Dr. Varshali Mali, MBBS, DNB - Obstetrician and Gynecologist

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Contraceptive pills and other hormonal contraception methods
Contraceptive pills and other hormonal contraception methods

How to avoid pregnancy by hormonal contraception methods

Methods | Schedule | Pros & Cons

By

MBBS, DNB (OBGY)

Gynecologist & Pregnancy Doctor

Contraceptive pills and other hormonal contraception methods
Hormonal contraception and family planning methods mainly works on regulating the change in hormone levels during the menstrual cycle. These contraception methods use different forms of artificial hormones that mimic the production of estrogen and progesterone in a woman's body. The hormonal contraception methods act on the endocrine system, a chemical messaging system consisting of hormones, a group of organisms who carries the hormones to target organs and a feedback loop. How to avoid pregnancy question has been answered by these contraception methods since 1960. Over the years, many delivery methods are developed, but oral contraceptive pills and injectable methods are the most popular method amongst all. Of all the contraception methods, altogether, about 18% of the women rely on hormonal methods to avoid pregnancy.
There are mainly two categories of hormonal contraception methods or formulation: First is the combined method which contains both an estrogen and progestin. Second is the progesterone-only method which contains only progesterone or one of its synthetic analogs like progestins. The combined method suppresses the release of eggs from ovaries (ovulation) and thickens the cervical mucus. The progestogen-only method reduces the frequency of ovulation. Although these methods are used in quite different ways, most of them prevent mature eggs from being released by ovaries. Hormonal contraception methods are reliable to prevent pregnancy, but they can have side effects like headaches and spotting or breakthrough bleeding between periods. There are numbers of hormonal contraception methods including different types of contraceptive pills, vaginal ring, and contraceptive or transdermal skin patch.
This article contains details about all hormonal contraception methods and how to avoid pregnancy effectively using these methods.
Combination oral contraceptive pills (COC / COCP) hormonal contraception methods

Combination oral contraceptive pills (COC / COCP)

Combination oral contraceptive pills hormonal contraception methods type
Type
Hormonal contraception methods
Effectiveness of combination oral contraceptive pills hormonal contraception methods
Effectiveness
91%
Combination oral contraceptive pills hormonal contraception methods frequency of use
Frequency of use
Everyday
STD protection status by combination oral contraceptive pills hormonal contraception methods

