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Campus Health

Health Education

Sexual Health

Contraception

Many types of birth control are free with health insurance. Methods includes pills, patches, rings, IUDs and implants. Check your coverage to see which brands are free.

Women without insurance- generic OrthoCyclen, and Tri-Cyclen are available at WalMart, Target and Kroger for $9 per pack/$24 for 3 packs. Kroger has Trinessa and Sprintec; Walmart has Tri-Sprintec and Sprintec.

The method of contraception you choose should fit your needs and your lifestyle. Always be responsible for your own contraceptive and std prevention methods—do not rely on your partner! Most methods of contraception are reversible. Read the "Options from your healthcare provider" section below the PAP guidelines to learn about different types of contraception.

How to get birth control through the clinic

Meet with the Administrator to determine if you qualify for financial assistance before making an appointment .
The clinic carries a few brands for uninsured students who qualify for financial assistance.
Ortho Tri Cyclen (generic),
Aubra (low estrogen-generic for Alesse, Aviane and Sronyx),
Reclipsen (generic-as close to Yasmin as possible)
Emoquette (at the Campus Center clinc) and
the Depo shot.
Insured students will be given a written prescription to fill at the pharmacy of your choice.

PAP Guidelines

Pap guidelines are age-based. Guidelines emphasize detection of sexually transmitted infections. IUPUI Campus Health will screen women for sexually transmitted infections at annual visits for bcp refill and initiation.

  • Females 21-29 or older with a history of normal paps need one every 3 years.
  • Females 30 years of age or older with normal results for the last 3 consecutive smears need a pap every 3-5 years. If HPV testing is done with the pap, the schedule is every 5 years.

If you have had a pap done by another provider, please bring a copy of the report. If you don't bring a copy, you will be asked to sign a release of information so we can obtain a copy.

Routine Contraception

Routine contraception includes those methods that you have planned ahead to use. Rerversible contraception methods that require a prescription include: a variety of birth control pills, a vaginal ring, the Depo shot, the Ortho Evra patch, Implanon-an under the skin implant, and an intrauterine device (IUD). The IUPUI Health Center prescribes birth control pills,rings and patches. A Gyn referral will be made for diaphrams, Implanon and IUDs.

Options from your healthcare provider

The following routine contraception methods are available only through prescription, administration, or a procedure by your healthcare provider.

  • Birth Control Pill - Birth control pills prevent spikes in a couple of hormones to prevent ovulation. BCPs use synthetic hormones (similar to the estrogen and progesterone made in a woman’s body) to prevent the ovaries from releasing an egg. The amount and type of estrogens and progesterones vary. Birth control pills are 92-99.7% effective in preventing pregnancy; but they do not prevent STDs. It is important to use a barrier method in addition to the pill to prevent stds.

    The range in effectiveness depends on how consistently they are taken. See the package insert to see what to do if you forget one or more pills. No more than a 4 hour variance is recommended for low estrogen pills (Ortho Tri-Cyclen lo, Alesse, Aviane, or Loestrin etc).

    Side effects, such as irregular bleeding, weight changes, or nausea; more serious side effects such as blood clots, gall stones, and hypertension. Women who are 35 or older and/or who smoke are at greatest risk.

    Some side effects of BCPs are helpful: light periods, meaning lighter flow, fewer days of bleeding, and less cramping. Some clear up acne. They regulate your cycle so you can predict when your period will occur.

    Types-There are 2 basic types of bcps. Monophasic-each active pill contains the same amount of hormones and triphasic, the amount of progesterone varies. Examples are Tri-Sprintec, TriPrevifem, and OrthoTri-Cyclen.

  • The last week of a monophasic pill pack contains no hormones. These pills are a different color. That week of pills is included simply to maintain the habit of taking a pill. They do not need to be taken. If you skip them, you must remember to begin taking the active pills after 7 days of not taking any pills.

    Some birth control pills have fewer placebo pills which decreases the length or number of periods. Seasonale contains 84 active pills. Women taking this pill have only 4 periods per year. Some women will have unplanned spotting until their body becomes accomstomed to the schedule. Another brand, Seasonique, has 84 pills with usual hormones levels and 7 with less estrogen (no inactive pills). The week of low hormone pills decreases spotting.

    The benefit of skipping inactive pills is fewer or lighter periods. Skipping the week of inactive pills will delay your next period. Spotting may occur due to the changed hormone levels. The number of inactive pills that are taken each month may be gradually decreased to avoid spotting. The clinic handout provides information about when to start pills, what to do for missed pills etc. The manufacturer's insert is very helpful in answering questions about BCPs also.

