Types of Vaginal Rings and IUDs

Intrauterine copper-bearing devices are small, flexible plastic frames with copper wire around it. Most IUDs, have 1-2 strings tied to them hanging through the cervix into the vagina.

Active ingredient: None! The "active ingredient" of copper-bearing IUDs are not hormones at all but the copper itself

Action: The copper in the IUD prevents pregnancy by damaging the sperm chemically, before it has a chance to meet the egg

Effectiveness: In the first year of use, less than 1 pregnancy is expected per 100 woman, however this increases slightly to 2 pregnancies per 100 women over 10 years of use. 

Protection against STIs: None

Benefits: IUDs are long-term birth control showing effectiveness for up to 12 years after insertion. Although it must be inserted by a trained professional, there is little maintenance required by the person thereafter making it less prone to user error. IUDs also have to be removed by a professional, however they are immediately reversible with no effects on fertility thereafter. The IUDs is also very confidential about a woman's contraceptive use, however, partners may be able to feel the strings during sex. 

Side Effects: Users of copper IUDs experience prolonged and heavy bleeding in the first 3-6 months causing more cramping and pain. Bleeding changes are normal however, if it becomes too bothersome they should reach out to their provider.

These forms of IUD are T-shaped plastic devices that steadily release small amounts of levonorgestrel daily. 

Active Ingredient: As discussed, these IUDs release levonorgestrel which is a common type of progestin hormone

Action: thickens cervical mucus which blocks sperm from fertilization, and prevents the release of eggs from the ovaries, thereby hindering ovulation

Effectiveness: In the first year of use, 2/1000 pregnancies are expected in women, this risk increases through the duration of use to 5-8/1000 pregnancies expected over the next 5 years

Protection against STIs: None

Benefits: Hormonal IUDs are similarly long-term birth control showing effectiveness for up to 7 years after insertion. Although it must be inserted by a trained professional, there is little maintenance required by the person thereafter making it less prone to user error. IUDs also have to be removed by a professional, however they are immediately reversible with no effects on fertility thereafter. The IUDs is also very confidential about a woman's contraceptive use, however, partners may be able to feel the strings during sex. 

Side Effects: Common side effects among women include acne, headaches, breast tenderness, nausea, weight gain, dizziness and mood swings. Bleeding patterns are irregular with some experiencing lighter and less frequent days to prolonged periods of bleeding. 

Vaginal rings are small flexible rings a woman places in her vagina that is left there at all times for three consecutive weeks between menstrual cycles.  

Active Ingredient: the two main ingredients are a progestin and an estrogen similar to the woman's natural hormones

Action: Continuous release of these hormones into the wall of the vagina to the bloodstream, prevents the release of eggs from the ovaries, thereby preventing ovulation

Effectiveness: Since these rings must be replaced for a woman's menstrual cycle, effectiveness is highly user dependent. In the first year of use, only 7 pregnancies are expected per 100 women. Without mistakes in contraceptive use, this decreases to less than 1 pregnancy per 100 women

Protection against STIs: None

Benefits: As these rings only need to be replaced once every menstrual cycle, this is much less maintenance than daily-pill taking which limits much of the user error. Contraceptive use is controlled by the woman and can be stopped at any time without a professional and without effecting fertility. Although this contraceptive is confidential to the woman's choice, it can sometimes be felt by the partner during intercourse

Side Effects: Common side effects among women include headaches, irritation or inflammation of the vagina (vaginitis) and white discharge. Bleeding patterns might also be effected with often lighter and less frequent bleeding but other times, prolonged or even no monthly bleeding altogether

Active Ingredient: the only hormone is natural progesterone, making it suitable for postpartum women who are actively breastfeeding four times a day

Action: Continuous release of these hormones into the wall of the vagina to the bloodstream, prevents the release of eggs from the ovaries, thereby hindering ovulation. In breastfeeding women, it delays the return of monthly bleeding caused by postpartum amenorrhea

Effectiveness: Only 1-2 pregnancies are expected in 100 women when using these vaginal rings for a year

Protection against STIs: None

Benefits: Compared to combined vaginal rings, these ones are replaced one after another, each in place for 90 days, without breaks in between. This reduces user error in maintaining replacement scheduling and can be used consecutively up to 4 times. This ring can be started 4-9 weeks postpartum and can be stopped at any time without physician intervention with no delay in fertility. As with all rings, contraceptive use is confidential however may be felt by a partner during intercourse. This ring is especially beneficial to breastfeeding women as there are no changes in breast milk production or composition when administered

Side Effects: Common side effects among women include spotting or irregular bleeding, low abdominal pain, breast pain and vaginal discharge

Let us know what contraceptives you have tried and your experience in the comments below! For more information please visit the link below to the Family Planning Handbook for Providers.

            (1) Huff, M. B. (2009). Family Planning: A Global Handbook for Providers. Journal of Pediatric and Adolescent Gynecology, 22(2), 135–135. Link.