Protection against STDs

No
Combination oral contraceptive pills (COC / COCP) hormonal contraception methods
Combined contraceptive pills, sometimes also referred to as just "the pill", is a tablet you take once in a day for a month to avoid pregnancy. It contains two hormones: estrogen and progesterone. These are the same hormones produced by women in their ovaries. The contraceptive pills are safe, affordable and effective contraception methods to avoid pregnancy. The combined contraceptive pills are taken orally and when taken correctly, alters the menstrual cycle to eliminate ovulation and prevent pregnancy. This is one of the most widely used contraception methods for how to avoid pregnancy and family planning.
Estrogen and progestogen hormone in combined contraceptive pills stop the ovaries from releasing the eggs. Pregnancy can't happen if no eggs are released. These hormones also thicken the cervical mucus, which makes it hard for sperms to swim to the egg. No ovulation means no pregnancy. In case if few sperms meet the egg and fertilization happens, the hormones contraceptive pills make the lining of your uterus (womb) thinner so it's less likely to accept the fertilized egg.
The contraceptive pills are an effective hormonal method to prevent pregnancy. When the pills are used perfectly (taken every day at the same time), it's more than 99% effective to avoid pregnancy. It means only 1 out of 100 women taking the pills will get pregnant. But in real life, it can be hard to maintain and follow the schedule. So, in real life, it is about 91% effective to avoid pregnancy.
Combination oral contraceptive pills schedule
Combination oral contraceptive pills - Hormonal pills
21 hormonal pills
First 21 pills in the pack are hormonal pills. Take one pill every day approximately at the same time
Combination oral contraceptive pills - Reminder pills
7 reminder pills
After 21 pills, there are 7 no hormones pills which helps to keep a schedule. You may skip these pills
How to use combination oral contraceptive pills to avoid periods
If you wish to avoid periods, you may skip the reminder pills and start a new pack immediately
How to avoid pregnancy effectively with this contraception methods depends on the schedule you follow to take these combined contraceptive pills. These pills typically come in 28-days or 21-days pack. In case if you are using 28-days contraceptive pills pack (also referred as everyday pills), you must take one pill each day at around same time. The last 7 pills in the pack are colored differently and do not have any hormones in it. Sometimes these 7 pills are also referred as "reminder" or "placebo" pills. Even if you don't take these 7 contraceptive pills, you will be protected from pregnancy. It's advisable to take them as it helps to maintain the routine and may also contain some iron or other supplements which will help you to remain healthy. In case if you are using 21-days contraceptive pills pack, take 1 pill every day in a row. Once the pack is complete, take a break of 7 days. You will get your periods during these 7 days while you are not taking the pills. You will be protected from pregnancy during these 7 days. Start your next pack after these 7 days. It's better to use a reminder or alarm to keep the track. If you want to avoid your periods completely, you can use combined contraceptive pills easily. You can skip the "reminder" or "placebo" pills in the 28-day pack and start the new pack immediately. This way you can always avoid the periods or use this technique if something special is coming up and you don't want your periods to come. Read the instructions on your combined contraceptive pills pack carefully. It's important that you follow the given instructions for daily routine or in case if you missed the pill.
The contraceptive pills are immediately effective if you start taking the pills within 5 days after your period starts. If you start the pills on any other day, it will take 7 days to start protecting you from pregnancy. So, use some other contraception methods during these 7 days to avoid pregnancy. For combined contraceptive pills to be effective, you must take them every day at around the same time even if you don't have a sex. Missing the pill or starting the pack late makes these contraception methods less effective. The chances of pregnancy depend on when and how many contraceptive pills you have missed. Missing the pill for a day or starting the pack one day later is not a problem. But if you miss two pills or start the pack two days later, you might get pregnant. If you are not sure about what to do, continue taking the pills and use some other contraception methods to be sure about the protection from pregnancy. In case of doubt, always consult the doctor.
