Batas karakter maksimum terlampaui

5000/5000
9421 karakter melebihi batas 5000 maksimum:
n – don’t flush it down the toilet Removing the ring should be painless. If you have any bleeding or pain,
or you can’t pull it out, tell your doctor or nurse immediately. When you’ve taken the ring out, you don’t
put a new one in for seven days (one week). This is the ring-free interval. You might have a period-type
bleed during this time. After seven days without a ring in, you need to insert a new one. Put the new ring
in even if you’re still bleeding. Leave this ring in for 21 days, then repeat the cycle. You can have sex and
use tampons while the ring is in your vagina. You and your partner may feel the ring during sex, but this
isn’t harmful. If you forget to take the ring out If you forget to take the ring out after 21 days, what you
should do depends on how much extra time the ring has been left in. If the ring has been in for up to
seven days after the end of week three: take the ring out as soon as you remember don’t put a new ring
in – start your seven-day interval as normal begin your new ring after your seven-day interval as normal
you’re still protected against pregnancy, and you don’t need to use additional contraception If the ring
has been in for more than seven extra days (more than four weeks in total): take the ring out as soon as
you remember put a new ring in straight away The licence for the vaginal ring states that you should use
additional contraception (such as condoms) until the new ring has been in for seven days. The FSRH
advice is different. Talk to your doctor or nurse about when you should use additional contraception.
You may need emergency contraception if you had sex in the days before changing the rings over. Talk
to your doctor or nurse. If you forget to put a new ring in Put in a new ring as soon as you remember,
and use additional contraception, such as condoms, for seven days. You may need emergency
contraception if you had sex before you remembered to put the new ring in, and the ring-free interval
was 48 hours or more longer than it should have been (nine days or more in total). If this is the case, talk
to your doctor or nurse. If the ring comes out by itself 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. The licence for the vaginal ring states that if the ring is out for more than three hours,
you will not be protected against pregnancy. The FSRH advises that you'll be protected for longer – up to
48 hours if the ring was in for seven continuous days before it came out. Talk to your doctor or nurse
about whether you'll be protected against pregnancy or not. The information below is based on the
licence information on what to do if the ring comes out. 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 seven 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: You can put a new ring in straight
away. You may not have a period-type bleed, but you may have spotting. OR Don’t put a ring in and have
a seven-day interval. You’ll have a period-type bleed, and you should put a new ring in seven days after
the old one came out (you can only choose this option if the ring was in continuously for the previous
seven days). Whichever option you choose, you need to use additional contraception until the ring has
been in for seven 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. Who can use the vaginal ring? Some women
cannot use the vaginal ring. Your doctor or nurse will ask about your medical history and your family's
medical history, to see whether the ring is suitable for you. The ring may not be suitable if you: have had
a blood clot in a vein or artery have had heart or circulatory problems, including high blood pressure are
35 or older and smoke, or stopped smoking in the past year have severe migraine with aura (warning
symptoms) have had breast cancer in the past five years have diabetes with complications are
overweight take certain medicines have vaginal muscles that can’t hold a vaginal ring If you don’t smoke
and there are no medical reasons why you can’t use the ring, you can use it until you are 50 years old.
After giving birth You can start using the vaginal ring 21 days after giving birth, and you will be protected
against pregnancy straight away. If you start the ring more than 21 days after giving birth, you need to
use additional contraception for seven days after you insert the ring. The vaginal ring may reduce your
flow of milk if you’re breastfeeding a baby under six months old. It’s usually recommended that you use
a different method. After miscarriage or abortion You can start using the ring immediately after a
miscarriage or abortion, and it will work straight away. You don’t need to use additional contraception.
Advantages and disadvantages Some of the advantages of the vaginal ring include: it doesn’t interrupt
sex it’s easy to put in and remove you don’t have to think about it every day or each time you have sex
the ring is not affected if you vomit or have diarrhoea it may help with premenstrual symptoms period-
type bleeding usually becomes lighter, more regular and less painful it may reduce the risk of cancer of
the ovary, uterus and colon it may reduce the risk of fibroids, ovarian cysts and non-cancerous breast
disease Some of the disadvantages of the vaginal ring include: it may not be suitable if you don’t feel
comfortable inserting or removing it from your vagina spotting and bleeding while the ring is in your
vagina can occur in the first few months it may cause temporary side effects, such as increased vaginal
discharge, headaches, nausea, breast tenderness and mood changes the ring does not protect against
STIs The vaginal ring with other medicines Some medicines may interact with the vaginal ring, meaning
it doesn’t work properly. If you want to check that your medicines are safe to take with the vaginal ring,
you can: ask your GP, practice nurse or pharmacist read the patient information leaflet that comes with
your medicine The vaginal ring can interact with medicines called enzyme inducers. These speed up
breakdown of progestogen by your liver, reducing the effectiveness of the ring. Examples of enzyme
inducers are: the epilepsy drugs carbamazepine, oxcarbazepine, phenytoin, phenobarbital, primidone
and topiramate St John’s Wort (a herbal remedy) some antiretroviral medicines used to treat HIV
antibiotics called rifampicin and rifabutin, which can be used to treat illnesses including tuberculosis (TB)
and meningitis Your GP or nurse may advise you to use an alternative or additional form of
contraception while taking any of these medicines. Risks There are some serious side effects, but these
are not common. They include: developing a blood clot in a vein or artery having a heart attack or stroke
Research into the risk of breast cancer and hormonal contraception is complex and contradictory. It
suggests that all women who use hormonal contraception appear to have a small increased risk of being
diagnosed with breast cancer, compared with women who don’t use hormonal contraception. Research
suggests there is a small increase in the risk of developing cervical cancer with longer use of oestrogen
and progestogen hormonal contraception. Some research suggests a link between oestrogen and
progestogen hormonal contraception and a very rare liver cancer. Where you can get the vaginal ring
Most types of contraception are available for free in the UK. Contraception is free to all women and men
through the NHS. Places where you can get contraception include: most GP surgeries – talk to your GP
or practice nurse community contraception clinics some genitourinary medicine (GUM) clinics sexual
health clinics – they also offer contraceptive and STI testing services some young people’s services (call
0300 123 7123 for more information) Find your nearest sexual health clinic by searching by postcode or
town. Contraception services are free and confidential, including for people under the age of 16. If
you're under 16 and want contraception, the doctor, nurse or pharmacist won't tell your parents or
carer as long as they believe you fully understand the information you're given and your decisions.
Doctors and nurses work under strict guidelines when dealing with people under 16. They'll encourage
you to consider telling your parents, but they won't make you. The only time that a professional might
want to tell someone else is if they believe you're at risk of harm, such as abuse. The risk would need to
be serious, and they would usually discuss this with you first. Page last reviewed: 31/12/2014 Next
review due: 30/09/2017
Cincin vagina

