Are you thinking about a family planning method? Or are you looking for a different, easier option than the one you're currently using? So, have you heard about this new method, the Vaginal Ring? Maybe a doctor has told you about it. Don't worry, it's not as complicated as you think. Let's talk about it all in simple terms today.
What is this vaginal ring?
Simply put, this is a birth control method that prevents pregnancy. It's like birth control pills, but you don't have to take it every day like a pill. It's a flexible, small plastic ring. You insert it into your vagina yourself.
This ring releases two types of female hormones, namely estrogen and a type of progestin called `Segesterone Acetate`, into the body in very small doses. The main function of these hormones is to stop the release of an egg from your ovaries, that is, ovulation. There is no way to get pregnant without an egg. In Sri Lanka, this may be known by the brand name `Annovera`.
Things you should tell your doctor before using this
This is not a one-size-fits-all method, so be sure to discuss any health concerns you have with your doctor. Using this ring may be risky, especially if you have any of the following conditions:
| Health condition or habit | Why is it important? (in brief) |
|---|---|
| If you are a smoker (especially if you are over 35 years old) | The risk of blood clots, heart attacks, and strokes is greatly increased. |
| Having blood vessel disease, a history of blood clots, or a stroke. | This medicine may increase the risk of blood clots. |
| Having cancer of the breast, cervix, uterus, ovaries, or liver. | Hormones can cause some cancers to grow. |
| High blood pressure, heart disease, high cholesterol or diabetes. | These conditions may increase the complications. |
| Severe migraine headaches. | Some people may experience increased migraines. |
| Liver or kidney disease, gallbladder disease. | The process of removing hormones from the body can be affected. |
| Abnormal vaginal bleeding for an unknown reason. | First you need to find the cause. |
| Being pregnant or trying to get pregnant, recently having a baby, having a miscarriage. | This is not appropriate to use in such cases. |
The most important thing is to honestly discuss your entire health history with your doctor so that you can choose the safest and most suitable method.
How exactly do you use this?
The way this is used is very systematic.
1. Keep it in for 21 days: You should insert the ring into your vagina as directed by your doctor. Then, you should keep it in for 3 weeks (21 days) .
2. 7-day break: After 3 weeks, you should take it out and rest for 7 days (a week). During this week, you may experience withdrawal bleeding, similar to your period.
3. Reinsertion: After a 7-day break, a new cycle should be started. This means that the same cleaned ring should be inserted again for 21 days.
This ring can be reused for up to a year (13 cycles). Between each cycle, that is, during the 7-day break, it should be washed thoroughly with soap and water, dried, and stored in the special little box (case) that comes with it.
You will receive an instruction leaflet on how to use this. Read it carefully. If you don't understand, ask your doctor.
What if I forget to put it in once?
The success of this method depends on your adherence to this schedule. If you forget to insert the ring on time, leave it in for too long, or it falls out, your protection against pregnancy may be reduced. If this happens, call your doctor immediately for advice.
Other things that may interact with this medicine (Interactions)
Some medications can reduce the effectiveness of this ring. This means that if you use the ring while taking those medications, there is a chance of pregnancy. So tell your doctor about all the medications you are taking, including vitamins and herbal remedies.
| Never use these with a ring! | |
|---|---|
| |
| Be sure to talk to your doctor about these. | |
| Type of medicine | Examples |
| Some antibiotics and antifungals | Rifampin, Griseofulvin, Ketoconazole |
| Medicine for epilepsy (fits) | Carbamazepine, Phenytoin, Topiramate |
| Some medications for HIV/AIDS | Ask the doctor. |
| Herbal products | St. John's Wort |
Things to be careful about when using this ring
- Regular medical checkups: Visit your doctor at regular intervals throughout the entire period of use. Don't skip things like Pap smears.
- No protection against sexually transmitted diseases: This is very important. This ring only prevents pregnancy. It does not protect you from HIV (AIDS) or any other sexually transmitted diseases (STIs). For that, using a condom is essential.
- Smoking and Risk: As we mentioned earlier, if you are a smoker and over the age of 35, your risk of blood clots, heart attacks, and strokes is very high. Talk to your doctor about this.
- Skin spots: Some people may develop brown spots (Chloasma) on their face. These can worsen when exposed to the sun. So, protect yourself from the sun and use sunscreen.
- Swelling in the body: Sometimes you may feel like your body is filling with water, your hands, feet, and ankles may swell. Your blood pressure may also increase. If you feel this way, tell your doctor.
- Before surgery: If you are planning to have surgery, ask your doctor if you should stop using this ring before.
What are the possible side effects?
Like any medication, this one can have side effects. Some are serious, some are common.
| If you have these symptoms, see a doctor immediately or go to the Emergency Department (ETU). | |
|---|---|
| Symptoms of a blood clot | Pain, swelling, redness on one side of the leg; difficulty breathing; chest pain. |
| Symptoms of a Stroke | Sudden numbness or weakness of the face, arm, or leg (especially on one side of the body); difficulty speaking; sudden, severe headache; changes in vision. |
| Symptoms of liver disease | Pain in the upper right side of the stomach, nausea, yellowing of the skin or eyes, dark urine. |
| Other serious symptoms | Severe allergic reactions (skin rash, swelling of the face/lips), worsening depression, new or severe migraines. |
| If these symptoms persist or are bothersome, tell your doctor. | |
| |
In case of accidental or excessive ingestion, immediately go to the National Poisons Information Centre at the Colombo National Hospital or the nearest Emergency Treatment Unit (ETU).
How do you keep this safe and remove it?
Store it out of reach of children and pets, at room temperature (15-30 Celsius), away from light. Between two cycles of use, wash and dry it and store it in the box that came with it. After one year of use (13 cycles), put the ring back in the box and dispose of it in a trash can out of reach of children. Never flush it down the toilet.
Take-Home Message
- The vaginal ring is a hormonal birth control method that prevents pregnancy.
- This must be used exactly as the doctor says (21 days on, 7 days off).
- Tell your doctor about all other medications you take and all your health conditions.
- This does not protect against sexually transmitted diseases, including HIV/AIDS. A condom is required for that.
- If you smoke, especially if you are over 35, your risk of blood clots and stroke is very high.
- Be aware of serious side effects such as chest pain, difficulty breathing, swelling in a leg, and difficulty speaking.
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