Learning About the Birth Control Ring
What is the birth control ring?
- The birth control ring is a soft, 5.5 cm (2 inches), clear, plastic (non-latex) ring that you put in your vagina to prevent pregnancy.
- The ring contains hormones (estrogen and progestin) that mimic natural hormones. They stop the ovaries from releasing an egg. You can’t get pregnant if you don’t release an egg.
How well does the ring work?
- With typical use (not following the exact directions) the ring is 91% effective.
- With perfect use (following the exact directions all the time) the ring is 99.7% effective.
- Most pregnancies happen because people don’t use the ring as directed.
- The ring doesn’t protect you from sexually transmitted infections (STIs) or HIV.
How do I start using the ring?
You need a prescription from your healthcare provider. Many sexual health clinics offer some types of birth control for free or low cost for people who qualify.
If you start the ring on:
- day 1 of your period, it works right away to prevent pregnancy
- any other day, use a backup form of birth control (like condoms) or don’t have vaginal sex for 7 days
How do I use the ring?
Put the ring in your vagina. Leave the ring in for 3 weeks (21 days). After 3 weeks, take the ring out. You’ll start your 7 hormone-free days. You’ll get your period when you aren’t wearing the ring. You’re still protected from pregnancy during this time. There are apps you can use to help you remember when to put in and take out the ring.
After your 7 hormone-free days, always put in a new ring. Even if you still have your period, you need to put a new ring in. You can still use a tampon or menstrual cup when you have the ring in. If you haven’t had your period, put a new ring in and contact your healthcare provider.
The ring can be stored for up to 4 months at room temperature.
While using the ring, you should not use internal methods of birth control such as diaphragm, cervical cap, or internal (vaginal) condom as your extra method of birth control. The ring can get in the way of those methods being in the right place to work.
How do I put the ring in?
- Wash your hands. Get into a comfortable position (like standing with one foot up on a chair).
- Squeeze the ring between your thumb and finger. Gently push it up into your vagina. It doesn’t matter how the ring is placed, as long as it’s high enough that it won’t fall out. If it feels uncomfortable, the ring might not be up far enough. Use your finger to push it further up. The ring can’t get lost in your vagina or be pushed in too far.
How do I take the ring out?
- Wash your hands.
- Hook your finger under the rim and pull the ring down and out. Throw it in the garbage, away from children and pets because it still contains hormones.
What are the benefits of the ring?
- Your period may be more regular, lighter, or shorter with less cramping.
- The ring may lower your risk of ovarian and endometrial cancer.
- The ring may help with acne and painful periods (dysmenorrhea).
- It’s safe to use the ring for many years. There’s no need to “take a break” from the ring.
- You can get pregnant as soon as you stop using the ring.
What are the side effects of the ring?
There’s a chance (more likely in the first 3 months) that you might have:
- headaches
- breast or chest tenderness
- bloating
- upset stomach (nausea)
- moodiness
- spotting or bleeding between periods
- vaginal irritation or more discharge
If you have any side effects, don’t stop using the ring. Talk to your healthcare provider. Most side effects get better within 3 months.
Can the ring cause blood clots?
When using the ring, there’s a small risk of blood clots in the legs, lungs, heart, or head. The risk is higher depending on your:
- age
- weight
- history (or family history) of blood clots, heart attack, or stroke
- history of smoking or vaping nicotine (especially people older than 35 who smoke)
- history of migraines with aura or other nervous system problems affecting speech, vision, movement, or sensations
- risk factors for heart disease (like high blood pressure, diabetes, or high cholesterol)
- history of other medical problems (ask your healthcare provider about this)
The risk of getting a blood clot is higher during pregnancy and right after having a baby than when using the ring.
Blood clots are very serious. Go to the nearest emergency room or call 911 if you have:
- trouble breathing or it hurts to breathe
- a very bad headache
- sudden numbness in the face, arms, or legs (often only on one side of the body)
- very bad pain in your abdomen, chest, or legs
- eye problems (like sudden blurry vision or loss of vision)
- sudden problems with walking or balance
- sudden confusion or trouble understanding what people say to you
What if I forget the ring or it falls out?