Seorang wanita bisa hamil jika sperma pria mencapai salah satu telurnya (ova). Kontrasepsi mencoba
menghentikan hal ini terjadi dengan menjaga sel telur dan sperma terpisah atau dengan menghentikan
produksi telur. Salah satu metode kontrasepsi adalah cincin vagina.

Sekilas: cincin vagina

Bagaimana cincin itu bekerja?

Siapa yang bisa menggunakan cincin itu?

Keuntungan dan kerugian

Resiko cincin

Cincin vagina adalah cincin plastik lembut kecil yang Anda tempatkan di dalam vagina Anda. Ini sekitar
4mm tebal dan 5.5cm diameter. Anda tinggalkan di vagina selama 21 hari, lalu keluarkan dan buang di
tempat sampah (jangan di toilet) di kantong pembuangan khusus. Tujuh hari setelah mengeluarkan
cincin, Anda memasukkan yang baru selama 21 hari berikutnya.

Cincin tersebut melepaskan estrogen dan progestogen. Ini mencegah ovulasi (pelepasan telur),
menyulitkan sperma untuk sampai ke telur dan menipiskan lapisan rahim, jadi kemungkinan telur akan
ditanam di sana.
Sekilas: fakta tentang cincin vagina

Jika digunakan dengan benar, cincin vagina lebih dari 99% efektif. Ini berarti bahwa kurang dari satu
wanita dari setiap 100 yang menggunakan cincin vagina karena kontrasepsi akan hamil dalam satu
tahun.
Satu cincin akan memberikan kontrasepsi selama sebulan, jadi Anda tidak perlu memikirkannya setiap
hari.
Itu tidak mengganggu seks, karena Anda bisa berhubungan seks dengan cincin di tempat.
Berbeda dengan pil, cincinnya masih efektif jika Anda mengalami muntah atau diare.
 Cincin ini bisa mengurangi gejala pramenstruasi, dan pendarahan mungkin akan lebih ringan dan
kurang menyakitkan.
Beberapa wanita memiliki efek samping sementara, termasuk lebih banyak keputihan, nyeri tekan
dada dan sakit kepala.
Beberapa wanita mengembangkan bekuan darah (trombosis) saat menggunakan cincin, tapi ini jarang
terjadi.
Cincin itu terkadang bisa keluar dengan sendirinya, tapi Anda bisa membilasnya dengan air hangat dan
memasukkannya kembali sesegera mungkin. Anda mungkin memerlukan kontrasepsi darurat,
tergantung pada berapa lama waktu yang dibutuhkan.
Cincin vagina tidak melindungi terhadap infeksi menular seksual (IMS). Dengan menggunakan kondom
dan juga cincinnya, Anda akan melindungi diri terhadap IMS.

