistent and correct use.

Return of fertility after ring use is stopped: No delay

Protection against sexually transmitted infections (STIs): None

Side Effects

Some users report the following:

• Changes in monthly bleeding, including:
  • Lighter bleeding and fewer days of bleeding
  • Irregular bleeding
  • Less frequent bleeding
  • Prolonged bleeding
  • No monthly bleeding
• Headaches
• Irritation, redness, or inflammation of the vagina (vaginitis)
• White vaginal discharge

Known Health Benefits and Health Risks

Long-term studies of the vaginal ring are limited, but researchers expect that its health benefits and risks are like those of combined oral contraceptives.

1. Left ring out for more than 3 hours during weeks 1 or 2?

Put the ring back in as soon as possible. Use a backup method* for the next 7 days.

2. Left ring out for more than 3 hours during week 3?

• Stop the current cycle and discard the ring.
• Insert a new ring immediately and keep it in place for 3 weeks, starting a new cycle. Use a backup method for the next 7 days.

(Another option, if the ring was used continuously and correctly for the past 7 days: Leave the ring out and make the next 7 days the week with no ring. After those 7 days, insert a new ring, starting a new cycle, and keep it in place for 3 weeks. Use a backup method for the first 7 days with the new ring.)

3. Waited more than 7 days before inserting a new ring, or kept ring in longer than 4 weeks?

• Insert a new ring as soon as possible and begin a new 4-week cycle. Use a backup method for the first 7 days of ring use.
• Also, if a new ring was inserted 3 or more days late (ring was left out for 10 days or more in a row) and unprotected sex took place in the past 5 days, consider taking emergency contraceptive pills.