    Some pills include iron (FE) in the last week of pills.

  • Birth Control Patch - The Ortho Evra patch is a thin hormone-coated adhesive patch which is placed on your skin (free of lotions, creams and sweat) of the upper arm, buttocks, stomach, or upper torso. The patch remains in place for one week, and then is replaced by a new patch. After three weeks of wearing a patch, the woman goes without a patch and has a period. The patch is up to 99.7% effective in preventing pregnancy because women forget pills. Patches have a higher risk for stroke.

  • Vaginal Ring - Like the pill and the patch, the Nuva Ring (a prescription brand), uses synthetic hormones similar to estrogen and progesterone to prevent the ovaries from releasing an egg. To use, a small, flexible ring is inserted deep into the vagina for three weeks and is taken out for the fourth week. The ring is up to 99.7% effective in preventing pregnancy when used correctly; but it is not effective in protecting against stds so a barrier method should also be used (diaphragms, caps, and shields cannot be used with the ring). The side effects of the vaginal ring are similar to those of the patch and the pill (with special concerns for women who are age 35 or older and/or women who are smokers). Additional side effects might include increased vaginal discharge and vaginal irritation or infection.

  • Injection - The injection (shot) Depo method of birth control uses a progesterone-only hormone to prevent the ovaries from releasing an egg or, sometimes, to thicken the cervical mucus to prevent the joining of sperm and egg. Using this method requires visits to your healthcare provider every 12-13 weeks for an injection. The shot is 97-99.7% effective in preventing pregnancy; but it does not protect against STDs so use of a barrier method is recommended. Side effects might include weight changes, depression, skin rash, headache, dizziness, and others that might last 12 weeks until an injection wears off. An increased risk of osteoporosis has been linked to use of the injection method but appears to be reversed once the Depo shot is discontinued. Return of fertility can take up to 18 months after the last injection.

  • Implants - Implanon is a non-estrogen hormone which is effective for up to 3 years. This method involves the implantation of a small rod in the upper arm by a trained healthcare provider. The rods continuously releases synthetic hormones similar to estrogen and progesterone. Implants are 99.95% effective in preventing pregnancy.

  • IUD - The IUD (intrauterine device) is a small T-shaped device that is placed in the uterusr. There are two types of IUDs—one releases hormones (levonorgestrel, a form of progestin, is effective for 5 years) and the other uses copper (which is toxic to sperm; effective for 10 years) as a means of contraception. Both types of IUD prevent implantation of the egg into the lining of the uterus. The IUD is 99.4-99.9% effective in preventing pregnancy.

  • Diaphragm, Cap, and Shield - The diaphragm is a shallow latex cup that fits into your vagina and is 84-94% effective at preventing pregnancy. The cervical cap is a silicone cup shaped like a sailor’s hat that fits into the vagina and is about 86% effective in preventing pregnancy in women who have never been pregnant or who have never given birth vaginally. It is about 71% effective in preventing pregnancy in women who have given birth vaginally. (After childbirth, the cervical opening is larger). The shield is a silicone cup with an air valve to the vagina and is about 85% effective in preventing pregnancy.

  • Permanent Methods - Vasectomies for men and tubal ligation or tubal implants (ESSURE) are permanent methods of birth control. A vasectomy or tubal ligation may sometimes be reversed. Essure is a a spring-shaped wire inserted into the fallopian tube via the uterus. These methods are recommended for men/women who are sure they do not want any or anymore children.

Options that do not require a visit to your healthcare provider

Non-prescription methods such as emergency contraception, withdrawal, condoms, sponges, spermacides, and fertility awareness (natural family planning) are available without prescriptions..

Not all are very reliable methods but are commonly used. Some of the following contraception options are available for over-the-counter purchase at drug stores, grocery stores, discount stores, etc.

  • Withdrawal - The withdrawal method of contraception involves the man pulling his penis out of the vagina before ejaculation. Withdrawal is not a recommended method of contraception because it requires self-control and experience. It is not for men who ejaculate prematurely. Men release a pre-ejaculate fluid that contains sperm, so pregnancy is still possible. Withdrawal can be 73-96% effective in preventing pregnancy, but the effectiveness is highly dependant on the situation and the couple. Withdrawal does not protect against stds. Use of a condom is recommended. With a condom, withdrawal can be nearly 100% effective in preventing pregnancy.