Bagaimana cincin itu bekerja?

Menggunakan cincin vagina

Jika Anda lupa mengeluarkan cincin itu

Jika Anda lupa memasang cincin baru

Jika cincin itu keluar dengan sendirinya

Cincin ini terus melepaskan estrogen dan progestogen, yang merupakan versi sintetis dari hormon yang
secara alami dikeluarkan oleh indung telur. Ini:

Mengurangi ovulasi (pelepasan telur)

Mengental lendir vagina, yang membuatnya lebih sulit bagi sperma untuk melewatinya
Menipiskan lapisan rahim sehingga telur cenderung ditanamkan di sana

Menggunakan cincin vagina

Anda bisa mulai menggunakan cincin vagina kapan saja selama siklus haid Anda. Anda tinggalkan selama
21 hari, lalu keluarkan dan jaga-jaga selama tujuh hari tanpa henti. Anda terlindungi dari kehamilan
selama istirahat tanpa henti. Anda kemudian memasang cincin baru selama 21 hari lagi.

Anda bisa mendapatkan kontrasepsi di:

Kebanyakan operasi GP
Klinik kontrasepsi masyarakat
Beberapa klinik GUM
Klinik kesehatan seksual
Beberapa layanan orang muda
Temukan klinik di dekat Anda

Lisensi untuk cincin vagina menyatakan bahwa:

Anda akan terlindungi dari kehamilan segera jika Anda memasukkannya pada hari pertama menstruasi
Anda (hari pertama siklus menstruasi Anda)
Anda tidak akan terlindungi dari kehamilan jika Anda mulai menggunakannya pada waktu lain dalam
siklus haid Anda, dan Anda harus menggunakan kontrasepsi tambahan (seperti kondom) selama tujuh
hari pertama.

Namun, panduan dari Fakultas Kesehatan Seksual dan Reproduksi (FSRH) sedikit berbeda, memberi tahu
bahwa cincin tersebut akan melindungi terhadap kehamilan segera jika Anda memulainya sampai hari
kelima siklus haid Anda. Ini karena sebuah penelitian menemukan bahwa ovulasi ditekan pada wanita
yang mulai menggunakan cincin vagina pada hari kelima siklus mereka.

Anda bisa membicarakannya dengan dokter atau perawat Anda untuk menentukan kapan waktu terbaik
bagi Anda untuk mulai menggunakan cincin itu.
Untuk memasukkan cincin:

Dengan tangan yang bersih, peras cincin antara ibu jari dan jari Anda, dan masukkan ujungnya ke
dalam vagina dengan lembut
Dengan lembut dorong cincin itu ke vagina Anda sampai terasa nyaman

Tidak seperti diafragma atau tutup, cincin tidak perlu menutupi serviks Anda (pintu masuk rahim) untuk
bekerja.

Jika Anda bisa merasakan cincin dan tidak nyaman, dorong sedikit lebih jauh ke dalam vagina Anda.
Tidak ada tempat yang benar atau salah untuk itu, asalkan tidak nyaman.

Anda harus bisa mengecek apakah cincin itu masih ada dengan menggunakan jari Anda. Jika Anda tidak
bisa merasakannya, tapi Anda yakin itu ada di sana, ketemu dokter atau perawat Anda. Cincin itu tidak
bisa "hilang" di dalam dirimu.

Setelah cincin itu berada di vagina Anda selama 21 hari (tiga minggu), Anda akan menghapusnya. Ini
harus pada hari yang sama minggu dimana Anda memasukkannya ke dalam.
Untuk menghapus dering:

