birth-control-abroad

What’s the best birth control for long-term travel?

Of all the things I’ve had to do to prepare for this Germany move, I did not expect birth control to be one of the most difficult things to sort out.

Full disclosure: this post discusses birth control for women. I’m not a doctor, and options will differ per person. I’m just speaking from personal experience, and as a Canadian. Men, your options are even more limited than ours, congratulations. Condoms for everyone!

Also this blog post discusses periods so maybe you wanna turn back now and I don’t blame you.

I’ve been on the pill since I was about 14 years old, which means I’ve been pumping hormones into my body since I was barely a teenager. This is because I had the kind of painful menstrual cramps that made me want to scoop out my uterus with a spoon. I used to have to leave school to come home and curl up on the bathroom floor, pressing myself into the cold tiles, because the cramps made me violently ill and puke-y. I called it the “Cycle of Pain” because even if I did puke my guts up there’d be no relief.

When I briefly came off the pill in my early 20s the results were the same. I’d miss work, and I simply couldn’t afford to do so. There are other options out there but this one also controlled my flow. Whatever small male audience I have retained up until this point just said “NOPE” and went to crack open a beer.

But the pill is expensive if you’re paying for personal drug insurance because we live in a world where things like not ruining your life by getting pregnant aren’t considered much of a priority. And since I do have the immense “privilege” of living in Canada where birth control is even an option for me, and I CAN consult a doctor for free, I wanted to take care of it all before moving to Berlin. And I didn’t want to be on the pill, I wanted to try something different – what would my body be like without all those extra hormones after 15 years? Would I be a whole different person? The pill is SO HARD to stay regular with when you’re travelling non-stop and your schedule is more erratic than Donald Trump’s comb over.

Long story short: I got off the pill, and then got back on it. So what’s the best birth control for long-term travel?

 THE IUD

After exploring all my options (LOL like all four of them), I made an appointment with a doctor re: getting the IUD. The IUD is a t-shaped device that’s inserted into your uterus in what apparently feels like the most painful process on the planet. This was the best option for me. Why?

1. They’re low hormonal – You can get a copper IUD in the US that’s not hormonal at all, or something like Mirena that releases a small dose of progestin.

2. Once inserted, you can leave ‘em in for five years. Like, don’t have to mess around with anything. Glorious!

3. It’s one of the most effective methods for preventing pregnancy.

4. Usually your period slows down drastically, or sometimes even stops. This is especially helpful when it comes to travelling through countries that may not even have the kind of feminine hygiene products you need.

5. It’s relatively affordable, somewhere between $200-$400. Although if it falls out (happened to a friend), you’ll have to pay to reinsert it.

The only reason I DIDN’T go with this option is because I stupidly put off my appointment until mid July and didn’t have enough time to go through with it before leaving for Germany. And honestly, I’ve heard a few horror stories. Although apparently only 1 in 100 people get pregnant from the IUD, I know of at least three people who have. Another friend had to have hers surgically removed because the strings got lost, and so on.

Basically there’s no perfect form on birth control other than abstinence. But this post is not about abstinence. Also, if you know how fertile my huge family is, you’ll know I can likely get pregnant just by looking at some dude the wrong way.

THE PILL

So we’re back at the pill. I used to be on Triphasil and Triquilar because their high hormone dosages helped with the menstrual cramps. But in this new birth control quest of mine, I ended up going back to the doctor and requesting a lower dosage. She gave me Alysena, which is apparently just as effective as the others in preventing pregnancy.

While the pill isn’t the greatest of options while travelling long-term, since schedules are erratic and not taking the pill on time every day means its effectiveness is lowered, it’s also easier to get…at least in modern countries. I know a girl who used to order her pills online, and somehow it worked. There is actually a black market for birth control – I’m not kidding. You can also usually stock up beforehand. I bought a six-month supply, because that’s all I could afford at the time, and then will have my friend pick up another prescription for me and mail it to Berlin. Yeah, there’s no real easy way to do this, I admit. Not having babies is expensive, but you know what’s more expensive? Having babies.

THE RING

The NuvaRing is a vaginal ring that’s inserted for three-week periods at a time, then removed for the fourth week. You insert it yourself and remove it yourself. If you don’t like digging around in your vagina, this is not for you. But when inserted properly, you won’t feel it and neither will your partner.

