Conditions and Management

The vaginal ring is a popular hormonal birth control method that steadily releases progestin and estrogen into your system. This stops you from ovulating and thickens your cervical mucus to prevent sperm from reaching an egg.

The flexible plastic ring is inserted into the vagina, where it stays for three weeks at a time before being removed for a break of one week. If you use the vaginal ring as prescribed, it is over 99% effective at preventing pregnancy.

But to maintain this high efficacy, you must know how to properly remove the ring after the 3-week period. This straightforward process only takes a minute once you understand the simple steps.

When to Remove the Vaginal Ring

The vaginal ring works on a 28-day cycle. You insert a ring and leave it in for three weeks straight. Then, you remove the ring the same day you inserted it (21 days later). This is followed by a 1-week pause before starting a new ring.

For example, if you insert a new ring on Sunday the 1st, you would remove it on Sunday the 22nd. Your weekly ring-free break lasts from Monday the 22nd through Sunday the 28th.

On Sunday the 29th, you would insert the next ring to start the cycle again. It is essential to take the ring out after exactly 21 days of use. Leaving it in longer than the recommended three weeks makes it less effective at preventing pregnancy.

Step-by-Step Guide to Removing the Ring

Removing the vaginal ring is a quick and simple process. With a bit of practice, it should come right out painlessly. Here is a step-by-step guide:

Before Removal

Wash your hands with water and soap to prevent transferring bacteria into the vagina.

Removing the Ring

• Get comfortable. You can stand with one foot raised on the toilet seat or sit on the toilet.
• Reach up into your vagina with your pointer finger. Feel around the upper vaginal wall until you locate the ring.
• Curl your finger slightly and hook it under the edge of the ring. You should be able to feel the entire ring with your fingertip.
• Gently pull down and forward. The ring should slide smoothly out of the vagina. Don’t apply force if you encounter resistance.
• The removal should not hurt at all. If you experience any pain, stop and go to your gynecologist.

After Removal

• Put the used ring back in the foil sleeve it originally came in. Then throw the pouch away in the garbage – do not flush it.
• If desired, rinse the ring with cool water before throwing it away.
• Your 1-week ring-free break now begins. You may get your period during this time.

Inserting a New Ring

• After exactly seven days, insert a new ring on the same day you removed the previous one.
• Use a backup method, such as condoms, for the first week of the new ring. The hormones take time to become effective.
• Follow the same steps to insert the new ring as you did the first time. Push it gently into the vagina until comfortable.

Troubleshooting Ring Removal

For most women, removing the vaginal ring is uncomplicated. But, issues can occasionally arise. Here is what you should do if you run into problems:

Forgot to Remove on Time

If you leave the ring in for up to 7 days past the 3-week mark (up to 4 weeks total):

• If you planned a ring-free week, remove it as soon as you remember and start your break.
• If you planned continuous use without a break, remove the old ring as soon as you remember and put a new one in right away.

You remain protected against pregnancy in both cases and don’t need backup contraception. But leaving the ring in for more than four weeks in a row makes it much less effective.

Ring Stuck Inside

If you cannot grasp the ring with your finger to pull it out:

• Stay calm and relax your muscles. Anxiety can cause tightening that makes removal harder.
• Try squatting or bearing down as if having a bowel movement. This helps push the ring lower in the vagina so it is easier to reach.
• Wait a few hours and attempt the process again. The ring cannot get lost or go too far up.
• If you still cannot remove it, call your gynecologist for an in-office visit. They can safely remove the ring.

Ring Falls Out

The ring can sometimes partially or fully slip out during sex, while using the bathroom, or with straining. If this happens:

• Rinse the ring in cool water and reinsert it as soon as possible if It’s been out for less than 3 hours.
• If it’s been out for over 3 hours in weeks 1 or 2, reinsert the ring and use backup contraception for seven days.
• If it’s been out for more than 3 hours in week 3, dispose of the ring and use a backup method of birth control. Insert a new ring no later than 7 days after the previous ring was removed or expelled.
• Pay attention to symptoms such as cramping or bleeding, which could signal expulsion. See your doctor if you are concerned.

Master the Vaginal Ring with Assistance from Raleigh Gynecology & Wellness

Properly inserting, using, and removing the vaginal ring is essential for it to work effectively as your contraceptive method. While the process can seem complicated at first, it becomes second nature for most women with some practice.

If you have concerns about using the ring or have problems, don’t hesitate to consult your gynecologist. The Raleigh Gynecology & Wellness team can walk you through all aspects of the vaginal ring, from insertion to removal.