Taking the combined contraceptive pills may cause some side effects. It is important to know that most of the side effects will go away in 2-3 months. Some women experience headaches, nausea, sore breasts, or spotting (light bleeding) between periods. Taking the contraceptive pills may change your period or stop them completely. If you are experiencing the side effects even after 2-3 months, if you are not comfortable with the change in your periods, talk to the doctor. The doctor may suggest another brand or another contraception methods altogether.
Contraceptive pills are safe for almost every woman. It's been there for more than 50 years and used by millions of women. But, it might not be suitable contraception methods for few. If you are over 35 and have smoking habits, it's not a good idea to take combined contraceptive pills. You may consider progestin-only pills (mini-pills) to avoid pregnancy. Also avoid taking combination contraception pills in case if you have health problems like blood clots, a blood-clotting disorder, breast cancer, heart attack, stroke, angina, or other serious heart problems, migraine headaches, uncontrolled high blood pressure, very bad diabetes or liver disease. Even though combination contraceptive pills are very safe, using the pills can slightly increase your risk of health problems. These include heart attack, stroke, blood clots, and liver tumors. It is important to remember that the chances of these health problems are really, really small. So, please consult the doctor before you come to any conclusion about using contraceptive pills as your contraception methods for family planning.
Advantages
If you follow the schedule of contraceptive pills correctly, these are very effective contraception methods to avoid pregnancy. Apart from preventing the pregnancy, it also has other health benefits. It reduces menstrual cramps, lighten periods, and lower your risk of ectopic pregnancy. Combined contraceptive pills can also reduce or prevent acne, bone thinning, cysts in the breasts and ovaries, endometrial and ovarian cancers, serious infections in the ovaries, fallopian tubes, and uterus, iron deficiency (anemia), and PMS (premenstrual syndrome). Many women like the contraceptive pills as it makes the periods regular and easy to predict. The hormones in the pills may reduce the menstrual cramps and make your period lighter. You can easily get the combined contraceptive pills from the medical store with a doctor's prescription. They are cost effective, very easy to carry and does not interrupt the sex. If taken correctly, the contraceptive pills protect you all day, every day. You can also stop taking the pills whenever you want to get pregnancy. The fertility returns immediately after you stop the pills. You may experience some irregularity in the periods for initial few months, but your chances of getting pregnant returns to normal conditions immediately after you stop taking the pills.
Disadvantages
The effectiveness of these contraception methods depends highly on the schedule you follow. It's important to take these contraceptive pills every day. The protection goes away in a day after you stop taking the pill. If you have a busy schedule, many times it's hard to remember to take the pill. So, keep it next to the things you daily use like a toothbrush or phone charger, or makeup material. These are hormonal contraceptive methods and can have some side effects. These hormones can change the sexual desire, you may experience bleeding between periods, sore breast or nausea. These should go within the first 2-3 months. If you experience these side effects, talk to the doctor and just don't stop taking the contraceptive pills without any other contraception methods. Very rarely, taking combined contraceptive pills might cause serious health problems. Talk to your doctor immediately in case if you are experiencing something different than usual. The contraceptive pills do not protect you from sexually transmitted diseases. You need to use other contraception methods like condoms for protection against STDs.
Progestogen-only contraceptive pills (POP / Mini-pills) hormonal contraception methods