Dengan tangan bersih, letakkan jari ke dalam vagina dan kaitkan di sekitar tepi ring
Tarik perlahan cincin itu keluar
Memasukkannya ke dalam tas khusus yang disediakan dan membuangnya di tempat sampah - jangan
menyiramnya ke toilet. Diamkan cincin itu tidak menimbulkan rasa sakit. Jika Anda mengalami
perdarahan atau rasa sakit, atau Anda tidak dapat menariknya keluar, segera beritahu dokter atau
perawat Anda. Bila Anda telah mengeluarkan cincin itu, Anda tidak memasukkan yang baru selama tujuh
hari (satu minggu). Ini adalah interval bebas pulsa. Anda mungkin mengalami menstruasi tipe-tipe
selama masa ini. Setelah tujuh hari tanpa dering, Anda perlu memasukkan yang baru. Letakkan cincin
baru di bahkan jika Anda masih berdarah. Tinggalkan cincin ini selama 21 hari, lalu ulangi siklusnya. Anda
bisa melakukan hubungan seks dan menggunakan tampon saat cincin berada di vagina Anda. Anda dan
pasangan mungkin merasakan cincin itu saat berhubungan seks, tapi ini tidak berbahaya. Jika Anda lupa
mengeluarkan cincin itu. Jika Anda lupa mengeluarkan cincin setelah 21 hari, apa yang harus Anda
lakukan bergantung pada berapa banyak waktu ekstra yang dimiliki cincin tersebut. Telah ditinggalkan.
Jika cincin itu sudah sampai tujuh hari setelah akhir minggu ketiga: ambillah cincinnya segera setelah
Anda ingat jangan memasang cincin baru - mulailah interval tujuh hari Anda seperti biasanya memulai
Cincin baru setelah selang tujuh hari Anda normal Anda tetap terlindungi dari kehamilan, dan Anda tidak
perlu menggunakan kontrasepsi tambahan. Jika cincin itu sudah lebih dari tujuh hari ekstra (lebih dari
empat minggu total): ambillah Segera keluar saat Anda mengingat memasang cincin baru secara
langsung. Lisensi untuk cincin vagina menyatakan bahwa Anda harus menggunakan kontrasepsi
tambahan (seperti kondom) sampai cincin baru telah ada selama tujuh hari. Saran FSRH berbeda.
Bicaralah dengan dokter atau perawat Anda kapan harus menggunakan kontrasepsi tambahan. Anda
mungkin memerlukan kontrasepsi darurat jika Anda melakukan hubungan seks pada hari-hari sebelum
mengganti cincin di atas. Bicaralah dengan dokter atau perawat Anda. Jika Anda lupa memasang cincin
baru diPut di ring baru segera setelah Anda mengingatnya, dan gunakan kontrasepsi tambahan, seperti
kondom, selama tujuh hari. Anda mungkin memerlukan kontrasepsi darurat jika Anda melakukan
hubungan seks sebelum Anda Ingat untuk memasang cincin baru, dan interval bebas cincin adalah 48
jam atau lebih lama dari seharusnya (sembilan hari atau lebih total). Jika ini masalahnya, bicarakan
dengan dokter atau perawat Anda. Jika cincin itu keluar dengan sendirinya. Kadang cincin itu mungkin
keluar dengan sendirinya (ini disebut pengusiran). Hal ini kemungkinan besar akan terjadi setelah atau
saat berhubungan seks, atau saat Anda mengalami konstipasi. Apa yang harus Anda lakukan tergantung
pada berapa lama cincin itu habis, dan apakah Anda berada di minggu pertama, kedua atau ketiga