We’ll make sure you feel comfortable with this convenient monthly contraceptive. Contact us today at (919) 636-6670 or schedule a consultation online to discuss whether the vaginal ring is right for you, and we’ll provide the guidance you need every step of the way.

With the array of birth control options at our fingertips today, it’s no wonder many women feel overwhelmed when choosing the best method for their needs. There are many factors to consider, from implants and IUDs to patches and rings. But among hormonal contraceptives, one underrated option stands out for its stellar benefits: the progestin-only pill.

Let’s explore five compelling reasons progestin-only pills deserve a top spot on your list if you want practical, reversible family planning.

Reduced Risk of Blood Clots

Traditional combo birth control pills include estrogen and progestin. Estrogen increases blood clotting factors, which raises the risk of developing dangerous clots compared to not using hormones.

The risk of blood clots is small in otherwise healthy women, but those with certain medical conditions such as inherited blood clotting disorders and smokers over 35 are at higher risk and should avoid estrogen-containing birth control.

Progestin-only pills avoid this risk by excluding estrogen entirely. This reduces the risk of complications such as deep vein thrombosis (DVT) or pulmonary embolism – threats that can become fatal if a clot travels to the lungs.

Clots usually start in the deep veins of the legs before breaking off and moving to the lungs, obstructing blood flow. Chest pains, leg swelling/pain, shortness of breath, and similar issues might indicate a clot.

Those prone to clotting or with a family history have higher risks from the estrogen in combination pills. Progestin-only options let these women access birth control without increasing clot odds.

No More Estrogen-Related Side Effects

The estrogen in combination pills can trigger unpleasant side effects such as breast tenderness, nausea, headaches, and mood swings. By avoiding estrogen altogether, progestin-only contraceptives let women dodge these bothersome symptoms.

Without estrogen peaks and dips every month, progestin-only pills promote hormonal stability day-to-day. This may lead to more even moods, comfortable breasts, and calm digestion for improved well-being.

Preventing estrogen-related discomforts makes progestin-only birth control an excellent choice for healthy women who want to avoid disrupting their lifestyle.

A Safe Harbor for Estrogen-Sensitive Women

Certain conditions warrant avoiding estrogen-containing medications. For instance, women prone to migraines with aura should avoid combination pills with estrogen due to increased stroke risks. Women with uncontrolled hypertension or significant risks for heart disease should also avoid estrogen containing birth control.

In these cases, progestin-only pills offer a safe harbor for women needing contraception. The total lack of estrogen lets women with these sensitivities access effective birth control without compromising their health or exacerbating their condition. For optimal outcomes, progestin-only pills support women who prefer estrogen-free contraception.

Worry-Free Breastfeeding

New moms who choose to breastfeed often worry about selecting postpartum birth control. Estrogen-containing combination pills can interfere with milk production and have potential developmental effects for nursing infants.

Progestin-only options avoid these concerns by excluding estrogen. The progestin hormone used in these pills transfers only minimally through breastmilk, allowing moms to nurse their babies without worry.

For women seeking effective birth control after giving birth that also preserves healthy breastfeeding, progestin-only pills thoughtfully check all the boxes. Mothers can relax knowing their infants receive the ideal balance of nutrients in their milk, even while taking these pills.

Discover Your Personalized Birth Control Options with Help from Raleigh Gynecology & Wellness

With so many birth control options to evaluate, it can be challenging to identify the best fit for your needs and priorities. But as you can see, progestin-only contraceptives offer compelling benefits, making them worth a close look.

By avoiding the risks and unpleasant side effects of estrogen while providing a safe yet effective approach, progestin-only pills are advantageous for many women. Their gentle formulation also enables worry-free breastfeeding and safe contraception for women who cannot use estrogen.

The Raleigh Gynecology & Wellness team has extensive experience guiding women to contraceptive solutions that align best with their needs. Contact us today at (919) 636-6670 or schedule a consultation, where we can explore if progestin-only pills may be right for you.

Several effective hormonal birth control options contain progestin but no estrogen. These progestin-only contraceptives include injections, implants, pills, and certain intrauterine devices (IUDs).

Let’s look at the unique benefits of progestin-only birth control pills, sometimes termed “mini-pills.”

What Are Progestin-Only Pills?

Progestin-only pills are oral contraceptives that contain progestin without estrogen. They come in 28-day packs. These pills are termed “mini-pills” because the amount of progestin in each active pill is lower than in combination birth control pills, which contain estrogen and progestin. The mini-pill contains only the hormone progestin at a relatively low dose.

