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Sexual Development

About the Birth Control Ring

Talking to your kids about sex can be daunting, no matter how close you are. But discussing issues like abstinence, sexually transmitted diseases (STDs), and birth control can help lower teens’ risk of an unintended pregnancy or contracting an STD.


The American Academy of Pediatrics (AAP) supports sex education that includes information about both abstinence and birth control. Research has shown that this information doesn’t increase kids’ level of sexual activity, but actually promotes and increases the proper use of birth control methods among sexually active teens.

How and when you discuss sex and birth control is up to you. Providing the facts is vital, but it’s also wise to tell your kids where you stand. Remember, by approaching these issues like any other health topics, not as something dirty or embarrassing, you increase the odds that your kids will feel comfortable coming to you with any questions and problems. As awkward as it might feel, answer questions honestly. And if you don’t know the answers, it’s OK to say so, then find out and report back.

If you have questions about how to talk with your son or daughter about sex, consider consulting your child’s doctor. Lots of parents find this tough to tackle, and a doctor may offer some helpful perspective.

What Is the Birth Control Ring?

The birth control ring is a soft, flexible, doughnut-shaped ring about 2 inches (5 centimeters) in diameter. It is inserted into the vagina where it slowly releases hormones through the vaginal wall into the bloodstream. The hormones in the ring affect the ovaries and the uterus in order to prevent pregnancy.

How Does the Ring Work?

The combination of the hormones progesterone and estrogen in the birth control ring prevent ovulation (the release of an egg from the ovaries during a woman’s monthly cycle). If an egg isn’t released, a woman can’t get pregnant because there’s no egg for a male’s sperm to fertilize.

The hormones in the ring also thicken the cervical mucus (the mucus produced by cells in the cervix). This makes it difficult for sperm to enter the uterus and reach any eggs that may have been released. The hormones in the ring can also sometimes affect the lining of the uterus so that an egg will have a hard time attaching to the wall of the uterus.

Like the birth control pill or patch, a woman uses the birth control ring based on her monthly menstrual cycle. She inserts it into the vagina (similar to the insertion of a tampon) on the first day of her menstrual cycle or before day 5 of her menstrual cycle, where it remains in place for 3 weeks in a row. At the end of the third week, on the same day of the week it was inserted and about the same time of day, she removes it. Within a few days her menstrual period should start. At the end of the fourth week, on the same day of the week the last ring was inserted, she inserts a new ring and the process begins again. The new ring should be placed on that day, even if a girl still has her period.

Because the hormones in the ring don’t take effect immediately, another form of birth control (such as a condom) should be used for 7 days when a girl first starts using the ring. After 7 days, the ring should work alone to prevent pregnancy. But continuing to use condoms will protect against sexually transmitted diseases (STDs).

The exact position of the ring in the vagina is not critical as long as it feels comfortable. If it doesn’t feel comfortable, it can be pushed further back or removed and reinserted. Most women do not feel the ring once it is in place. It can be left in place during swimming, bathing, and exercise. It can also remain in place during intercourse.

The ring is held in place by the vaginal muscles, so it’s unlikely that it will fall out. If it does, it can be rinsed under cool water (not hot) and reinserted within 3 hours. If more than 3 hours pass without the ring in the vagina, there’s a risk of pregnancy and an additional form of birth control should be used until the ring has been in place for 7 days.

If the ring is out for more than 3 hours during a woman’s third week wearing it, she should call the doctor for advice. The doctor may say to put a new ring in, or not to replace it, so that the period starts early. Either way, an additional form of birth control should be used.

How Well Does the Ring Work?

The effectiveness of the vaginal birth control ring seems to be similar to other hormonal methods of birth control, like the patch or the Pill. Results show that over the course of a year, about 8 out of 100 typical couples who rely on the ring to prevent pregnancy will have an accidental pregnancy. Of course, the chance of getting pregnant depends on whether a woman uses the ring correctly. Delaying or missing a monthly insertion or removing a ring too early reduces its effectiveness.

In general, how well each type of birth control method works depends on many things. These include whether a woman has any health conditions or is taking any medications that might interfere with its use. It’s important for a doctor to be aware of all medications and herbal supplements that a girl might be taking. Although using the ring means not having to remember to take a pill every day or replace a patch, it still needs to be removed after 3 weeks and then replaced a week later. If it is not replaced on time, it loses its effectiveness.

Protection Against STDs

The vaginal ring does not protect against STDs. Couples having sex must always use condoms along with the vaginal ring to protect against STDs.

Abstinence (not having sex) is the only method that always prevents pregnancy and STDs.

Possible Side Effects

The vaginal ring is a safe and effective method of birth control. Most young women who use the ring have no side effects. Smoking cigarettes and using the ring can increase the risk of certain side effects, which is why health professionals advise those who use the ring not to smoke.

The side effects that some women have while using the ring are similar to those experienced with the birth control pill. These may include:

  • irregular menstrual bleeding
  • nausea, headaches, dizziness, and breast tenderness
  • mood changes
  • blood clots (rare in women under 35 who do not smoke)

Other possible side effects seen in ring users include:

  • vaginal irritation or infections
  • vaginal discharge
  • problems with contact lens use, such as a change in vision or inability to wear the lenses

Many of these side effects are mild and tend to disappear after 2 or 3 months.

Who Uses the Birth Control Ring?

The vaginal ring may be a good choice for young women who find it difficult to remember to take a pill every day or who have difficulty swallowing pills. They must feel comfortable enough with their bodies to be able to insert a device into the vagina.

Not all women can — or should — use the vaginal ring. Certain medical conditions can make the use of the ring less effective or more risky. For example, it is not recommended for females who have had blood clots, severe high blood pressure, certain types of cancers, certain types of migraine headaches, or diabetes with certain complications. Those who have had unexplained vaginal bleeding (bleeding that is not during their periods) or who suspect they may be pregnant should talk to their doctors, stop using the ring, and use another form of birth control in the meantime.

Where Is the Birth Control Ring Available?

A doctor or a nurse practitioner must prescribe the birth control ring, and will probably ask questions about your daughter’s health and family medical history. He or she may also do a complete physical exam, including a blood pressure measurement and a pelvic exam. If the ring is prescribed, the doctor will also provide instructions on how to use it.

A young woman may have to go back to the doctor a few months after using the ring to get her blood pressure measured and to ensure that there are no problems. After that, a doctor may recommend routine exams once or twice a year or as needed.

How Much Does the Birth Control Ring Cost?

The ring usually costs between $30-$50 a month, although health and family planning clinics (such as Planned Parenthood) might sell them for less. In addition, the vaginal ring and doctor’s visits are covered by many health insurance plans.

Reviewed by: Mary L. Gavin, MD
Date reviewed: August 2013