Vaginal Ring (NuvaRing)

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What is the vaginal ring (NuvaRing)?

The vaginal ring is a soft plastic ring that contains two hormones – oestrogen and progestogen. These are similar to the hormones that are produced by the ovaries and used in the Pill (combined pill or oral contraceptive pill). The vaginal ring is sold as NuvaRing in Australia.

How effective is the vaginal ring?

If used correctly the vaginal ring can be over 99% effective at preventing pregnancy. If you forget to put a new ring in, use it incorrectly or take certain medications, it might only be 93% effective.

How does the vaginal ring work?

The vaginal ring works by stopping the ovaries from releasing an egg each month.

It also thickens the fluid around the cervix (opening to the uterus/womb). This helps to prevent the sperm from entering.

How do I use the vaginal ring?

You squeeze the vaginal ring and insert it into your vagina (like inserting a tampon).

A new vaginal ring is needed every 4 weeks. Each ring stays in the vagina for 3 weeks. You then take it out and throw it away and wait 7 days before inserting a new ring. Most users cannot feel the ring once it is in the vagina. You will usually have your period (bleeding from your vagina) a few days after removing the ring. You can skip your period by missing the 7-day break and inserting a new ring straight away.

When does it start to be effective?

When you start the vaginal ring for the first time or after a break it can take up to 7 days to start working to prevent pregnancy. This depends on the timing of your menstrual cycle and if you are already using contraception. Speak with your doctor, nurse or pharmacist for more information.

Where can I get the vaginal ring?

Your doctor or nurse will provide a script which you can take to the pharmacy, who will sell you the vaginal ring. The vaginal ring should be used within 4 months of purchase from the pharmacy.

What is good about the vaginal ring?

• It can be used to skip your period if you want to.
• Periods usually become lighter, more regular, and less painful.
• Acne can improve.
• Chance of getting cancer of the uterus (womb) and ovaries decreases.
• It can help with symptoms of polycystic ovary syndrome (PCOS) and endometriosis.
• Once stopped your fertility quickly returns to what is normal for you.

Are there any side effects from using the vaginal ring?

Possible side effects for a small number of users can include:

• an increase in vaginal discharge (fluid from the vagina)
• irregular vaginal bleeding
• nausea
• sore/ tender breasts
• headaches
• bloating
• changes to your skin
• mood changes.

These side effects often settle with time. The vaginal ring has not been shown to cause weight gain.

A small number of people find the vaginal ring uncomfortable. Partners are usually not bothered by the ring during sex.

Can the vaginal ring cause any serious health problems?

The vaginal ring causes a very small increase in your chances of a deep vein blood clot/thrombosis, heart attack and stroke. The vaginal ring is associated with a very small increase in the risk of cervical and breast cancer which reduces with time after stopping.

Reasons why the vaginal ring may not be a good option for you:

• Have certain types of migraine headache.
• Are very overweight.
• Have a close family member who has had a deep vein blood clot/thrombosis.
• Are taking certain types of medication which might stop the vaginal ring from working (check with your doctor, nurse or pharmacist).
• Have had some health problems like, high blood pressure, heart or liver problems (check with your doctor or nurse).
• Are over 35 years and smoke.
• Have breast cancer or have been treated for breast cancer.
• Have severe liver disease.
• Are unable to move around for a long time (for example because of surgery or disability).

What if I am late inserting the vaginal ring?

• Insert a vaginal ring as soon as you notice.
• Abstain from sex or use condoms for the next 7 days.
• If you have had sex without a condom in the 7 days before missing the ring, you may need emergency contraception or to insert a new ring straight away. What you need to do depends on how many days the ring has been in for (check with your doctor, nurse or pharmacist).

What happens if I get pregnant while I am using the vaginal ring?

The vaginal ring will not harm the pregnancy. It is safe to continue the pregnancy (and stop the vaginal ring) or to have an abortion.

Can I use the vaginal ring after I have had a baby?

If you are breastfeeding, the vaginal ring cannot be used until your baby is 6 weeks old. After 6 weeks you can use the ring but other types of contraception might be more suitable choices.

If you are not breastfeeding the vaginal ring can generally not be used until your baby is 3 weeks old. After 3 weeks you can use the vaginal ring if you do not have any medical risk factors (check with your doctor or nurse or pharmacist).

What if I am using the vaginal ring and I want to become pregnant?

You can stop the vaginal ring at any time and your fertility will usually quickly return to what is normal for you.

What else should I know about the vaginal ring?

• The vaginal ring does not protect you from sexually transmissible infections(STIs).
• It is safe to use condoms with the vaginal ring.
• You do not have to take the vaginal ring out for sex.
• It is good to record the date or enter a reminder into your phone for when your vaginal ring is due to be removed and a new one inserted.
• The vaginal ring is one of many types of contraception. See other contraceptive options

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Where to get more information, support or advice

• Sexual Health Victoria
• A doctor or nurse
• Your local community health service
• An obstetrician or gynaecologist
• 1800 My Options phone line 1800 696 784 or website
• Better Health Channel
• Equinox – for transgender services
• Jean Hailes
• Marie Stopes Australia
• Multicultural Centre for Women’s Health
• The Women’s (The Royal Women’s Hospital)