Contraceptive Ring
The contraceptive ring easily folds for
insertion into the vagina
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The contraceptive ring is a soft, plastic ring that is worn in the vagina,
where it slowly releases it's active ingredients, etonogestrel and ethinyl
estradiol, at an average rate of 0.120 mg and 0.015 mg per day. The patient
reacts as though she were taking oral contraceptive pills.Each ring lasts
one week. The ring is used for 3 consecutive weeks (3 weeks "on") and then not
used for one week (1 week "off"). The patient's normal menstrual flow occurs
during the "off" week.
The benefits and risks are essentially the same as for OCPs, and the
effectiveness is between 98% and 99%. This is nearly as effective as OCPs, and
comparable to the effectiveness of an IUD or condoms.
The ring remains in place during intercourse. Most women and their partners
are not conscious of the ring being present. For those who do notice it, most
are not bothered by its presence.
If the ring should come out of the vagina, it should be re-inserted within
3 hours, after rinsing it off with cool or luke-warm water. If it remains out
of the vagina for more than 3 hours, it can still be re-inserted, but backup
contraception should be used for 7 days following re-insertion.
Starting the Ring
Insert the first ring within 5 days of the beginning of the
menstrual flow. Use backup contraception for the first 7 days following
insertion.
Changing from OCPs to the Ring
At the normal time for starting a new pack of pills, insert the ring.
Starting the ring after a 1st trimester miscarriage
Insert the ring within 5 days of the miscarriage (spontaneous abortion or
induced abortion). No backup contraception is needed.
Starting the ring after a 2nd or 3rd trimester delivery
Insert the ring 4 weeks after delivery (for those not breastfeeding).
Breastfeeding and the ring
The ring manufacturer recommends that the ring not be used while
breastfeeding, based on absence of scientific studies examining the effect of
these hormones on the newborn.
Many physicians, however, routinely use oral contraceptive pills in
breastfeeding women, and the American Academy of Pediatricians has declared
breastfeeding and the concurrent use of oral contraceptive pills to be
compatible. It is unlikely that the ring's hormonal properties are so much
different from the OCPs properties as to place it in a different category. |