Contraceptive Services

Some women prefer birth control methods that do not involve medications or devices. Natural family planning (sometimes called fertility awareness) focuses on understanding the body’s natural cycle and identifying the days when pregnancy is most likely. This may involve tracking cycle timing, basal body temperature, and changes in cervical mucus.

Other approaches that patients sometimes ask about include withdrawal and the Lactational Amenorrhea Method (LAM). LAM can provide temporary pregnancy prevention during the first several months after delivery when a mother is fully breastfeeding and certain conditions are met.

These approaches can work for some couples, but they require careful attention and tend to be less reliable than many modern contraceptive options. During a visit, we’re happy to talk through how these methods work and help you decide whether they fit your goals and lifestyle.

Barrier methods such as condoms help prevent pregnancy by blocking sperm from reaching the egg. Condoms also provide protection against sexually transmitted infections (STIs), which makes them an important option for many patients. Spermicides are chemical agents that reduce sperm mobility and are sometimes used with condoms or diaphragms to increase effectiveness.

Birth control pills are one of the most commonly used and reliable contraceptive options. When taken daily, they work primarily by preventing ovulation and by thickening cervical mucus, which helps prevent sperm from reaching the egg. Many women also notice additional benefits such as lighter periods, improved acne, less menstrual cramping, and more predictable cycles.

There are two main types of birth control pills.

Combined hormonal pills contain both estrogen and progesterone. These are the most commonly prescribed pills and are highly effective when taken consistently. Combined pills are also frequently used to help manage heavy periods, painful periods, irregular cycles, acne, and other hormone-related symptoms.

Progesterone-only pills (sometimes called the “mini-pill”) do not contain estrogen. These may be recommended for women who cannot take estrogen, including some breastfeeding mothers or patients with certain medical conditions. Progesterone-only pills primarily work by thickening cervical mucus and sometimes by suppressing ovulation.

Most birth control pills historically used ethinyl estradiol as the estrogen component. Newer pills now use estrogen formulations that are closer to the body’s natural hormones, including estradiol and estetrol. These newer formulations were designed to better mimic natural estrogen and may offer advantages for some patients.

Birth control pills also come in different phasic formulations, meaning the hormone dose can change throughout the month. Some pills are monophasic, where the hormone dose stays the same every day, while others are biphasic or triphasic, where the dose shifts slightly during the cycle to more closely resemble the body’s natural hormonal pattern.

Another option many women appreciate is extended-cycle or continuous birth control pills. These pills allow patients to have fewer periods per year—or sometimes skip periods altogether—by taking active hormone pills for a longer stretch before having a withdrawal bleed. For some women, this can significantly reduce menstrual symptoms and improve quality of life.

During your visit, we take time to understand your health history, your goals, and how different options may fit into your life. Birth control is not one-size-fits-all, and the best choice often depends on factors such as medical history, lifestyle, future pregnancy plans, and personal preferences. Our goal is to help you understand your options so you can make the decision that feels right for you.

The birth control patch is a small adhesive patch worn on the skin that releases hormones similar to those found in birth control pills. The patch is typically changed once a week for three weeks, followed by a patch-free week. For many women, it offers the convenience of effective birth control without needing to remember a daily pill.

Like birth control pills, the patch works by preventing ovulation and thickening cervical mucus to reduce the chance of pregnancy.

It’s also worth noting that the patch may be somewhat less effective in women with higher body weights or higher BMI. For this reason, we often talk through whether the patch is the best option or if another contraceptive method might provide more reliable protection.

During a visit, we can review how the patch works and help you decide whether it fits your health, lifestyle, and pregnancy prevention goals.

The vaginal ring is a small, flexible ring that is placed inside the vagina and slowly releases hormones to prevent ovulation. It works similarly to birth control pills but provides a convenient monthly routine instead of a daily pill. Most rings are worn for three weeks and then removed for one week before starting a new cycle.

Many patients are initially nervous about inserting the ring, but it is generally very easy to place—often easier than inserting a tampon. Once in place, most women do not feel it during normal activities.

The ring can stay in place during intercourse, but some patients prefer to remove it temporarily. If removed, it should typically be replaced within a few hours to maintain contraceptive effectiveness.

Occasionally, patients notice that the ring can slip or fall out, particularly during bowel movements or when removing a tampon. If that happens, the ring can usually simply be rinsed and reinserted.

During a visit, we can talk through how the ring works and help you decide whether it fits your health, lifestyle, and pregnancy prevention goals.

The birth control shot (Depo-Provera) is an injection given once every three months that helps prevent pregnancy by suppressing ovulation and thickening cervical mucus. Because it only needs to be given four times per year, many women appreciate the convenience of not having to remember a daily pill or weekly medication.

One important thing to know about the shot is that it can increase appetite in some patients, and over time this may lead to weight gain for certain women. Not everyone experiences this, but it is something we discuss ahead of time so patients know what to expect.

Many women also notice that their periods become lighter or stop altogether after several injections. For patients who struggle with heavy or painful periods, this can be a welcome benefit.

