SyreniRing Contraceptive Ring

SyreniRing Vaginal Contraceptive Ring

Medication Name	SyreniRing Contraceptive Ring
Active Ingredients	Etonogestrel 11.0mg and Ethinylestradiol 3.474mg
Medication Form	Vaginal ring
Used for	Contraception (pregnancy prevention)
Dosage	One ring worn for 3 weeks (21 days), followed by a 1-week (7 days) ring-free interval
Common Side Effects	Headache, nausea, vaginal discomfort, mood changes, acne
Do you need a prescription?	Yes, prescription required
Other names	NuvaRing (etonogestrel/ethinylestradiol ring)
Patient Information Leaflet	SyreniRing Patient Information Leaflet

How does the SyreniRing contraceptive ring work?

SyreniRing is a combined hormonal contraceptive vaginal ring that contains two female sex hormones: etonogestrel (a progestogen) and ethinylestradiol (an oestrogen). This flexible vaginal ring sits inside your vagina and slowly and continuously releases these hormones directly into the bloodstream.

Unlike contraceptive pills, you don’t need to remember to take a tablet every day. A single soft plastic ring is worn for three weeks at a time, making it a convenient form of hormonal contraception for many women.

The hormones in SyreniRing prevent pregnancy in three ways:

• Stopping ovulation: the hormones prevent your ovaries from releasing an egg each month. Without an egg, pregnancy cannot occur.
• Thickening cervical mucus: the ring makes the mucus at the entrance to the womb thicker, making it much harder for sperm to reach an egg.
• Thinning the lining of the uterus: the womb lining becomes thinner, reducing the chance of a fertilised egg implanting and developing.

When used consistently and correctly, SyreniRing is over 99% effective at preventing pregnancy. SyreniRing is not a barrier method and does not protect against sexually transmitted infections.

Who can use SyreniRing?

SyreniRing is suitable for women who need a reliable method of birth control. However, it is not right for everyone, and there are some situations where you should not use it.

Do not use SyreniRing if you:

• Have or have ever had a blood clot in your legs, lungs, or other organs
• Have had a heart attack or stroke
• Have migraines with aura
• Have severe diabetes with blood vessel damage
• Have very high blood pressure or very high cholesterol
• Have or have had breast cancer or other hormone-sensitive cancers
• Have severe liver disease or liver tumours
• Have any unexplained vaginal bleeding
• Are pregnant or think you might be pregnant
• Are allergic to etonogestrel, ethinylestradiol, or any other ingredients in SyreniRing
• Have hepatitis C and are taking certain antiviral medicines (including ombitasvir/paritaprevir/ritonavir or glecaprevir/pibrentasvir)

Speak to your doctor before using SyreniRing if you:

• Smoke, especially if you are over 35
• Are overweight
• Have a family history of blood clots, heart disease, or stroke
• Have epilepsy, Crohn’s disease, or ulcerative colitis
• Have recently given birth
• Are breastfeeding
• Have varicose veins or a history of superficial thrombophlebitis
• Have systemic lupus erythematosus (SLE)
• Have ever had chloasma (yellowish-brown pigmentation patches on the skin)

Your doctor or pharmacist will assess whether SyreniRing is suitable based on your medical history and any risk factors you may have. You can buy SyreniRing contraceptive ring online through our sexual health clinic after completing a short consultation.

How to Use SyreniRing

SyreniRing is worn for 3 weeks, then removed for a 1-week break. You will usually have a withdrawal bleed during this ring-free week. After the break, put a new ring in to start the next cycle.

1. Wash your hands, then choose a comfortable position: standing with one leg raised, squatting, or lying down.
2. Take the soft plastic ring from its sachet and compress it by pressing the sides together between your thumb and index finger.
3. Gently insert the ring inside your vagina until it feels comfortable. The exact position does not matter. If you can still feel it, push it a little further in.
4. Leave the ring in place for 3 weeks, using the ring as your sole method of contraception throughout this time.
5. To remove the ring, hook your index finger under the front rim and pull it out. Place the used ring back in its sachet and dispose of it in your household waste. Do not flush it down the toilet.
6. After the 1-week break, insert a new ring in to begin the next cycle, even if you are still bleeding.

