Alternatives to the pill

What is the contraceptive patch and the vaginal ring?

The contraceptive patch available in the UK is known as the Evra Patch. It works in the same way as nicotine patches for smoking cessation; each patch is applied to a smooth part of the body and the ingredients are absorbed through the skin. When used correctly, it provides near total protection against pregnancy.

The only available contraceptive ring in the UK is the NuvaRing. It is inserted into the vagina, similar to a tampon, where it remains for three weeks. Again, when inserted correctly, the NuvaRing is the same effectiveness as the patch at over 99% protection.

What are the advantages of using the ring and patch?

Since further options have been made available in the UK, thousands of British women have found it to be an effective alternative to the pill. Like the combined pill and mini pill, the NuvaRing and Evra Patch are just as effectiveness at around 99% making it a highly successful form of pregnancy protection.

One prime advantage is that effectiveness is not affected by illness - vomiting and diarrhoea - like the contraceptive pills. When vomiting and during severe bouts of diarrhoea, the pill is not always absorbed into the system meaning efficacy is severely compromised. This is never the case with the ring and patch.

Like the combined and mini pills, the level of efficiency is in line with using the contraception correctly. This means changing the ring when required and it doesn't come out and ensuring that the patch stays on. Both of these scenarios are unlikely.

Another bonus of the patch and the ring is that it also doesn't interrupt sex like barrier contraception such as condoms (although it's worth noting that only condoms provide significant protection against STIs) and your partner should not be able to feel the ring during intercourse. The patch is beige, small and discreet, needing to be placed on a flat smooth area of the skin, which often goes unnoticeable during sex as well.

Another main plus is that both the patch and ring are low maintenance in how they are used in comparison to other forms of contraception. Remembering to take the pill every 21 days, or 28 days if it's the mini pill, can be an inconvenience. Missing a couple of pills can also reduce the effectiveness resulting in stress and possible costs for the morning after pill. For women who find the scheduling associated with the pill tiresome, the ring and patch provides an effective solution.

• The Evra patch must be applied once a week for three weeks followed by a seven-day break where you experience a withdrawal bleed similar to a period.
• The NuvaRing is inserted just once a month. Some women experience periods and others don't.

The patch and the ring are also hormonal contraceptives meaning they have similar benefits to the contraceptive pills including:

• Control of mood swings and other mood fluctuations
• Lighter more manageable periods (less cramps and pain)
• Predictable periods (the ring could stop periods altogether)

Not experiencing a period could be a welcomed scenario for many women, especially if that time of the month is particularly troublesome, however other women like having a regular period as a sign that their contraception has worked.

How do the ring and the patch work?

The vaginal ring and contraceptive patch works in a similar way to the combined pill by releasing a steady dose of oestrogen and progestogen. This will prevent pregnancy in three ways. It stops the egg from being released from the ovaries (ovulation) while also preventing sperm from reaching the womb by thickening the cervix mucus. It also thins the lining of the womb, which makes it difficult for an egg to attach itself and grow.

How do you use these alternatives?

As with any form of contraception, there is a teething period to get used to the new protection in the way it works and for your own body. Like the contraceptive pills, it is advised to give both the patch and the ring a three-month trial period. If there are any side effects, these should disappear or significantly lessen and you should have gotten used to how it is applied/inserted.

• To use the ring, you remove it from its packaging, squeeze it between your thumb and index finger and insert it into your vagina. This process is very similar to a tampon or Mooncup. To remove the ring you can make a hook with your index or middle finger and gently pull it out. Removing and inserting the ring should be relatively easy.
• To use the patch, remove from its packaging and stick onto a flat smooth area of the skin such as your lower back, arm, shoulder or buttock. Do not place on your breasts. It is advised to change the position each time to avoid irritation to the skin. This is kept in place for a week. Use the patch three weeks in a row before a one-week break.

Depending on when you start the patch or ring, it may take up to seven days to be 99% effective. Therefore, it is advised to wear a condom during this time. Check the patient leaflet before using and ask your doctor any questions to determine when your contraception will be fully effective.

Active ingredients

In terms of active ingredients, both the patch and ring contain both oestrogen and progestogen like the combined pill. These are synthetic hormones used to manipulate your menstrual cycle in a natural way.

• The NuvaRing contains etonogestrel and ethinylestradiol
• The Evra Patch contains norelgestromin and ethinylestradiol

What are the potential side effects of the vaginal ring and the patch?

As with all contraceptives, you should be aware of any potential side effects that may be associated with them. If you are concerned by any side effects, it's always best to talk to your doctor for further information.

Contraceptive patch side effects

If the patch is applied to the same place continually, it can cause irritation and redness. It is advised to move the location of the patch around every time to avoid this. Some women may experience weight gain, however, this is mainly to do to water storage and should disappear after the first few months. As the contraceptive begins to work, you may experience spotting and irregular bleeding, which is usually light in nature. Other side effects include nausea, loss of sex drive and mood swings.

Contraceptive Ring Side Effects

The more common side effects include abdominal pain, breast tenderness, mood changes, nausea and headaches. Again, there may be weight gain but this can alleviate over time. Some women experience acne. Lastly, some women experience changes to the vagina including infections such as thrush and discharge.

If side effects are unmanageable and persist past the first three months, make an appointment with your doctor to review these contraceptive options.

What precautions should be taken with the ring and the patch?

The ring and patch is suitable for most women seeking an alternative to the contraceptive pill. However, it is considered unsuitable if you are 35 or over, a regular or heavy smoker, experience severe migraines or are overweight. If you have a history of conditions such as high blood pressure, blood clots, stroke, diabetes or have heart or circulatory problems, then these contraceptive options may not be suitable for you. It's always best to disclose full medical details upon consultation, so that our doctors can ensure that the ring is safe and suitable for you to use.

If you have suffered from migraines in the past, or are prone to headaches, it is important to monitor this whilst taking hormonal contraception. If you feel like headaches are frequent, visit your doctor.

Is the vaginal ring or patch available to buy online?

There is only one type of contraceptive ring and contraceptive patch available in the UK - Nuvaring and Evra Patch - which are both available to buy online at HealthExpress.

All hormonal contraception is only available on prescription. First, you will need to fill in our brief medical questionnaire. After this and providing that you have been approved, our doctors can issue a prescription that will be sent directly to our certified pharmacy, where they will prepare your contraceptive for free next day delivery.