Progestogen-only contraceptive pills (POP / Mini-pills)

Progestogen-only contraceptive pills hormonal contraception methods type
Type
Hormonal contraception methods
Effectiveness of progestogen-only contraceptive pills hormonal contraception methods
Effectiveness
91%
Progestogen-only contraceptive pills hormonal contraception methods frequency of use
Frequency of use
Everyday
STD protection status by progestogen-only contraceptive pills

Protection against STDs

No
Progestogen-only contraceptive pills (POP / Mini-pills) hormonal contraception methods
Progestogen-only pills or progestin-only pills (POP) are contraceptive pills which contain hormone progestogens (progestins). As that of combined contraceptive pills, this does not contain estrogen hormone. Progestogen-only pill is an "every day" pill and contains 28 pills in a pack. There is no hormone free or "reminder" pills. You need to take one pill every day within the same three hours to avoid pregnancy. For example, if you have taken your progestogen-only pill at 8.00 in the morning, you need to take it BETWEEN 8.00 to 11.00 in the morning to get protection from pregnancy. Taking it after 11.00 in the morning will put you at risk of getting pregnant. This is one of those contraception methods where you need to follow the schedule very strictly. Alarm or reminders can help you keep track of your pill and take it on time. So, choose a convenient time to take the pill so that you can follow it. You can also keep it close to your daily used stuff like brush, charger or purse so that it's easy for you to remember.
Progestogen-only contraceptive pills / mini-pills schedule
28 pills packfor progestogen-only contraceptive pills / mini-pills
28 pills in a pack. Take one pill every day within 3 hours window
3 hours window for progestogen-only contraceptive pills hormonal contraception methods
3 hours window
Less than 3 hours {PROTECTED}
Missed the exact time to take the pill, but not late than 3 hours? Take the pill immediately and you are still protected from pregnancy.
More than 3 hours {NOT PROTECTED}
Are you late by 3 hours to take the pill? Take the pill when you remember. You are NOT protected for the next 48 hours.
Progestogen-only contraceptive pills are one of the hormonal contraception methods and work by releasing progestogen which is absorbed into your bloodstream. These POPs work either by avoiding the fertilization (meeting of sperms and egg) or by stopping ovaries from releasing the egg or both. The hormone progestogen thickens the mucus of your cervix or neck of the womb. This thickening makes it difficult for sperms to move through it and reach the egg. All progestogen-only contraceptive pills make the lining of your uterus thinner and make it less likely to accept the fertilized egg.
The effectiveness of progestogen-only pills is same that of combination contraceptive pills. But POPs have a more stringent time restriction. You must take the POP pill within 3 hours window. This is one of the very effective contraception methods when you always use it perfectly. With the perfect schedule, POPs are 99% effective, means only 1 out of 100 women on POP will get pregnant. In real-life, considering some uncertainties, it is considered as 91% effective to avoid pregnancy.
The effect of progestogen-only contraceptive pills depends on when you start taking the pill. If you start the pack within the first 5 days of your period, you will be protected from pregnancy immediately. If you start taking the pill on any other day, you will not be protected for first 48 hours. Use some other contraception methods to avoid pregnancy. If you have a short menstrual cycle with your periods coming in 23 or fewer days, taking POP as late as 5th day might put you at risk of pregnancy. In case of doubt, consult the doctor to be sure about when to start taking the pill, if you are protected from pregnancy or not, or in-general counseling about how to avoid pregnancy using contraception methods.
For progestogen-only contraceptive pills to work perfectly, it is important that you take the pill in 3 hours window. If you miss taking the pill, its effect to prevent pregnancy depends on how much late you are. If you have just missed the time, but are still in the 3-hour window, take the pill as soon as you remember it. For example, if you have taken the pill yesterday at 8.00 in the morning. Even if you miss the 8.00 in the morning time, it's OK. Take the pill before 11.00 in the morning and you will be protected. But if you miss the 3-hour window (in the example given, if you are late than 11.00 in the morning), you will not be protected from pregnancy. Please take the pill as soon as you remember. Do not stop taking the pills. You need to take the next pill on regular time (in the above case 8.00 in the morning) and follow the schedule. Remember that you will not be protected from pregnancy for the next two days (48 hours). So, use some other contraception methods to avoid pregnancy.
Progestogen-only contraceptive pills are safe for most of the women. Taking POPs might not be safe, if you are pregnant, on certain medicines, or if there is a current or past history of certain heart diseases or stroke, liver or breast cancer. Talk to the doctor who will understand your medical history and suggest if its safe contraception option for you or not. If you are healthy and does not have any medical conditions, you can take the POP as long as you want to avoid pregnancy (until your menopause or until you're 55 years old). POP may develop small fluid-filled cysts on the ovaries. Other risks are the same as that of taking combination contraception pills. But the chances of these problems are really, really small. So please consult the doctor before you come to any conclusion.
Advantages
Many advantages are the same as that of combination contraceptive pills. Convenient, safe and easy to use. This is one of the contraception methods which does not need any medical procedure to start and you can stop using it anytime you want. It is safe to use even during breastfeeding. Some women are allergic or face some health problem due to hormone estrogen (found in combination contraceptive pills, contraceptive patch, vaginal ring). POP is a safe option for them as it doesn't contain hormone estrogen. You can take it at any age even if you have smoking habits (its highly advised to stop smoking as it will have an impact on your pregnancy, fertility and will cause other serious health problems). POP may help you to reduce the painful periods, may reduce the mood swings and symptoms that occur before your period.
Disadvantages
Taking the progestogen-only contraceptive pills may change the period and for some women, it is a bit difficult to accept. How to avoid pregnancy effectively depends a lot on how strictly you are following the POP schedule. Taking progestogen-only contraceptive pills may have some side effects like spotty skin, breast tenderness, and headaches. But these should stop in the first few months. Talk to the doctor to know about all the side effects and most importantly if the side effects are not stopping ever after a few months. Also take the advice of doctor about contraception methods, family planning and how to avoid pregnancy.
Transdermal patch hormonal contraception methods

Transdermal patch

Transdermal patch hormonal contraception methods type
Type
Hormonal contraception methods
Effectiveness of transdermal patch hormonal contraception methods
Effectiveness
91%
Transdermal patch hormonal contraception methods frequency of use
Frequency of use
Weekly
STD protection status by transdermal patch hormonal contraception methods

