A patient calls a family planning clinic and tells the nurse that her vaginal ring, which has been in place for 2 weeks, came out sometime during the night while she was sleeping. The nurse will instruct her to:
a. clean the ring with warm water, reinsert it, and use condoms for 7 days.
b. discard the ring and insert a new ring after 1 week has passed.
c. discard the ring and insert a new one to begin a new cycle.
d. wash the ring in hot, soapy water and reinsert it.
A
If a ring is expelled before 3 weeks have passed, it can be reinserted after being washed in warm water. If the ring has been out longer than 3 hours, backup contraception should be used for 7 days. Because this ring was expelled while the patient was sleeping, using backup contraception is prudent. Discarding the ring is not indicated if it can be cleaned. The ring should not be washed in hot water.
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