Etonogestrel and ethinyl estradiol combination comes as a flexible ring to place in the vagina.It is usually placed in the vagina and left in place for 3 weeks. After 3 weeks, it is removed for a 1-week break; then a new ring is inserted. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use the contraceptive ring exactly as directed. Never use more than one contraceptive ring at a time and always insert and remove the ring according to the schedule your doctor gives you.
You should always insert and remove the contraceptive ring on the same day of the week and at about the same time of day. Your menstrual period will probably start 2 to 3 days after you remove the contraceptive ring and may continue through that week. Be sure to insert your new ring at the end of the week on the same day and at the same time that you usually insert or remove the ring even if you have not stopped bleeding.
Your doctor will tell you when you should insert your first contraceptive ring. This depends on whether you were using a different type of birth control in the past month, were not using birth control, or have recently given birth or had an abortion or miscarriage. In some cases, you may need to use an additional method of birth control for the first seven days that you use the contraceptive ring. Your doctor will tell you whether you need to use backup birth control and will help you choose a method, such as male condoms and/or spermicides. You should not use a diaphragm when a contraceptive ring is in place.
You do not need to position the contraceptive ring a certain way inside your vagina. The ring will work no matter how it is positioned, but will be more comfortable and less likely to fall out when it is placed as far back in your vagina as possible. The ring cannot get past the cervix, so it will not go too far into the vagina or get lost when you push it in.
The contraceptive ring will usually stay in your vagina until you remove it. It may sometimes slip out when you are removing a tampon or having a bowel movement, or if you are very constipated or have not placed it properly in your vagina. Call your doctor if your contraceptive ring slips out often.
If your contraceptive ring slips out, you should rinse it with cool or lukewarm (not hot) water and replace it in your vagina as soon as possible. If your ring falls out and gets lost, you should replace it with a new ring and remove the new ring at the same time you were scheduled to remove the ring that was lost. Try to replace your ring within 3 hours after it falls out.If you do not replace your ring within 3 hours, you must use a backup method of birth control until you have had the ring in place for 7 days in a row.
To use the contraceptive ring, follow these steps:
- Wash and dry your hands.
- Remove one contraceptive ring from its foil pouch, but do not discard the pouch. Put the pouch in a safe place so you can use it to properly discard the contraceptive ring after you remove it.
- Lie down on your back with your knees bent, squat, or stand with one leg up on a chair, step, or other object. Choose the position that is most comfortable for you.
- Hold the contraceptive ring between your thumb and index finger and press the opposite sides of the ring together.
- Gently push the folded ring into your vagina.
- If you feel discomfort, push the ring further back into your vagina with your index finger.
- Wash your hands again.
- When it is time to remove the contraceptive ring, hook your index finger under the front rim or hold the rim between your index and middle fingers and pull it out.
- Put the used ring into the foil pouch and discard it safely, so that it is out of the reach of children and pets. Do not throw the used ring in the toilet.
- Wash your hands.
- Wait one week, then insert a new ring following the directions above.