Liking Your Birth Control Pills? Should You Switch to A Contraceptive Ring?

You will love the ring. It’s handy, you can control when to pop it in and when to pop it out, so you are controlling the hormone use, and it’s more effective at having steady blood levels. So do consider switching to the ring even if you are quite pleased with your pills. Today you have to take your pill, and yesterday, and tomorrow, and we have you scheduled to take over 3650 of these pills over the next ten years. So trying to minimize that day in and day out issue has been one of the main driving forces behind the popularity of the vaginal ring for contraception. Vaginal rings should be available in the 40 different sizes and shapes that birth control pills come in, but they are not, they are currently available in one size and one shape. The shape is simple: a ring. It’s soft, it sits pretty much anywhere in the vagina. It doesn’t need the careful engineering of a diaphragm placement, and it’s not likely to pinch or be felt. About 1/10 women in some studies report the ring can slip out at least once a week, so do check it, but in our patients we do not get reports of slippage that are as common as all that (I’m proud of you girls, good job, beating the averages). You can even have a pap smear while it’s sitting there. Pills contain progesterone to stop a woman from getting pregnant by stopping ovulation, the estrogen in pills helps to make that ovulation prevention more effective and it makes a woman less likely to have breakthrough bleeding.  The NuvaRing has essentially the same estrogen: ethinylestradiol specifically most birth control pills have, it releases etonogestrel, which is a form of desogestrel, one of the progesterones found in birth control pills, and the hormone, is released though the silicone wall that houses the hormone, over the lining of the vagina, into the complex network of arteries and veins that surround this delicate tissue and without giving a large exposure to one’s liver, gets the hormone into the circulation very quickly and effectively. The hormone probably accumulates a bit on the surface of the ring while sitting in your fridge waiting for the first use, and the first day or so you pop your ring in the hormone levels can be the highest. For most women that tiny extra hormone burst is not something to worry about, not like eating the cherries in the Whitches of Eastwick, dramatic consequences are not likely! If your moods, your periods, your waist line or your skin is getting out of whack, you and your gyno need a longer talk, it might be that new contraceptive ring, but likely there are other contributing factors that have to be evaluated. The hormones estrogen and progesterone have a bit of a burst then they slightly but steadily decline from week one to week 3, again, for most, this slight decline is not very noticeable, for others it maybe. Most studies show that about three quarters of women who launch off on the use of a NuvaRing will still be using it at the end of the first year, but there are so many reasons stop their method of contraception, its as likely as not, that you will be very happy with this method, and more likely if you were already liking the pill!


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