menggunakannya. Lisensi untuk cincin vagina tersebut menyatakan bahwa jika cincin itu keluar lebih
dari tiga jam, Anda tidak akan terlindungi dari kehamilan. FSRH menyarankan agar Anda dilindungi lebih
lama - sampai 48 jam jika cincin itu menyala selama tujuh hari terus menerus sebelum keluar. Bicaralah
dengan dokter atau perawat Anda tentang apakah Anda akan terlindungi dari kehamilan atau tidak.
Informasi di bawah ini didasarkan pada informasi lisensi tentang apa yang harus dilakukan jika cincin itu
keluar. Jika cincin keluar lebih dari tiga jam pada jam pertama. Atau minggu kedua menggunakannya,
bilas dan masukkan kembali. Anda perlu menggunakan kontrasepsi tambahan selama tujuh hari. Anda
mungkin memerlukan kontrasepsi darurat jika Anda pernah berhubungan seks dalam beberapa hari
terakhir - bicarakan dengan dokter atau perawat Anda. Jika cincinnya keluar lebih dari tiga jam pada
minggu ketiga saat menggunakannya, jangan memasukkannya kembali. Dari itu dengan cara biasa. Anda
sekarang memiliki dua pilihan: Anda bisa memasang cincin baru secara langsung. Anda mungkin tidak
mengalami menstruasi tipe-periode, tapi mungkin Anda bercakap-cakap.OR Jangan menaruh cincin dan
memiliki interval tujuh hari. Anda akan mengalami pendarahan tipe-periode, dan Anda harus memasang
cincin baru dalam tujuh hari setelah yang lama keluar (Anda hanya dapat memilih opsi ini jika cincin itu
terus berlanjut selama tujuh hari sebelumnya). Pilihan mana pun yang Anda pilih , Anda perlu
menggunakan kontrasepsi tambahan sampai cincin itu berada selama tujuh hari berturut-turut. Anda
juga harus berbicara dengan dokter atau perawat Anda jika Anda pernah berhubungan seks dalam
beberapa hari terakhir, karena Anda mungkin memerlukan kontrasepsi darurat. Siapa yang dapat
menggunakan cincin vagina? Beberapa wanita tidak dapat menggunakan cincin vagina. Dokter atau
perawat Anda akan menanyakan tentang riwayat kesehatan dan riwayat kesehatan keluarga Anda,
untuk mengetahui apakah cincin itu cocok untuk Anda. Cincin mungkin tidak sesuai jika Anda: memiliki
bekuan darah di pembuluh darah atau arteri memiliki masalah jantung atau peredaran darah, termasuk
tekanan darah tinggi adalah 35 atau lebih tua dan merokok, atau berhenti merokok pada tahun lalu
memiliki migrain parah dengan aura ( Gejala peringatan) telah mengalami kanker payudara dalam lima
tahun terakhir memiliki diabetes dengan komplikasi kelebihan berat badan. Obat-obatan tertentu
memiliki otot vagina yang tidak bisa menahan cincin vagina. Jika Anda tidak merokok dan tidak ada
alasan medis mengapa Anda tidak dapat menggunakan Cincin, Anda bisa menggunakannya sampai
berusia 50 tahun. Setelah melahirkan Anda bisa mulai menggunakan cincin vagina 21 hari setelah
melahirkan, dan Anda akan terlindungi dari kehamilan dengan segera. Jika Anda memulai cincin lebih
dari 21 hari setelah melahirkan. , Anda perlu menggunakan kontrasepsi tambahan selama tujuh hari
setelah Anda memasukkan cincin itu