How Do Mini-Pills Prevent Pregnancy?

Mini-pills prevent pregnancy through three key mechanisms:

• They thicken the mucus in the cervix to block and trap sperm, preventing passage through the cervix into the uterus.
• They provide inconsistent ovulation prevention – around 4 out of 10 mini-pill users will still ovulate sometimes. However, the thick cervical mucus prevents sperm from meeting and fertilizing the eggs.
• They thin the uterine lining, making implantation of an embryo extremely difficult or unlikely.

Taking the mini-pill at precisely the same time daily helps ensure the cervical mucus remains thick. Taking it more than 3 hours late, or missing pills altogether, allows the mucus to thin out. This could permit ovulation and sperm passage into the uterus to occur.

What Are the Benefits of Mini-Pills?

When taken exactly in line with the recommendations, mini-pills prevent pregnancy effectively, with less than 1% of women getting pregnant in the first year of ideal mini-pill use.

Mini-pills do not affect breastfeeding or harm infants in any way. This makes them a good birth control choice for postpartum women, allowing new mothers to prevent pregnancy without interrupting breastfeeding.

Some women experience much lighter menstrual periods or no periods when taking mini-pills. For those who normally have heavy, painful monthly bleeding, this relief can be substantial. Mini-pills may help make periods lighter, shorter, and more manageable. Some women also appreciate eliminating monthly bleeding for convenience.

Mini-pills are safe for those who cannot use contraceptives containing estrogen due to health risks. Some conditions where estrogen poses dangers include:

• History of blood clots: The estrogen in combination pills increases clotting factors in the blood, which can be hazardous for women already prone to blood clots. Progestin has a lower clot risk than estrogen.
• Migraines with aura: Estrogen can exacerbate migraine headaches. In women who have migraines with neurological aura symptoms, taking estrogen may significantly increase stroke risk.
• High blood pressure: Mini pills are considered safe for women with hypertension.
• Liver tumors: Estrogen may cause or worsen the growth of tumors in the liver. Mini-pills are a safe oral contraceptive choice for these women.

Because they lack estrogen, mini-pills do not raise clotting factors or cardiovascular disease risk for users. This makes them a safer contraceptive choice for those who cannot take estrogen for medical reasons.

You can start mini-pills right after pregnancy without delaying the return of your fertility. You can get pregnant quickly after stopping mini-pills, as progestin has no lingering effect on ovulation.

What Are the Potential Side Effects?

Unpredictable spotting or bleeding between periods is the most common side effect women report with mini-pill use. You may experience frequent spotting or irregular bleeding that is difficult to predict. This abnormal bleeding pattern could persist over time.

Other potential side effects include nausea, headaches, and breast tenderness. These are usually minor and often resolve after a few months of mini-pill use.

With mini-pill packs containing four inactive pills, you may get your withdrawal bleeding during those inactive pill days. This allows for more predictable monthly menstruation.

Who Should Avoid Using Mini-Pills?

Certain women with particular medical conditions should avoid using mini-pills:

• Women with active liver disease: Progestin gets metabolized by the liver, so impaired liver function can be problematic.
• Those diagnosed with breast cancer: Progestin may adversely affect the growth of certain types of breast cancer.
• Women with unexplained uterine bleeding: The cause of bleeding should be investigated before progestin use.

You should thoroughly discuss your complete medical history with your doctor before using mini-pills. Women over age 35 who smoke should use caution with mini-pills, as the risks likely outweigh the benefits.

Consult Raleigh Gynecology & Wellness for Progestin-Only Guidance

Progestin-only contraceptives such as mini-pills can provide effective birth control and unique benefits for many women. If you think this progestin-only pill option may suit your needs, schedule a consultation with Raleigh Gynecology & Wellness.

Our team of experts can review your health history, discuss your preferences, and determine if mini-pills or other progestin methods are a good match for you. Contact us today at (919) 636-6670 or schedule an appointment online so we can help you take charge of your reproductive health with confidence.

The vaginal ring offers a convenient, effective birth control option for many women. This discretely worn ring provides monthly hormone release to prevent pregnancy. Learning proper use of the vaginal ring is key for reliability.

Here are some tips to achieve the best outcomes with this approach to birth control.

How Does the Vaginal Ring Work?

The vaginal ring is a flexible, transparent ring about two inches wide. It releases steady levels of estrogen and progestin once in place. These hormones stop ovulation and thicken your cervical mucus to block sperm from meeting an egg.

The ring stays comfortably in place, with most women and partners unable to feel it during intimacy. One ring worn for three weeks prevents pregnancy, and then you replace it with a new ring after a one-week break.