If you need help deciding what to do, talk to your healthcare provider, read the chart below, or use the Sex & U – Stay on Schedule tool.
If the ring is out for less than 3 hours, put it in right away. You’re protected from pregnancy. If the ring has been out over 3 hours (or you don’t know how long), follow these directions:
| Week 1 | Week 2 or 3 |
|---|
Started more than 24 hours late or out for more than 3 hours | Out for 3 to 72 hours | Out more than 72 hours or you don't know how long |
- Rinse the ring and put the ring in right away. Keep it in until your next normal removal day.
- Use backup form of birth control (like condoms) or don't have vaginal sex for 7 days.
- Get emergency contraception as soon as possible if your extra method of birth control fails (like the condom breaks) or you've had vaginal sex without a condom in the last 5 days.
| - Rinse the ring and pout the ring in right away. Keep it in until your next normal removal day.
- On removal day, take out the old ring and put in a new one. Don't take the hormone free days.
- Leave the new ring in for 3 weeks.
- You might have spotting or miss your period this month. Don't take the ring out.
- You're protected from pregnancy.
| - Rinse the ring and pout the ring in right away. Keep it in until your next normal removal day.
- On removal day, take out the old ring and put in a new one. Don't take the hormone free days.
- Leave the new ring in for 3 weeks.
- You might have spotting or miss your period this month. Don't take the ring out.
- Use an extra method of birth control (like condoms) or don't have vaginal sex until the ring has been in for 7 days.
- Get emergency contraception as soon as possible if your extra method of birth control fails (like the condom breaks) or you've had vaginal sex without a condom in the last 5 days.
|
What if I forget to take out the ring?
| 21 to 27 days | 28 to 35 days | More than 35 days |
- Remove the ring.
- Take a 7-day, hormone-free break.
- Start a new ring cycle with a new ring schedule.
- You're still protected from pregnancy.
| - Remove the ring. Put a new one in right away. Don't take the hormone-free break.
- Leave the new ring in for 3 weeks.
- You might have spotting or miss your period this month. Don't take the ring out.
- You're still protected from pregnancy.
| - Remove the ring. Put a new one in right away. Don't take the hormone-free break.
- Leave the new ring in for 3 weeks.
- You might have spotting or miss your period this month. Don't take the ring out.
- Use backup form of birth control (like condoms) or don't have vaginal sex for 7 days.
- Get emergency contraception as soon as possible if your extra method of birth control fails (like the condom breaks) or you've had vaginal sex without a condom in the last 5 days.
|
What else is important to know about consent, sexual activity, and birth control?
- You have the right to decide to have sex or not. Talk with your partner or partners about consent.
- There’s an 85% chance of becoming pregnant within one year, if no birth control is used for vaginal sex.
- Use a condom or barrier every time you have sex (oral, vaginal, anal). Condoms help prevent pregnancy, STIs, and HIV.
- You can lower your risk of HIV by taking an HIV prevention medicine every day. Many Albertans can get it for free. Visit HIV PrEP to find out more.
- Transgender and gender diverse people who have a uterus can use hormonal birth control. It can help prevent pregnancy and make periods lighter and less painful.
Where can I find more information?
If you have questions, need to find a sexual health clinic near you, or want more information, call Health Link at 811 anytime, day or night, to talk to a registered nurse.
To see this information online and learn more, visit MyHealth.Alberta.ca/health/aftercareinformation/pages/conditions.aspx?hwid=custom.ab_birth_control_ring_inst.
Related to Sexual and Reproductive Health
For 24/7 nurse advice and general health information call Health Link at 811.
Current as of: February 12, 2024
Author: Sexual and Reproductive Health, Alberta Health Services
This material is not a substitute for the advice of a qualified health professional. This material is intended for general information only and is provided on an "as is", "where is" basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. Alberta Health Services expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use.