Interestingly, when researchers look at real-world contraceptive use, the birth control shot tends to have slightly higher patient satisfaction and continuation rates compared with methods like the pill, patch, or vaginal ring. This is likely because it removes the need to remember medication on a daily or weekly basis.

Patients can receive the injection here in the clinic, or in many cases we can send the medication to your pharmacy so it can be administered locally, depending on your preference and insurance coverage.

During a visit, we can talk through whether the birth control shot is a good fit for your health, lifestyle, and pregnancy prevention goals.

Hormonal IUDs are small devices that are placed inside the uterus and provide long-lasting, highly effective birth control. Depending on the specific device, they can work for up to eight years, which is currently the longest duration supported by available data.

Hormonal IUDs work primarily by thickening cervical mucus and thinning the uterine lining, making it very difficult for sperm to reach or fertilize an egg. They are one of the most effective forms of reversible birth control available, with pregnancy rates well under 1%.

Another advantage is that hormonal IUDs contain very small amounts of hormone that act mostly within the uterus, so systemic hormone exposure is minimal. Because of this, most patients experience few to no hormone-related side effects such as mood changes, nausea, bloating, or weight gain.

Hormonal IUDs can also have a meaningful impact on menstrual bleeding. About 50% of patients stop having periods by the end of the first year, and that percentage tends to increase over time. Among those who continue to have periods, most experience significantly lighter and more manageable menstrual bleeding.

Hormonal IUDs are also completely reversible. If a patient decides she would like to become pregnant—or simply wants the device removed—it can be taken out during a quick office visit and fertility typically returns quickly.

Because of their convenience, effectiveness, and minimal side effects, hormonal IUDs tend to have very high patient satisfaction rates. During a visit, we can talk through whether a hormonal IUD may be a good option for your health, lifestyle, and future family plans.

The copper IUD is a long-lasting, hormone-free form of birth control that can provide pregnancy prevention for up to 12 years. It works by releasing small amounts of copper within the uterus, which creates an environment that prevents sperm from fertilizing an egg.

Because it contains no hormones, the copper IUD can be an excellent option for women who prefer to avoid hormonal contraception. It is also one of the most effective reversible contraceptive methods available, with pregnancy rates well under 1%.

The copper IUD tends to work best for patients who do not already struggle with heavy or prolonged periods, as some women may notice heavier or more crampy cycles, particularly during the first several months after placement.

Like all IUDs, effectiveness depends on proper positioning within the uterus. Once placed, the device typically remains in position for many years, but if a patient ever has concerns about the strings or symptoms that feel unusual, we’re always happy to evaluate the device and make sure everything is positioned correctly.

During a visit, we can review whether a copper IUD may be a good option based on your health history, menstrual patterns, and pregnancy prevention goals

The birth control implant (Nexplanon) is a small, flexible rod placed just under the skin of the upper arm that provides long-acting pregnancy prevention. Once in place, it slowly releases a progesterone hormone that prevents ovulation and thickens cervical mucus, making it very difficult for sperm to reach the egg.

The implant provides highly effective birth control for up to five years and is one of the most effective reversible contraceptive options available, with pregnancy rates well under 1%. Because it works continuously once placed, it removes the need to remember a daily pill, weekly patch, or monthly ring.

Insertion and removal are quick in-office procedures performed under local anesthesia. If a patient decides she would like to become pregnant—or simply prefers a different method—the implant can be removed at any time, and fertility typically returns quickly.

The most common side effect patients notice is changes in menstrual bleeding patterns. Some women experience lighter or less frequent periods, while others may have irregular spotting. Because the hormone dose is low and delivered steadily, most patients tolerate the implant very well.

For patients looking for long-lasting, low-maintenance birth control, Nexplanon can be an excellent option. During a visit, we can talk through whether the implant fits your health history, lifestyle, and pregnancy prevention goals.

Permanent birth control may be an option for women who are certain they do not want future pregnancies. These procedures work by blocking or removing the fallopian tubes so that the egg and sperm cannot meet.

Today, many patients choose salpingectomy, which involves removing the fallopian tubes entirely. In addition to providing permanent contraception, this approach has been shown to significantly reduce the risk of ovarian cancer, as growing evidence suggests that many ovarian cancers actually begin in the fallopian tubes.

Sterilization is intended to be permanent, so it is important for patients to feel confident in their decision. For patients using insurance programs such as Medicaid, federal regulations typically require that patients be at least 21 years old in order to consent to sterilization.

Like any major life decision, some patients may later wish they had chosen differently. Studies show that the risk of regret tends to be higher among patients who undergo sterilization at younger ages, particularly those under 30 years old or with fewer than two children.

Our role is to provide clear information and thoughtful counseling so you can make the decision that feels right for your life. Ultimately, we understand that you are the one who would carry the responsibility of either a future pregnancy or a permanent sterilization, and our goal is to support you with honest guidance and respectful care as you make that decision.