Menyusui bayi di bawah usia enam bulan Biasanya disarankan agar Anda menggunakan metode yang
berbeda. Setelah keguguran atau aborsi Anda bisa mulai menggunakan cincin segera setelah keguguran
atau aborsi, dan ini akan langsung bekerja. Anda tidak perlu menggunakan kontrasepsi tambahan.
Kelebihan dan kekurangan Beberapa keuntungan dari cincin vagina meliputi: tidak mengganggu
hubungan seks sehingga mudah dimasukkan dan dikeluarkan Anda tidak perlu memikirkannya setiap
hari atau setiap kali Anda melakukannya. Berhubungan seks cincin tidak terpengaruh jika Anda muntah
atau diare bisa membantu dengan gejala pramenstruasi tipe perdarahan tipe biasanya menjadi lebih
ringan, lebih teratur dan kurang menyakitkan sehingga bisa mengurangi risiko kanker ovarium, rahim
dan usus besar sehingga bisa mengurangi Risiko fibroid, kista ovarium dan penyakit payudara non-
kanker Beberapa kelemahan cincin vagina meliputi: mungkin tidak sesuai jika Anda merasa tidak nyaman
memasukkan atau mengeluarkannya dari vagina dan bercak darah saat cincin berada di vagina Anda.
Dapat terjadi pada beberapa bulan pertama ini dapat menyebabkan efek samping sementara, seperti
peningkatan keputihan, sakit kepala, mual, nyeri payudara dan perubahan mood cincin tidak melindungi
terhadap IMS Cincin vagina Dengan obat-obatan lainBeberapa obat-obatan dapat berinteraksi dengan
cincin vagina, artinya tidak bekerja dengan baik. Jika Anda ingin memastikan bahwa obat Anda aman
dikonsumsi dengan cincin vagina, Anda dapat: bertanya kepada dokter umum Anda, periksakan perawat
atau apoteker untuk membaca selebaran informasi pasien yang disertakan dengan obat Anda Cincin
vagina dapat berinteraksi dengan obat-obatan yang disebut enzim inducer. Ini mempercepat
pemecahan progestogen oleh hati Anda, mengurangi keefektifan cincin. Contoh penginduksi enzim
adalah: obat epilepsi karbamazepin, oxcarbazepine, fenitoin, fenobarbital, primidona dan topiramate St
John's Wort (obat herbal) beberapa obat antiretroviral yang digunakan untuk Perlakukan antibiotik HIV
yang disebut rifampisin dan rifabutin, yang dapat digunakan untuk mengobati penyakit termasuk
tuberkulosis (TBC) dan meningitis Dokter atau perawat Anda mungkin menyarankan Anda untuk
menggunakan kontrasepsi alternatif atau tambahan saat menggunakan obat-obatan ini. Gejala Ada
beberapa efek samping yang serius. , Tapi ini tidak umum. Ini termasuk: Mengembangkan bekuan darah
di pembuluh darah atau arteri yang mengalami serangan jantung atau stroke. Cari tahu risiko kanker
payudara dan kontrasepsi hormonal yang kompleks dan kontradiktif. Ini menunjukkan bahwa semua
wanita yang menggunakan kontrasepsi hormonal tampaknya memiliki sedikit peningkatan risiko
didiagnosis menderita kanker payudara, dibandingkan dengan wanita yang tidak menggunakan
kontrasepsi hormonal. Penelitian menunjukkan ada sedikit peningkatan risiko pengembangan kanker
serviks dengan waktu yang lebih lama. Penggunaan kontrasepsi hormonal estrogen dan progestogen.
Beberapa penelitian menunjukkan adanya hubungan antara kontrasepsi hormon estrogen dan
progestogen dan kanker hati yang sangat jarang. Di mana Anda bisa mendapatkan cincin vagina.
Sebagian besar jenis kontrasepsi tersedia secara gratis di Inggris. Kontrasepsi bebas untuk semua wanita
dan pria melalui NHS. Tempat-tempat di mana Anda bisa mendapatkan kontrasepsi antara lain:
kebanyakan operasi GP - berbicara dengan dokter umum Anda atau melatih klinik kontrasepsi perawat
di klinik kedokteran seksual beberapa alat kelamin (GUM) klinik kesehatan seksual - mereka juga
menawarkan layanan pengujian kontrasepsi dan IMS untuk beberapa layanan kaum muda (hubungi
0300 123 7123 Untuk informasi lebih lanjut) Temukan klinik kesehatan seksual terdekat Anda dengan
mencari melalui kode pos atau kota. Layanan kontrasepsi gratis dan rahasia, termasuk untuk orang-
orang di bawah usia 16 tahun. Jika Anda berusia di bawah 16 tahun dan menginginkan kontrasepsi,
dokter, perawat atau apoteker menang Beri tahu orang tua atau wali Anda selama mereka yakin Anda
benar-benar memahami informasi yang Anda berikan dan keputusan Anda. Dokter dan perawat bekerja
dengan pedoman ketat saat berurusan dengan orang-orang di bawah usia 16 tahun. Mereka akan
mendorong Anda untuk mempertimbangkan untuk memberi tahu orang tua Anda, tapi mereka tidak
akan membuat Anda. Satu-satunya saat yang mungkin ingin dikatakan oleh seorang profesional kepada
orang lain adalah jika mereka percaya bahwa Anda berisiko mengalami bahaya, seperti pelecehan.
Resiko itu perlu menjadi serius, dan biasanya mereka akan membicarakan hal ini dengan Anda terlebih
dahulu. Terakhir ditinjau: 31/12 / 2014Next review due: 30/09/2017
Vaginal ring
A woman can get pregnant if a man’s sperm reaches one of her eggs (ova). Contraception tries to
stop this happening by keeping the egg and sperm apart or by stopping egg production. One
method of contraception is the vaginal ring. 

