Starting the contraceptive vaginal ring

The contraceptive vaginal ring can be started at any stage of the menstrual cycle (see Quick start). If early pregnancy cannot be excluded, a pregnancy test is recommended 4 weeks after starting, or 3 weeks after starting if no further episodes of unprotected sex occurred in the first week of use. For general advice about excluding pregnancy, see Starting intrauterine contraception.

The vaginal ring is immediately effective if:

• inserted on day 1 to 5 of a regular menstrual cycle
• inserted less than 21 days postpartum
• inserted within 5 days of an abortion
• switching from an etonogestrel implant or depot medroxyprogesterone injection
• switching from a copper IUD during days 1 to 5 of a regular menstrual cycle
• switching from a combined oral contraceptive; insert the vaginal ring at any time but no longer than 24 hours after the end of the hormone-free interval.

The vaginal ring takes 7 days to work at all other times, and if the current method of contraception is not effective at the time of switching (eg late doses, injection or replacement). For more information about time to effectiveness when switching between contraceptive methods, see printable table.

Use:

Advise users:

• not to remove the vaginal ring for sexual intercourse
• what to do if vaginal ring insertion or removal deviates from the intended schedule.