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The Contraceptive Vaginal Ring: Pros and Cons for Women

The Contraceptive Vaginal Ring: Pros and Cons for Women

According to the Guttmacher Institute, 99% of women aged 15-44 who have had sexual intercourse have used at least one method of contraception. For those women who dislike the idea of taking a pill daily, having an implant placed, or getting injections, the contraceptive vaginal ring can present a viable alternative.

A relatively new technology that garnered recognition as one of Time Magazine’s Best Inventions of 2001, the contraceptive vaginal ring is a hormonal birth control method that follows a unique four-week pattern. Before women choose this birth control method over the others, it’s important to break down the facts, advantages, and disadvantages.

The Contraceptive Vaginal Ring

According to the American Pregnancy Association, the vaginal ring is quite simply a flexible ring of soft plastic that contains hormones that prevent pregnancy. Each ring lasts for a month of usage and generally costs between $30 and 35 (depending on factors like insurance). Women who are interested in getting the contraceptive vaginal ring will have to get a prescription from a physician.

Estrogen & Progestin

The contraceptive vaginal ring contains the hormones estrogen and progestin, which work in concert to prevent pregnancy. Together, these hormones prevent the body from ovulating, change the consistency of mucus at the cervix to prevent sperm from entering, and alter the lining of the uterus. With the vaginal ring, these two powerful hormones are absorbed through the vaginal lining.

Simple Insertion & Removal

The vaginal ring is unique among contraceptives because it’s inserted into the vagina. The process is simple as outlined on the NuvaRing website:

  1. Women should thoroughly wash and dry their hands before insertion.
  2. Choose a comfortable position for insertion; usually, women lie down, squat, or stand with one leg propped up.
  3. Pinch the ring between your thumb and index finger to get it into a flattened shape.
  4. Insert it into the vagina, then push it further into the vagina with the index finger.
  5. To remove, simply wash hands, get into a comfortable position, and use your index finger to hook into the ring and pull it out.

Time Frame

Though it doesn’t require daily maintenance like the Pill, the vaginal ring does require women to carefully follow a cycle of insertion and removal. Women are instructed to wear the ring for three weeks (21 days) and then remove and leave it out for one week (seven days). It’s important to pick a standardized time of day  for this (i.e. make it a habit to insert it and remove it at 9:30 p.m. on schedule), and to carefully mark a calendar with the details.

Advantages of the Vaginal Ring

Closeup of pharmacist's hands taking medicines from shelf at the pharmacy

For many women, the vaginal ring is attractive because of its effectiveness in preventing unwanted pregnancies: with perfect use, it’s 99% effective. Even in cases when women don’t use it correctly, it’s still 90% effective in preventing pregnancy.

Decreased Dysmenorrhea & Menorrhagia

For some women, a menstrual period is accompanied by extremely painful cramps known as dysmenorrhea. It can either be considered primary (caused by uterine chemicals called prostaglandins) or secondary (caused by co-factors like endometriosis or fibroids). Some women also experience menorrhagia during menstrual periods, which is marked by abnormally heavy bleeding.

Because of the way it interacts with estrogen and progestin, hormonal contraceptives like the vaginal ring can reduce symptoms of extreme pain and heavy bleeding in women.

Reduced Risk of Certain Cancers

According to, hormonal contraceptive methods like the vaginal ring can actually help reduce the risk of endometrial and ovarian cancer. For endometrial cancer, the effects can last up to ten years after a woman stops using the ring. For ovarian cancer, the longer a woman uses combination hormonal contraceptives, the lower her risk of developing these cancers. Though further research is needed, some studies suggest that hormonal contraceptives may also decrease the risk of colorectal cancer.

Lifestyle Fit

For some women, the advantages of the vaginal ring extend beyond lighter periods, reduced pregnancy risk: it’s just easier for some. Because it doesn’t require a daily commitment like the Pill, it may appeal to those who have difficulty remembering a daily action. And it definitely appeals to women who are wary with the more invasive insertion of an IUD, or who dislike the idea of receiving regular pregnancy-preventive injections.

Disadvantages of the Vaginal Ring

Some women may not like the idea of having to manually insert and remove the vaginal ring on a schedule. Others report discomfort from the ring, and there is even a rare risk of accidentally inserting the ring into the bladder. There are some other disadvantages as well.

Mild Side Effects

The contraceptive vaginal ring may have some mild side effects that are uncomfortable to women. Luckily, many of these minor side effects will go away within two or three months for most women:

  • Sore breasts
  • Spotting or bleeding between periods
  • Nausea
  • Headaches

Increased Risk of Some Cancers

Although combination hormonal birth control can reduce endometrial and ovarian cancer, reports that it can increase the risk of breast cancer and cervical cancer. For both breast and cervical cancer, the risk seems to increase depending on how long a woman has used hormonal contraceptives.

Not for Everybody: Some Serious Side Effects

Contraceptive vaginal rings can increase the risk of serious side effects like stroke, heart attack, and blood clots. For that reasons, it’s not recommended for certain women:

  • Women who have uncontrollable high blood pressure.
  • Those who have diabetes that’s caused kidney, eye, nerve, or blood vessel damage.
  • Women with liver disease or liver tumors.
  • Women who have certain types of severe migraine headaches.
  • Those who smoke cigarettes and are over the age of 35.

No protection against STD’s

Although the vaginal ring is quite effective against unwanted pregnancies, it provides no protection against STD’s like HIV, HPV, or herpes.

So Who Should Use the Contraceptive Vaginal Ring?

The choice to choose one contraceptive method over another is deeply personal and subject to a variety of different questions and circumstances. What’s the past medical history? Is there any history of cancer, high blood pressure, or smoking cigarettes? For women suffering from dysmenorrhea and menorrhagia, the contraceptive may offer enormous health benefits. As with any health choice – and especially choices which impact reproduction and women’s health—it’s important to present the facts and work on a case-by-case basis.

Our goal at obp is to provide safe and effective medical devices which empower practitioners and the individuals they serve. For more information, don’t hesitate to contact us today.

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