  • Male Condom - The male condom is a sheath-like piece of latex or sheepskin that fits over an erect penis to prevent the exchange of body fluids during sexual intercourse. When used properly, the condom is 85-98% effective; helping to prevent pregnancy and the transfer of stds. Be sure to follow the package instructions carefully for the most effective protection. Check the expiration date on the box before using a condom—an expired condom is more likely to break, allowing the transfer of body fluids to occur. Lubricant is also useful to prevent breakage. Planned Parenthood provides instructions for the correct use of a condom. Read package instructions carefully for information specific to the brand. FREE condoms are available at both clinics.

  • Female Condom - The female condom is a barrier method of contraception that the woman can insert into her vagina up to eight hours before sexual intercourse. The double-ringed polyurethane female condom is 79-95% effective in protecting against pregnancy and stds when used properly. Be sure to follow the package instructions carefully for the most effective protection; and because insertion can be tricky, it might be helpful to practice inserting a female condom a few times before you attempt to use one during intercourse. The female condom can help the woman take responsibility for contraception.

  • Emergency Contraception - There are times when the need for emergency contraception to prevent unintended pregnancy arises. If your method of routine birth control fails (a condom breaks, for example, or you haven’t taken your birth control pills properly), if you had unprotected sex, or if you have been sexually assaulted, seeking emergency contraception should be at the top of your priority list. Emergency contracepton is not fail-proof and does not protect against stds. It is most effective if used within 72 hours but may be used up to 120 hours after sex.Use of ECP reduces the risk of pregnancy after unprotected intercourse by 75%-89%.

    Two brands of emergency contraceptive pills (ECPs) are available without prescription for women age 18 and older. These pills contain progestin-only, no estrogen. Brand names are Plan B and NextChoice. Speak to the pharmacist to obtain ECP. Progestin-only ECPs contain only the hormone progestin. In the United, States, these pills are sold without a prescription for women 18 years of age and older. Plan B must be requested from the pharmacist; it is not out on the shelves. The risk of nausea and vomiting is lower with progestin-only ECPs.

    Several types of prescription birth control pills can be used for emergency contraception. See not-2-late.com for names and doses. More pills than usual must be taken. Most birth control pills contain estrogen and progesterone. About 50% of women who use regular birth control pills as emergency contraception will become nauseated and 20% will vomit due to the amount of estrogen.

  • Sponge - Today is a barrier method that returned to the U.S. market in 2005 after a 10-year absence. It is a soft, disk-shaped device with a loop for removal. It is made out of polyurethane foam and contains the spermicide nonoxynol-9 (which may cause vaginal irritation). The sponge is 84-91% effect in preventing pregnancy in women who have not had a child and 68-91% effective in preventing pregnancy in women who have had a child. The sponge is effective for more than one act of intercourse for up to 24 hours, and it needs to be left in for at least six hours after intercourse to prevent pregnancy. There is a risk of Toxic Shock Syndrome if the sponge is left in for more than 30 hours. The sponge does not protect against STDs, so use of a male condom is also recommended. There is only one brand of contraceptive sponge available in the U.S. – the Today Sponge, and it can be purchased in drug stores and other pharmacies. Be sure to follow the package instructions carefully for the most effective protection against pregnancy.

  • Spermicide - Spermicide can be in the form of a foam, cream, jelly, film, or suppository that is inserted into the vagina before intercourse to immobilize sperm and keep them from penetrating the egg. Some male condoms are also lubricated with spermicide. While spermicides are 71-85% effective in preventing pregnancy, they are not effective in protecting against STDs. Spermicides can be used as backup contraception with birth control pills, condoms, IUDs, and other methods. Spermicides with nonoxynol-9 may cause vaginal or rectal irritation: this irritation increases the risk of acquiring stds (including HIV transmission if your partner is infected with HIV).

  • Fertility Awareness - Fertility awareness methods of birth control involve carefully monitoring the woman's menstrual cycle to determine which days the woman is most/least fertile so that she can avoid intercourse on fertile days. This may involve daily monitoring of body temperature (kits available in drugstores) and cervical mucus consistency, careful and accurate recording of the menstrual cycle on the calendar, or keeping track of the menstrual cycle with CycleBeads (color-coded beads to help a woman determine her fertile days based on the start of her period). The fertility awareness method of contraception can be 75-99% effective depending on the woman's dedication to the daily record-keeping and observation that this method requires; but it is not effective in preventing transmission of STDs. Family planning centers and places of worship frequently offer classes on fertility awareness.
 

With so many varieties, it is important to consider factors that are important to your lifestyle. Those factors may include cost, reliability, frequency of use, length of use, reversability and risks.