At a glance: the vaginal ring

How the ring works
Who can use the ring
Advantages and disadvantages
Risks of the ring
The vaginal ring is a small, soft plastic ring that you place inside your vagina. It’s about 4mm
thick and 5.5cm in diameter. You leave it in your vagina for 21 days, then remove it and throw it
in the bin (not down the toilet) in a special disposal bag. Seven days after removing the ring, you
insert a new one for the next 21 days. 
The ring releases oestrogen and progestogen. This prevents ovulation (release of an egg), makes
it difficult for sperm to get to an egg and thins the womb lining, so it’s less likely that an egg will
implant there.  
At a glance: facts about the vaginal ring
 If used correctly, the vaginal ring is more than 99% effective. This means that fewer
than one woman out of every 100 who use the vaginal ring as contraception will become
pregnant in one year. 
 One ring will provide contraception for a month, so you don’t have to think about it every
day. 
 It doesn’t interrupt sex, because you can have sex with the ring in place. 
 Unlike the pill, the ring is still effective if you have vomiting or diarrhoea.
  The ring may ease premenstrual symptoms, and bleeding will probably be lighter and less
painful. 
 Some women have temporary side effects, including more vaginal discharge, breast
tenderness and headaches. 
 A few women develop a blood clot (thrombosis) when using the ring, but this is rare. 
 The ring can sometimes come out on its own, but you can rinse it in warm water and put
it back in as soon as possible. You might need emergency contraception, depending on
how long it has been out. 
 The vaginal ring doesn’t protect against sexually transmitted infections (STIs). By using
condoms as well as the ring, you’ll protect yourself against STIs.
How the ring works
Using the vaginal ring
If you forget to take the ring out 
If you forget to put a new ring in 
If the ring comes out by itself 
The ring continually releases oestrogen and progestogen, which are synthetic versions of the
hormones that are naturally released by the ovaries. This:
 reduces ovulation (the release of an egg)
 thickens vaginal mucus, which makes it more difficult for sperm to get through
 thins the lining of the womb so that an egg is less likely to implant there
Using the vaginal ring
You can start using the vaginal ring at any time during your menstrual cycle. You leave it in for
21 days, then remove it and have a seven-day ring-free break. You’re protected against
pregnancy during the ring-free break. You then put a new ring in for another 21 days.
You can get contraception at:
 most GP surgeries
 community contraception clinics
 some GUM clinics
 sexual health clinics
 some young people's services
Find a clinic near you
The licence for the vaginal ring states that:
 you will be protected against pregnancy straight away if you insert it on the first day of
your period (the first day of your menstrual cycle)
 you won't be protected from pregnancy if you start using it at any other time in your
menstrual cycle, and you'll need to use additional contraception (such as condoms) for the
first seven days
However, guidance from The Faculty of Sexual and Reproductive Healthcare (FSRH) differs
slightly, advising that the ring will protect against pregnancy straight away if you start it up to
day five of your menstrual cycle. This is because a study found that ovulation was suppressed in
women who started using the vaginal ring on day five of their cycle.
You can discuss this with your doctor or nurse to decide when might be the best time for you to
start using the ring.
To insert the ring:
  with clean hands, squeeze the ring between your thumb and finger, and gently insert the
tip into your vagina
 gently push the ring up into your vagina until it feels comfortable
Unlike a diaphragm or cap, the ring does not need to cover your cervix (the entrance to your
womb) to work.
If you can feel the ring and it is uncomfortable, push it a bit further into your vagina. There isn’t
a right or wrong place for it to be, as long as it isn’t uncomfortable.
You should be able to check that the ring is still there using your fingers. If you can’t feel it, but
you’re sure it’s there, see your doctor or nurse. The ring cannot get "lost" inside you.
After the ring has been in your vagina for 21 days (three weeks), you remove it. This should be
on the same day of the week that you put it in.
To remove the ring:
 with clean hands, put a finger into your vagina and hook it around the edge of the ring
 gently pull the ring out
 put it in the special bag provided and throw it in the bin – don’t flush it down the toilet
Removing the ring should be painless. If you have any bleeding or pain, or you can’t pull it out,
tell your doctor or nurse immediately.
When you’ve taken the ring out, you don’t put a new one in for seven days (one week). This is
the ring-free interval. You might have a period-type bleed during this time. 
After seven days without a ring in, you need to insert a new one. Put the new ring in even if
you’re still bleeding. Leave this ring in for 21 days, then repeat the cycle.
You can have sex and use tampons while the ring is in your vagina. You and your partner may
feel the ring during sex, but this isn’t harmful.
If you forget to take the ring out
If you forget to take the ring out after 21 days, what you should do depends on how much extra
time the ring has been left in.
If the ring has been in for up to seven days after the end of week three: 
 take the ring out as soon as you remember
 don’t put a new ring in – start your seven-day interval as normal
 begin your new ring after your seven-day interval as normal
 you’re still protected against pregnancy, and you don’t need to use additional
contraception
If the ring has been in for more than seven extra days (more than four weeks in total):
 take the ring out as soon as you remember
 put a new ring in straight away
The licence for the vaginal ring states that you should use additional contraception (such as
condoms) until the new ring has been in for seven days.
The FSRH advice is different. Talk to your doctor or nurse about when you should use additional
contraception.
You may need emergency contraception if you had sex in the days before changing the rings
over. Talk to your doctor or nurse.
If you forget to put a new ring in
Put in a new ring as soon as you remember, and use additional contraception, such as condoms,
for seven days.
You may need emergency contraception if you had sex before you remembered to put the new