When You’re Protected with the Vaginal Ring

You can begin using the vaginal ring any time, as long as you’re sure you aren’t pregnant. Suppose you insert it within the first five days of your period. In that case, you’ll be protected immediately from getting pregnant, so you don’t need a backup.

If you start the ring any other time, use an alternative as a backup for the first week. Your healthcare provider can advise on the best approach if switching from another birth control method to the ring.

Inserting and Removing the Vaginal Ring

Inserting the vaginal ring is easy. Get comfortable and gently push the ring into your vagina until it feels stable and secure. The exact positioning is not important. Most women do not feel the ring once inserted correctly.

Hook your finger under the ring’s rim and pull down and out to remove it. Make sure to be gentle. It might also help to engage your pelvic muscles and bear down. Place the used ring in its case and throw it out (don’t flush!).

Remember to remove the ring after wearing it for three weeks on the same day you inserted it. Allow ring-free time for your period, then insert a new ring in 7 days even if bleeding continues.

Tips for Proper Vaginal Ring Use

With consistent, proper use, the vaginal ring is over 99% effective at preventing pregnancy. However, incorrect use can reduce reliability. Here are tips for success:

• Do not spend more than a week without a ring inserted to avoid ovulation.
• If the ring comes out, rinse and reinsert it within 48 hours to stay protected.
• If it’s out over 48 hours, use backup birth control for a week. Take emergency contraception if needed.
• Mark your calendar to remind yourself of ring insertion and removal dates each month.

Who Shouldn’t Use the Vaginal Ring?

The vaginal ring is safe for most women. But some circumstances make it less ideal. Your healthcare provider may recommend against the vaginal ring if you:

• Smoke and are over age 35.
• Have a history of blood clots, heart disease, high blood pressure, or stroke.
• Have had breast cancer.
• Have diabetes, high cholesterol, or other medical conditions.
• Weigh over 198 pounds.
• Take certain medications that might interact with your ring.

The Pros and Cons of Vaginal Ring Birth Control

There are many benefits to using the vaginal ring:

• It doesn’t prevent you from having sex since most can’t feel it.
• No daily pill to remember.
• Vomiting/diarrhea doesn’t impact its effectiveness.
• It may result in lighter periods and help menstrual symptoms.
• It doesn’t require a procedure to start or stop.
• Some potential disadvantages include:
• Side effects such as discharge or headache, especially in the first 1-2 months.
• You must remember to replace it every month.
• It doesn’t protect against STDs, so you still need condoms.
• Risks, such as blood clots, are possible.

Side Effects and Health Risks to Know

All hormonal birth control carries some health risks. On the vaginal ring, these may include:

• Increased chance of dangerous blood clots, especially if you are a smoker or are overweight.
• High potassium levels.
• Rare liver tumors, gallstones, or jaundice.

More common side effects usually resolve within 1-2 months. They include discharge, headaches, breast tenderness, nausea, or mood changes. Discuss your full health history with your doctor before using the ring. Report any concerning symptoms after you begin using it.

Getting Your Vaginal Ring

The vaginal ring requires a prescription, which your healthcare provider can write after a discussion. Pick it up at your local pharmacy, where it may be covered by your insurance in part or in full.

You may also be able to get low-cost or free birth control, including the ring, through Medicaid or similar government programs.

Trust Raleigh Gynecology & Wellness for Personalized Reproductive Care

The vaginal ring can be an excellent contraceptive option when used properly. With its steady hormone release and low maintenance, it provides monthly pregnancy prevention without daily effort. However, correct and consistent use is imperative.

Raleigh Gynecology & Wellness team of expert healthcare providers has extensive experience helping women find the best birth control method for their needs. We keep up with the latest vaginal ring recommendations and research to provide the most up-to-date guidance and ensure you feel empowered in your choice.

Contact us today at (919) 636-6670 or schedule an appointment online to discuss whether the vaginal ring may be a good fit for you.

Combination contraceptive pills are composed of two synthetic hormones: estrogen and progestin. Regular intake of these pills prevents pregnancy by inhibiting ovulation and thickening the cervical mucus to obstruct sperm from reaching an egg.

Various formulations and schedules of combination contraceptive pills are available, making consultation with your healthcare provider crucial to determine which suits your requirements.

However, having basic knowledge of these contraceptive pills can be advantageous. Here is some essential information about these birth control methods.

Types of Combination Contraceptive Pills

Combination contraceptive pills come in different formulations, including monophasic, multiphasic, and extended-cycle pills, each with distinct proportions of estrogen and progestin.

