What to know about the combined vaginal ring

It sits inside the vagina, where the hormones are absorbed. Its main actions are stopping ovulation, thickening cervical mucus and making the womb lining less suitable for a pregnancy. It does not protect against sexually transmitted infections.

You insert and remove the ring yourself on a schedule. The exact timing can depend on the product and whether you are starting, changing methods or replacing a ring late. Follow the supplied instructions and check that the ring is still in place after sex or removing a tampon.

Some people notice changes in bleeding, headaches, nausea, breast tenderness or vaginal irritation. A clinician should assess whether an oestrogen-containing method suits you, especially if you have migraine with aura, a history of blood clots, certain heart or liver conditions, or use medicines that interact with hormonal contraception.

Set reminders for insertion and removal. If the ring comes out, is left out, or is changed later than planned, consult the product instructions or a pharmacist promptly because emergency contraception or temporary barrier protection may be needed. Do not insert more than one ring to make up for a timing error.

Tell any prescriber that you use a combined hormonal ring. Keep the ring as directed before use, and arrange another contraceptive method before stopping if you do not want to become pregnant.

Seek urgent medical help for sudden chest pain, unexplained shortness of breath, coughing blood, one-sided leg swelling or pain, sudden weakness, difficulty speaking, or a new severe headache with neurological symptoms. These can signal a blood clot or another serious problem.

Arrange a routine review for persistent troublesome bleeding, recurrent vaginal irritation, a ring that cannot be removed, or concern about pregnancy. Take a pregnancy test if advised after a contraceptive error or a missed withdrawal bleed.

Ask whether your medical history and medicines make an oestrogen-containing ring suitable, what to do if it is expelled, and when protection begins after starting. You can also discuss bleeding preferences and how the ring compares with a daily oral method.