Protection against STDs

No
Transdermal patch hormonal contraception methods
NOTE : The transdermal patch is not recommended in India considering the weather conditions. The atmospheric temperature and resulting sweat make patch remain on skin very hard. Before you decide to use a transdermal patch as your contraception method, please consult the doctor.
The transdermal patch or contraceptive patch looks just like a shiny plaster. It is a small, square, beige-colored patch of nearly 5cm x 5cm in size. The patch generally comes in the pack of three. This is one of the easy to use contraception methods, you simply stick the patch on your skin to avoid pregnancy.
You stick the patch on clean, dry skin on your belly, upper outer arm, buttocks (butt cheeks), or back. Clean and dry the skin before putting the patch, do not apply any cream, lotion, oil, powder or makeup to the skin. Do not touch the sticky part of the patch. Put the patch and press and hold for 10 seconds to make sure it is applied firmly. The contraceptive patch is designed to stay while swimming, sweating, or taking bath. Check your patch every day to make sure it is still there.
The transdermal or contraceptive patch contains hormones estrogen and progestogen. These are the same hormones produced by women in their ovaries. This is one of the hormonal contraception methods, and the hormones in the patch are released into your bloodstream through the skin. These hormones prevent pregnancy by stopping ovaries from releasing eggs. They also thicken the cervical mucus which makes it hard for sperms to swim through and meet the egg.
How to avoid pregnancy effectively depends on how perfectly you use the patch. When you use contraceptive patch perfectly, they are 99% effective to avoid pregnancy. You must change the patch after every week and make sure that it's there all the time. In real life, it's difficult to be perfect, so the contraceptive patch is considered about 91% effective. The effectiveness of a contraceptive patch might be affected by certain medicines, like antibiotics Rifampin, Rifampicin, and Rifamate, antifungal Griseofulvin and HIV medicines. Talk to the doctor about all the medicines you are talking before you start using the patch.
The time required for the patch to come in effect depends on when you have started the first patch. If you apply the first patch within the first 5 days of your period, you will be protected from pregnancy immediately. If you apply the first contraceptive patch on any other day, you will not be protected for first 7 days. Use some other contraception methods to avoid pregnancy. If you have a short menstrual cycle with your periods coming in 23 or fewer days, taking contraceptive patch as late as 5th day might put you at risk of pregnancy. In case of doubt, consult the doctor to be sure about when to start using the patch, if you are protected from pregnancy or not, or in-general counseling about how to avoid pregnancy using contraception methods.
Schedule for transdermal patch hormonal contraception methods
Transdermal patch change day
Patch change day
Each patch is effective for 7 days. Start the first patch on selected day and replace the old patch with new one after every 7 days at different location.
Transdermal patch free week
Patch free week
After use of three patches, the fourth 4th week is patch free week. Don't use the patch and you are still protected from pregnancy.
How to use transdermal patch contraception method to avoid periods
If you wish to avoid periods using transdermal patch, do not stop using the patch in 4th week also. Keep changing the patch on every week on patch change day.
The contraceptive patch pack comes with three patches. Put on the first patch and this becomes your "patch change day". If you start on Monday, Mondays will be the days where you remove your old patch and put the new patch. Don't keep the patch for more than a week. They will not prevent pregnancy. Put on the first patch and change it every week for three weeks. The fourth week is "patch-free week". You get 7 days where you need not wear the patch. You are protected from pregnancy during these days and you will get your periods during these days. You can use the contraceptive patch to skip your period. Just skip the "patch-free week" and start the new patch pack immediately after three weeks. You may have some bleeding or spotting for the first six months when you use the patch to skip your period. It's totally normal and should go away eventually.