Monophasic Pills

In monophasic pills, each active pill contains identical amounts of estrogen and progestin, providing consistent dosing that helps to minimize side effects caused by varying hormone levels. Monophasic pills are available in both 21-day and 28-day cycles.

Multiphasic Pills

Multiphasic combination pills alter the estrogen and progestin doses throughout the monthly pill cycle, mimicking the body’s natural hormonal fluctuations. These pills may reduce side effects such as breakthrough bleeding and headaches that can occur with monophasic pills. Most multiphasic pills adhere to a 28-day cycle.

Extended-Cycle Pills

Extended-cycle combination pills decrease the frequency of withdrawal bleeding. Instead of monthly periods, you experience a period every three months or less. This can alleviate menstrual symptoms, cramps, and anemia. Extended-cycle pills come in 13-week packs, with active pills for 12 weeks and inactive pills for the following week.

Advantages of Combination Contraceptive Pills

When administered as directed, combination pills proffer numerous advantages:

• Efficient Pregnancy Prevention: Exhibiting nearly 99% efficacy under perfect use, they offer reliable protection against unintentional pregnancies.
• Regulation of Menstrual Cycles: Combination contraceptive pills can aid in managing heavy or irregular menstrual cycles.
• Management of Hormonal Conditions: These pills effectively control hormonal health conditions such as endometriosis, premenstrual syndrome, ovarian cysts, and other related conditions.
• Potential Reduction in Certain Cancer Risks: Combination contraceptive pills may assist in reducing the risks related to ovarian and endometrial cancer.
• Effective in acne management: These pills, by curtailing the production of androgens (sex hormones associated with puberty), can potentially lessen acne breakouts.
• Support in maintaining bone health: The estrogen in these pills helps preserve bone mineral density, hence aiding in the prevention of bone loss.

Potential Side Effects and Risks

Combination pills have been shown to be safe for most women. However, as with any form of medication, side effects are possible. Common side effects encompass nausea, tender breasts, migraines and headaches, mood changes such as depression, anxiety, irritability, and spotting or breakthrough bleeding between periods.

A more serious concern is an increased risk of blood clots, potentially leading to stroke, heart attack, or pulmonary embolism. This stems from how estrogen impacts the clotting system.

The risk depends on your medical history and factors such as smoking, obesity, age, etc. Your healthcare provider can determine if combination pills are safe for you. Be sure to report any worrying symptoms promptly.

Who Should Avoid Combination Contraceptive Pills?

Combination pills may not be appropriate if you have specific health conditions or risk factors. You should avoid taking combination birth control if you:

• Are older than 35 and a smoker.
• Have experienced blood clots, a heart attack, or a stroke.
• Have uncontrolled high blood pressure.
• Experience migraines with aura.
• Have liver disease or breast cancer.
• Take medications that may interact with combination birth control, such as Rifampin, certain seizure meds, and St. John’s Wort.

Choosing the Right Pill for You

There is a wide array of combination pill brands and formulations. The ideal choice for you depends on aspects such as:

• Your menstrual symptoms: Extended-cycle pills can reduce heavy bleeding.
• Your health conditions: If you can’t take estrogen, you may need a progestin-only pill.
• Other medications you take: Some may negatively interact with combination pills.

Confer with your doctor about your medical history and preferences to ascertain which combination birth control pill is optimal.

How to Use Combination Pills

Combination pills must be taken daily around the same time. Here are some guidelines for proper usage:

• Start a new pack the Sunday after your period begins for immediate pregnancy protection.
• If starting mid-cycle, use a backup form of birth control, such as a condom, sponge, or diaphragm, for a week.
• Take your pill at the same time daily, but if not possible, do not exceed a three-hour window.
• If you miss a contraceptive pill, take it the moment you remember. If two or more are missed, use backup protection for seven days.
• Begin each new pack on time, as delays can increase pregnancy risk.
• Some medications can make the pills less effective, so discuss possible drug interactions with your provider.

Take Charge of Your Reproductive Health with Raleigh Gynecology & Wellness

Finding the optimal birth control method is vital to manage your reproductive health effectively. Combination birth control pills can provide an effective, convenient, customizable way to prevent pregnancy when taken correctly. However, combination birth control isn’t suitable for everyone.

Raleigh Gynecology & Wellness is here to help. Our expert healthcare providers have extensive experience and can help you make an informed decision about your reproductive health. Contact us today at (919) 636-6670 or schedule an appointment online, and let us help you find the best birth control solution.