If you have not used a hormonal contraceptive in the past month, insert your first SyreniRing on the first day of your period for immediate protection. If switching from another contraceptive method, speak to your doctor or pharmacist for guidance on when to start.

• Check regularly that the ring is still in place, particularly before and after sex. Some couples may notice the ring during sex, but this is normal and it does not need to be removed.
• You can use tampons while using the ring. Insert the ring first, and take care not to pull the ring out when removing a tampon.
• If the ring slips out, rinse it with cool or lukewarm water and reinsert it as soon as possible. If it has been out for more than 3 hours, contraceptive protection may be reduced. See the patient information leaflet for full guidance.
• Do not use SyreniRing alongside a diaphragm, cervical cap, or female condom as a barrier method, as these may interfere with correct placement.
• If you miss a period and you have not been using the ring consistently and correctly, a pregnancy test should be performed before starting a new ring.

Side Effects of SyreniRing

Like all medicines, SyreniRing can cause side effects, although not everyone experiences them. Most side effects are mild and settle down after the first few months of use.

Common Side Effects

These may affect up to 1 in 10 women:

• Headache or migraine
• Nausea
• Abdominal pain
• Vaginal yeast infection (thrush)
• Vaginal discomfort or discharge
• Genital itching
• Depressed mood or low sex drive
• Breast pain
• Pelvic pain or painful periods
• Acne
• Weight gain
• The ring slipping out

Uncommon Side Effects

These may affect up to 1 in 100 women:

• Dizziness or disturbed vision
• Vomiting, diarrhoea, or constipation
• Swollen abdomen
• Fluid retention
• Tiredness, irritability, or mood swings
• Increased blood pressure
• Increased appetite
• Back pain or muscle spasms
• Urinary tract or bladder infections
• Difficulty or pain when passing urine
• Pain, bleeding, or discomfort during sex
• Changes to menstrual periods, including irregular, heavy, or absent periods
• Vaginal dryness, burning, or bacterial infection
• Hair loss, eczema, rash, or hot flushes

Rare Side Effects

These may affect up to 1 in 1,000 women:

• Blood clots in a vein or artery, including deep vein thrombosis (DVT), pulmonary embolism (PE), heart attack, or stroke
• Breast discharge

If you experience any severe or persistent side effects or notice any changes to your health that you think may be related to SyreniRing, speak to your doctor or pharmacist.

You can report side effects to the MHRA Yellow Card Scheme to help monitor the safety of this medicine.

SyreniRing Ingredients

Active ingredients: Etonogestrel 11.0mg and ethinylestradiol 3.474mg. The ring releases etonogestrel and ethinylestradiol at an average of 0.120mg/0.015mg, respectively, per 24 hours over 3 weeks.

Other ingredients: Ethylene vinyl acetate copolymer (28% vinyl acetate) and polyurethane.

SyreniRing Warnings

• Some medicines can make SyreniRing less effective, including certain epilepsy medications, rifampicin, some HIV and hepatitis C treatments, and St John’s Wort. Always tell your doctor or pharmacist that you are using SyreniRing if any new medicines are prescribed.
• If you experience persistent vomiting or severe diarrhoea, SyreniRing may not work properly. Use additional contraception until the situation has resolved.
• SyreniRing is not suitable for use as emergency contraception. If you need emergency contraception, speak to your pharmacist or doctor as soon as possible.
• If you need surgery or will be immobile for a long period, tell your doctor you are using SyreniRing as it may need to be temporarily stopped to reduce the risk of developing blood clots.
• Keep SyreniRing out of the sight and reach of children.
• Store in the original packaging, away from light.
• Do not use after the expiry date shown on the packaging.