ring in, and the ring-free interval was 48 hours or more longer than it should have been (nine
days or more in total). If this is the case, talk to your doctor or nurse.
If the ring comes out by itself
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.
The licence for the vaginal ring states that if the ring is out for more than three hours, you will
not be protected against pregnancy. The FSRH advises that you'll be protected for longer – up to
48 hours if the ring was in for seven continuous days before it came out. Talk to your doctor or
nurse about whether you'll be protected against pregnancy or not.
The information below is based on the licence information on what to do if the ring comes out.
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 seven 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: 
 You can put a new ring in straight away. You may not have a period-type bleed, but you
may have spotting.
OR
 Don’t put a ring in and have a seven-day interval. You’ll have a period-type bleed, and
you should put a new ring in seven days after the old one came out (you can only choose
this option if the ring was in continuously for the previous seven days).
Whichever option you choose, you need to use additional contraception until the ring has been in
for seven 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.
Who can use the vaginal ring?
Some women cannot use the vaginal ring. Your doctor or nurse will ask about your medical
history and your family's medical history, to see whether the ring is suitable for you. The ring
may not be suitable if you:
 have had a blood clot in a vein or artery
 have had heart or circulatory problems, including high blood pressure
 are 35 or older and smoke, or stopped smoking in the past year
 have severe migraine with aura (warning symptoms)
 have had breast cancer in the past five years
 have diabetes with complications
 are overweight
 take certain medicines
 have vaginal muscles that can’t hold a vaginal ring
If you don’t smoke and there are no medical reasons why you can’t use the ring, you can use it
until you are 50 years old.
After giving birth
You can start using the vaginal ring 21 days after giving birth, and you will be protected against
pregnancy straight away.
If you start the ring more than 21 days after giving birth, you need to use additional
contraception for seven days after you insert the ring.
The vaginal ring may reduce your flow of milk if you’re breastfeeding a baby under six months
old. It’s usually recommended that you use a different method.
After miscarriage or abortion
You can start using the ring immediately after a miscarriage or abortion, and it will work straight
away. You don’t need to use additional contraception.
Advantages and disadvantages
Some of the advantages of the vaginal ring include:
 it doesn’t interrupt sex
 it’s easy to put in and remove
 you don’t have to think about it every day or each time you have sex
 the ring is not affected if you vomit or have diarrhoea
 it may help with premenstrual symptoms
 period-type bleeding usually becomes lighter, more regular and less painful
 it may reduce the risk of cancer of the ovary, uterus and colon
 it may reduce the risk of fibroids, ovarian cysts and non-cancerous breast disease
Some of the disadvantages of the vaginal ring include:
 it may not be suitable if you don’t feel comfortable inserting or removing it from your
vagina
 spotting and bleeding while the ring is in your vagina can occur in the first few months
 it may cause temporary side effects, such as increased vaginal discharge, headaches,
nausea, breast tenderness and mood changes
 the ring does not protect against STIs
The vaginal ring with other medicines
Some medicines may interact with the vaginal ring, meaning it doesn’t work properly. If you
want to check that your medicines are safe to take with the vaginal ring, you can: 
 ask your GP, practice nurse or pharmacist
 read the patient information leaflet that comes with your medicine
The vaginal ring can interact with medicines called enzyme inducers. These speed up breakdown
of progestogen by your liver, reducing the effectiveness of the ring.
Examples of enzyme inducers are:
 the epilepsy drugs carbamazepine, oxcarbazepine, phenytoin, phenobarbital, primidone
and topiramate 
 St John’s Wort (a herbal remedy) 
 some antiretroviral medicines used to treat HIV
 antibiotics called rifampicin and rifabutin, which can be used to treat illnesses including
tuberculosis (TB) and meningitis
Your GP or nurse may advise you to use an alternative or additional form of contraception while
taking any of these medicines.
Risks
There are some serious side effects, but these are not common. They include: 
 developing a blood clot in a vein or artery
 having a heart attack or stroke
Research into the risk of breast cancer and hormonal contraception is complex and contradictory.
It suggests that all women who use hormonal contraception appear to have a small increased risk
of being diagnosed with breast cancer, compared with women who don’t use hormonal
contraception.
Research suggests there is a small increase in the risk of developing cervical cancer with longer
use of oestrogen and progestogen hormonal contraception. Some research suggests a link
between oestrogen and progestogen hormonal contraception and a very rare liver cancer.
Where you can get the vaginal ring
Most types of contraception are available for free in the UK. Contraception is free to all women
and men through the NHS. Places where you can get contraception include:
 most GP surgeries – talk to your GP or practice nurse 
 community contraception clinics 
 some genitourinary medicine (GUM) clinics
 sexual health clinics – they also offer contraceptive and STI testing services
 some young people’s services (call 0300 123 7123 for more information)
Find your nearest sexual health clinic by searching by postcode or town.
Contraception services are free and confidential, including for people under the age of 16.
If you're under 16 and want contraception, the doctor, nurse or pharmacist won't tell your parents
or carer as long as they believe you fully understand the information you're given and your
decisions. Doctors and nurses work under strict guidelines when dealing with people under 16.
They'll encourage you to consider telling your parents, but they won't make you. The only time
that a professional might want to tell someone else is if they believe you're at risk of harm, such
as abuse. The risk would need to be serious, and they would usually discuss this with you first.
Page last reviewed: 31/12/2014
Next review due: 30/09/2017