48 hours window for transdermal patch off your body
48 hours window
Less than 48 hours {PROTECTED}
During your patch days, if the patch is not on the body for less than 48 hours, apply the patch immediately. Follow the regular patch cycle. You are still protected from pregnancy.
More than 48 hours {NOT PROTECTED}
If the patch is not on the body for more than 48 hours, apply new patch. Define a new "patch change day" and follow the new schedule. You are not protected from pregnancy for the next 7 days.
Patch is very sticky and should stay on. But if it comes off, protection from pregnancy and what to do next depends on how long it's not been on your body. If the patch is off your body for less than 48 hours, reapply the patch immediately. If it's not sticky enough or you cannot find it, apply the new patch. You are protected from pregnancy and follow the routine of replacing the patch on your regular "patch change date". If the patch is off for more than 48 hours, you need to break the old patch cycle and start altogether a new cycle. Start with the first patch and this will become your "patch change date". Use other two patches as per the schedule. You will not be protected for the first 7 days. So, use some other contraception methods. If you forgot to apply any patch, the same rules are applied. If you are late by less than 48 hours, apply the new patch as soon as possible. You are protected from pregnancy and need not change the "patch change day". If you are late for more than 48 hours, break the old cycle and start the new contraceptive patch cycle. Use other contraception methods for next 7 days.
The contraceptive patch is one of the safe contraception methods for most of the women. But very few women may develop venous thrombosis, arterial thrombosis, heart attack or stroke. If you've ever had thrombosis, you should not use the patch. The risk of thrombosis is more for the first year especially for those who have a smoking habit, are overweight, are immobile for a long time, use wheelchair or someone in the immediate family has venous thrombosis before they were 45 years old. If you smoke, are diabetic, have hypertension, are very overweight, have migraines with aura, consult the doctor before you start using the contraceptive patch to avoid pregnancy. Also see the doctor immediately if have any symptoms like pain in the chest, breathlessness you cough up blood, painful swelling in your leg, weakness, numbness or bad 'pins and needles' in an arm or leg, severe stomach pains, a bad fainting attack or you collapse, unusual headaches or migraines that are worse than usual, sudden problems with your speech or eyesight, jaundice (yellowing skin or yellowing eyes). Remember that these symptoms and health issues are very rare. So, consult your doctor before coming to any conclusion not using contraceptive patch.
Advantages
The contraceptive patch is one of the very safe, simple and convenient contraception methods to prevent pregnancy. Following the schedule correctly gives you great protection from unplanned pregnancy. Like pills contraception methods, you don't have to think about it every day, just remember to change it every week. You can stop it any time you want to have a baby. It usually takes about 1-2 months for your periods to come back to normal. Unlike contraceptive pills, the hormones need not be absorbed by the stomach, so the patch is not affected if you vomit or have diarrhea. Contraceptive patch helps to make your period regular and reduce the premenstrual symptoms. It also has some health benefits. The patch can also help reduce or help prevent acne, bone thinning, cysts in your breasts and ovaries, ectopic pregnancy, endometrial and ovarian cancers, serious infections in your ovaries, fallopian tubes, and uterus, iron deficiency (anemia), PMS (premenstrual syndrome).
Disadvantages
How to avoid pregnancy effectively is highly depends on the patch change schedule you follow. You must change the contraceptive patch on time. The contraceptive patch is visible which might not be comfortable for few women. The hormones in the patch can cause bleeding between periods, tender breasts, headaches, or nausea. Some people notice a little soreness on their skin where the patch is. But these symptoms should go away in 2-3 months. The patch may cause skin irritation. The contraceptive patch does NOT protect from sexually transmitted diseases. You need to use condoms contraception methods to protect yourself from STDs.
Contraceptive or vaginal ring hormonal contraception methods

