Some people do this when they want to put off bleeding, for example if they are going on holiday or want to have sex. You can miss out the ring-free interval by using another ring straight away. This isn’t harmful and you will still be protected against pregnancy. Sometimes you will still get bleeding.

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When you first start using the vaginal ring you will be given a supply to see how it suits you. After that you should go back to the doctor or nurse to get new supplies and to have your blood pressure checked. If there are no problems, you can be given a further supply of vaginal rings. You will only be able to get the ring in 3 month intervals as they need to be stored in a fridge before dispensing.

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Medications used to treat epilepsy, HIV and TB, and the herbal medicine St John’s Wort). Ask your GP, clinician or pharmacist and read the information that comes with your medicine.

Always tell your doctor that you are using the ring if you are prescribed any medicines.

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Sometimes the ring may come out on its own (this is called expulsion). This is most likely to happen after or during sex, or when you're constipated. What you should do depends on how long the ring is out for, and whether you’re in the first, second or third week of using it.

	If the ring is out for more than three hours in the first or second week of using it, rinse it and put it back in. You need to use additional contraception for 7 days. You may need emergency contraception if you have had sex in the last few days – talk to your doctor or nurse.
	If the ring is out for more than three hours in the third week of using it, don’t put it back in. Dispose of it in the normal way. You now have two options:

Option 1

You can put a new ring in straight away. You may not have a period-type bleed, but you may have spotting.

Option 2

Don’t put a ring in and have a 7 day interval. You’ll have a period-type bleed, and you should put a new ring in 7 days after the old one came out (you can only choose this option if the ring was in continuously for the previous 7 days).

Whichever option you choose, you need to use additional contraception until the ring has been in for 7 days in a row. You should also talk to your doctor or nurse if you’ve had sex in the last few days, as you may need emergency contraception.

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If you have just had a baby and are not breastfeeding, you can start using the ring on day 21 after the birth. You will be protected against pregnancy straight away. If you start using the ring later than 21 days after giving birth, you will need additional contraception (such as condoms) for the next 7 days.

If you are breastfeeding a baby less than six months old, using the ring can reduce your flow of milk. It is recommended that you use a different method of contraception until you stop breastfeeding.

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These are very rare:

A very small number of women may develop venous thrombosis, arterial thrombosis, heart attack or stroke. If you have ever had thrombosis, you should not use the vaginal ring.

Some users of the ring appear to have a small increased risk of being diagnosed with breast cancer or cervical cancer compared to non-users of hormonal contraception, which reduces with time after stopping the ring.

See a doctor straight away if you have any of the following:

• Pain in the chest, including any sharp pain which is worse when you breathe in
• Breathlessness
• You cough up blood
• Painful swelling in your leg(s)
• Weakness, numbness, or bad 'pins and needles' in an arm or leg
• Severe stomach pains
• A bad fainting attack or you collapse
• Unusual headaches or migraines that are worse than usual
• Sudden problems with your speech or eyesight
• Jaundice (yellowing skin or yellowing eyes).

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Most women can use the ring, but your GP or clinician will ask about your family and medical history to determine whether or not it is the best method for you.

The ring is not suitable for women who:

• Are pregnant
• Are breastfeeding
• Smoke (or stopped smoking less than a year ago) and are 35 or older
• Are very overweight
• Are over 50 years old
• Take certain medicines (ask your GP about this)
• Have or have had thrombosis
• Have or have had a heart abnormality or heart disease, including high blood pressure
• Have or have had diabetes
• Are immobile for a long period of time or use a wheelchair
• Have systemic lupus erythematosus
• Have loose vaginal muscles.

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