|Street names||The ring, the halo|
|Medical names||Combined Vaginal Ring, Nuvaring® (brand)|
|It lasts||28 days|
|Fertility||No contraceptive effect when ring is removed|
|Who can use it?||People with a vagina and uterus of any age from menarche to menopause|
|Hormones||Contains oestrogen and progestogen hormones|
|Visibility||Discreet and not visible during sex|
|STIs||No protection ?|
|Side effects||Headaches, nausea, breast tenderness, bloating, uterine spotting. Allow 6 months to adjust to the hormones|
|Cost||$100 for a 3 month supply|
|Where to get it||Visit a reproductive and sexual health clinic or your local doctor. You may need to visit a pharmacy to pick up a prescription|
How does it work?
The ring fits comfortably inside the vagina and releases a small amount of hormones every day. The hormones prevent the ovaries from releasing eggs (ova). It also changes the mucus of the cervix and lining, making it harder for any sperm to enter the uterus. This prevents pregnancy.
The plastic contains 0.015mg of a progestogen hormone called oestrogen and 0.12 mg of a progestogen hormone called etonogestrel. One ring contains enough hormones to work as a contraceptive for 21 days. If you like the daily combined contraceptive pill but find it difficult to remember taking it every day, the contraceptive ring is a good option as the hormone dosages are very similar.
You will still need to consider the risk of Sexually Transmitted Infections (STIs) every time you have sex.
What’s it like to use?
Using a contraceptive ring is a bit like using a tampon, so you need to be comfortable inserting something small into your vagina. To insert the ring, it can be folded into a thin shape and slid into the vagina. As the space expands at the top of the vagina, the vaginal ring will return to more of a circular shape.
You or a sexual partner should not feel the ring during vaginal sex. The vaginal wall is warm, soft and bumpy, so the contraceptive ring easily fits in with its surroundings. The contraceptive ring will stay within the vagina. It is held in place by pelvic muscles.
Your body stops ovulating. Every 21 days the contraceptive ring is removed for 7 days. During that week you may experience uterine bleeding which is similar to a menstrual period. After 7 days you insert a new contraceptive ring and leave it in place for 21 days.
You no longer have menstrual bleeding and instead experience uterine bleeding, which can feel similar but is usually lighter in flow. Tricycling is possible. Tricycling involves using 3 rings in a row without a break. It means you experience uterine bleeding less often. Before you experiment with tricycling, discuss it during an appointment at a reproductive and sexual health clinic or your local doctor.
What if I forget about it?
To be effective you need to remember the correct dates for removing and inserting the ring. This method is 91% effective because 9% of people forget to change the ring. Using a calendar or menstruation app may be helpful.
- If you have left the ring in for longer than 21 days but less than 28 days, insert the new ring as initially scheduled.
- If you have left the ring in for longer than 28 days, remove the ring and use alternative contraception for 7 days. If there has been any unprotected penis in vagina (PIV) sex in the previous 5 days emergency contraception should be considered.
- If you are within the 21 day period of wearing the ring: If the ring has been removed from the vagina for less than 24 hours, insert a new ring and it will continue to work.
- If you are within the 21 day period of wearing the ring: If there has been no ring in the vagina for more than 24 hours, insert a new ring and use an alternative contraceptive method for 7 days. If there has been any unprotected penis in vagina (PIV) sex in the previous 5 days emergency contraception should be considered.
- If you have forgotten to put the ring in after a 7 day break and a uterine bleed occurs: put in a new ring and use an alternative contraceptive method for 7 days.
Who can use it?
People with a vagina and uterus of any age, from menarche to menopause.
The contraceptive ring is suitable for people who have never experienced pregnancy and for use as contraception after pregnancy.
Contraceptives that contain oestrogen may be less suitable if you have a Body Mass Index (BMI) above 30. Use this calculator to estimate your BMI. Consider progestogen only or non-hormonal contraceptive options.
If you experience polycystic ovarian syndrome (PCOS), the Combined Hormonal Contraceptive Pill is generally considered to be the best contraceptive option. Given the contraceptive ring contains similar hormone doses, it is also a good option. However, it is best to discuss your exact situation with a doctor.
If you are over 40 years old, contraceptives that contain oestrogen may be less suitable, especially if you have other medical conditions. The contraceptive ring should generally not be used by people beyond the age of 50 years old.
The contraceptive ring is suitable for people who may have a family history of breast cancer. It is not suitable for people who have breast cancer or have experienced breast cancer in the past.
During the first 6 months your body may take time to adjust to the hormones.
Side effects can include increased headaches, nausea, breast tenderness, bloating, and uterine spotting. You may find that you experience less hormonal mood changes and that your acne decreases. While body weight can change alongside hormonal changes, there is no reliable medical that links the contraceptive ring with weight gain. Learn more about your reproductive organs and sexual health and hormonal contraceptives.
If at any point you feel that this contraceptive method is making you feel uncomfortable or unwell, get advice from a doctor or medical professional. If it is an emergency, call an ambulance on 000.
What if you change your mind
The contraceptive ring is reversible. Any time you want to stop using it, just remove the ring and ovulation will return. Visit a reproductive and sexual health clinic or your local doctor to discuss other contraceptive options.
How and where to get it
A reproductive and sexual health clinician or your local doctor can explain how to insert contraceptive rings, provide a prescription, and explain which local pharmacies may sell them.
It costs approximately $100 for a pack of 3 rings, which will last 12 weeks. There may also be consultation fees. You can ask for a quote when you book an appointment.