Contraceptive or vaginal ring

Contraceptive or vaginal ring hormonal contraception methods type
Type
Hormonal contraception methods
Effectiveness of contraceptive or vaginal ring hormonal contraception methods
Effectiveness
91%
Contraceptive or vaginal ring hormonal contraception methods frequency of use
Frequency of use
3 weeks
STD protection status by contraceptive or vaginal ring hormonal contraception method

Protection against STDs

No
Contraceptive or vaginal ring hormonal contraception methods
The contraceptive ring also referred to as a vaginal ring, is a small plastic ring that is placed inside your vagina to prevent pregnancy. It is a clear and flexible ring of polyethylene vinyl acetate and about 4 mm thick and 5.5 cm in diameter.
Like most other hormonal contraception methods, the vaginal ring contains the hormones estrogen and progestogen. These are the same hormones your body make naturally. Once you wear the ring inside your vagina, it releases these hormones slowly which are then absorbed by your vaginal lining. The hormones released by vaginal ring prevents pregnancy by stopping the ovaries from releasing the eggs or ovulation. No ovulation means there is no egg for sperms to fertilize and so no pregnancy. These hormones also thicken the mucus at the entrance to the womb, making it hard for sperm to swim through and reach the egg. Even if some sperms meet the egg, the thinning of the lining of the womb done by these hormones makes it very difficult for a fertilized egg to grow.
The vaginal ring is one of the very effective hormonal contraceptive methods to prevent pregnancy. How to avoid pregnancy effectively depends on how old you are, how often you have a sex and whether you follow the instruction and schedule properly. When you use the vaginal ring perfectly, it is 99% effective to avoid pregnancy. It means only 1 out of 100 women using the ring will get pregnant over the year. In reality, there are few challenges to maintain the schedule and use the ring perfectly. So, the ring is considered as 91% effective. The effectiveness of a contraceptive ring might be affected by certain medicines like antibiotics Rifampin, Rifampicin, and Rifamate, antifungal Griseofulvin and HIV medicines. Talk to the doctor about all the medicines you are talking before you start using the contraceptive ring and see if this or any other contraception methods are suitable for you.
If you are not pregnant and wish to avoid pregnancy, you can start using the vaginal ring on any day during your menstrual cycle. If you start using the ring on the first to fifth day of your period, you will be immediately protected from pregnancy. If you start using the ring on any other day, it will take 7 days to become effective to prevent pregnancy. During these days, you need to use other contraception methods to avoid pregnancy. If you have a short menstrual cycle with your periods coming in 23 or fewer days, inserting the contraceptive ring as late as 5th day might put you at risk of pregnancy. In case of doubt, consult the doctor to be sure about when to start using the ring, to know if you are protected from pregnancy or not, and to understand how to avoid pregnancy.
Contraceptive or vaginal ring hormonal contraception method schedule
Contraceptive ring in day - Hormonal contraception method
Ring in day
A day when the ring is inserted. Ring will be effective for 21 days and you will be protected from pregnancy.
Contraceptive ring out day - Hormonal contraception method
Ring out day
Take out the ring on 22nd day. You will get 7 ring-free days. You will be protected for these 7 days.
How to use contraceptive ring to avoid periods
If you wish to avoid periods, you may skip the ring free days and insert the new ring immediately after 21 days.
Once the vaginal ring is inserted, it is effective for 3 weeks (21 days). Insert the vaginal ring and mark it as "ring in" day. Take the ring out after 3 weeks (21 days). This day is marked as "ring out" day. After 3 weeks, you will get 7 "ring free" days. During these ring-free days, you need not use any other contraception methods and you will be protected from pregnancy. You will also get your periods during these 7 days. After completing the 7 ring-free days, start the new ring cycle by inserting the new ring on the 8th day. Repeat this cycle to avoid pregnancy. You can also use the contraceptive ring to skip your period. Just make sure that the ring is in for all the days in a month. You can follow the schedule of changing the ring on a particular date. For example, you can decide to change the ring on 1st of every month irrespective of how many days are there in the month. You can also follow a schedule of changing a ring on a particular day. For example, you can change the ring on 4th Saturday in a month. If you use the vaginal ring to skip your periods, you may have some bleeding or spotting for the first six months. It's normal and if it does not go away, consult the doctor. If the ring is not in use, store it at normal room temperature and away from direct sunlight. If its left over for more than 4 months, put it in the refrigerator. Read the storage instruction given on the package carefully.
Sometimes it is hard to follow the "ring in", "ring out" and "new ring day" schedule. If you forgot to take the ring out after 3 weeks, the protection from pregnancy depends on for how many days ring has left in since the ring out the day. If the ring is in for less than seven days since the ring out the day, remove the ring as soon as remember it and start your 7 days "ring-free interval". Put the new ring in on the 8th day. You don't need to use any other contraception methods to avoid pregnancy. If your ring is left in for more than 7 days after your "ring out" day, remove the ring as soon as you remember and insert the new ring immediately. Mark this as new "ring in" day and start your new ring cycle. For the next 7 days, you need to use another contraception methods to avoid pregnancy. If you had a sex during the ring spill over days, ask the doctor about the chances of pregnancy and if there is need of pregnancy test.
The vaginal ring is one of the safe contraception methods for most of the women. But, it might not be suitable for a few. If you are over 35 years old and have smoking habits, it's not a good idea to use the contraceptive ring. Also avoid vaginal ring in case if you have health problems like blood clots, a blood-clotting disorder, breast cancer, heart attack, stroke, angina, or other serious heart problems, migraine headaches, uncontrolled high blood pressure, very bad diabetes or liver disease. Even though the contraceptive ring is very safe, using the ring can slightly increase your risk of health problems. These include heart attack, stroke, blood clots, and liver tumors. It is important to remember that the chances of these health problems are really, really small. So, please consult the doctor before you come to any conclusion about not using the vaginal ring to avoid pregnancy. The doctor will be also able to guide you about other contraception methods and how to avoid pregnancy effectively.
Advantages
When used correctly, the contraceptive ring is one of the very effective contraception methods avoid pregnancy. Like contraceptive pills, you don't have to think about it every day, just change the ring once in a month. You are protected from pregnancy 24x7 and it does not interrupt the sex. You need to have a prescription from the doctor, but you can buy multiple rings at a time from the medical store. Unlike the contraceptive pills, hormones don't need to be absorbed by the stomach. It usually makes your periods regular, lighter and less painful. This contraception method may help with premenstrual symptoms and improves acne in some people.
Disadvantages
How to avoid pregnancy effectively depends on how accurate you are in following the vaginal ring "in" and "out" schedule. Using a reminder will help you to remember the "ring in" and "ring out" day. You may not feel comfortable inserting and removing it. You may experience some side effects like increased vaginal discharge, headaches, nausea, breast tenderness and mood changes. You may also have breakthrough bleeding and spotting. All this should go away during the first few months. If not, consult the doctor. The contraceptive ring does not protect from sexually transmitted diseases. You need to use condoms contraception methods to protect you from STDs. The contraception doesn't have to be very uncomfortable or make you feel sick. There are many contraception methods to choose from. You can talk to the doctor to choose the best suitable contraception methods based on your requirement and medical conditions.
Getting pregnant and having a baby is exciting and the best thing that can happen to a woman. Many times, the unplanned pregnancy is undesirable and can bring stress, disturbance in your plans and overall unhappiness about pregnancy. Unintended pregnancy has a major impact on numerous social, economic, and cultural aspects of life. Through a good selection from all contraception methods and appropriate family planning, you can avoid all this and decide when you want to get pregnant.
Hormonal contraception methods act on the endocrine system, the chemical messenger system consisting of hormones, the group of glands and feedback loop. These contraception methods use different forms of artificial hormones that mimic the production of estrogen and progesterone in a woman's body. These hormones prevent pregnancy by stopping the release of eggs, by thickening the cervical mucus, and by making the lining of uterus thinner. How to avoid pregnancy effectively is mainly dependent on the schedule to be followed. Contraceptive pills are by far the most widely used contraception methods and overall 18% of women worldwide use hormonal contraception methods. There are few side effects of using hormonal contraception methods, and they depend on what hormonal formulation is used. Many of the side effects should go away in a few months and the health problems caused by these methods are really, really small. So, please consult the doctor before you come to any conclusion about not using hormonal contraception methods. It's always better to know different contraception methods and how to avoid pregnancy.
Remember that having a baby is very exciting and a life-changing event. Do not allow this to happen as an accident. Plan for it to avoid stress, disturbance in your plans and overall unhappiness about pregnancy. You can learn to avoid pregnancy naturally, use barrier contraception methods, or use these hormonal contraception methods. If you sexually very active and looking for a long-term, fit-and-forget solution, you can use long-acting reversible contraception methods. It is also understood that selecting the best one from all available contraception methods might go tough. If you are in doubt, consult the doctor who will help you to choose contraception methods that are best suitable for you. The more you know about these contraception methods and family planning, the more in control you can be of your sexual health. If you do not want the pregnancy, use appropriate contraception methods to avoid pregnancy. Let the pregnancy bring happiness than a stress and worry about what to do next.
Dr. Varshali Mali (MBBS, DNB). Gynecologist & Pregnancy Doctor

About Author

Dr. Varshali Mali is an Obstetrician and Gynecologist. She did her MBBS from Dr. D. Y. Patil Medical College, Pune, and DNB (Obstetrics & Gynecology) from Jehangir Hospital, Pune. She has a number of years of experience working as a gynecologist, pregnancy doctor, and lecturer. Currently, through her clinic located at Life Republic township near Marunji, she provides gynecology and pregnancy care solutions to the women around Hinjewadi, Wakad and nearby area in Pune. In her patient community, she is known for her welcome nature, smiley face, supportive attitude, intelligence and in-depth knowledge about gynecology and pregnancy. Mother of two daughters, she believes that motherhood is the best gift one can get. As her contribution, she puts her best efforts to make the pregnancy journey most enjoyable for her patients.

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