This is the third best option, IMO. You can leave it in for three weeks and not think about it. The only thing it doesn’t really have going for it is that it’s so bloody expensive in most places. In the US it can be upwards of $100/month. In Canada it seems to be about $85/3 months, but my pill is much cheaper. AND it needs to be refrigerated…and if you’re travelling in developing countries, that can be a pain in the ass.

It also poses the risk off falling out sometimes, say, if you’re straining too hard on the toilet. Yes.

UPDATED — IMPLANTATION

I’ve updated this blog post to include implantation, which is a little rod that’s inserted under your skin to release progestin for up to three years. Implanon is the most common, but for some reason it wasn’t an option with my doctor and I’m not sure it’s available everywhere (plus it can cost up to $800 in Canada — but it lasts for two years or so). Many of you commenters seem to swear by it, although I have a cousin who had a terrible time with it. Still, I’d consider this option as well.

THE PATCH

This lovely little unsightly devil is slapped to your skin for a week at a time, and then removed for the fourth week. It’s just as effective as the IUD though, and costs anywhere between $0-80 a month.

Those options were the best options for as I prepare to move abroad. The others are less appealing: Depo-Provera has to be done every 12 weeks by a doctor, the sponge isn’t as effective, and who uses female condoms?

What has been your experience with birth control abroad?

If you like it you should put a pin on it 

Travelling long-term, and unsure about your options? This post (and its discussion) dives in deep.

  • July 14 2015
    camorose

    I got a Mirena IUD before I moved to Australia, and it’s been the best. I didn’t have to worry about looking for tampons in Asia, I didn’t have to worry about getting birth control abroad, and magic of all magic, I haven’t gotten pregnant. I have to get it out at the end of this year (5 whole glorious years later!), but I’ve been 100% happy with it so far. My yoga-ness wants to stop pumping all those hormones into my body buuuuuuut I’ve got to say–not having to deal with a period while traveling has been pretty stellar. Highly recommend!

    • July 14 2015

      Oooh that is a good point about not having to search for feminine hygiene products in countries where they’re hard to come by! Included in the post now. When I get back to Canada next year I’ll probably opt for the IUD, or see where I can get it done in Germany without paying a fortune.

      • July 14 2015
        camorose

        Definitely check in Germany. I remember going for a general pap smear/STD screen in Australia and paid like $40 for one of the most delightful public ob-gyn experiences of my life. Those semi-socialist countries really have it down when it comes to medical.

        • July 14 2015

          Seriously! I thought Canadian healthcare was good until I went to Scotland, haha. Amazing, and I didn’t even have to pay for my drug prescription when I was sick.

  • July 14 2015
    Kristian Fraser

    I’ve been off birth control for two years but before that I was also on the pill for like 8 years, and occasionally tried the patch and the nuva ring. Both were terrible for me.

    I’m actually going to a doctor today to see about getting back on birth control because cramps and self loathing are taking over my life 3 weeks out of 4. I’ve heard a bit about the implanon, which is a little tiny thing that gets inserted into your arm for 3 years. So I am going to be asking about that one! I didn’t see it mentioned here so I thought I’d share!

    • July 14 2015

      I did mention it, but it needs to be replaced every 12 weeks or so! At least Depo-Provera does, I’m not sure if there are others?

      • July 14 2015

        Oh wait, I totally confused injections with implants haha. You’re right, I’ll include that one! It wasn’t even an option with my doctor for some reason

  • July 14 2015
    Danika Krɪsməs

    I highly recommend the IUD! I personally have the Mirena, and despite what everyone’s saying against it, I’ve never had any issues.. Even the process of getting it put in wasn’t as bad as expected! I was back to normal the next day with little to no pain! I’ve had it for 2 years now and I’m super happy about my decision.

    • July 14 2015

      That’s awesome to know! It’s definitely my #1 choice at the moment. Seems to be the same way for a lot of people.

  • July 14 2015
    Terri O'Loughlin

    This is a really handy post, I hope a lot of people comment so other people can search it online.

    I had the Nexplanon implant put in while in the UK (free to get it done there, works for three years) but after 18 months, and while living in Canada I started to get depressed and gain a LOT of weight. The negatives eventually outweighed the positives and I looked into getting it removed. The implant hasn’t been approved in Canada, so hardly anyone has heard of it, even in sexual health clinics and gynecologists. I was quoted between 400-500$ Canadian for removal. Not much less than a flight home to England where i could get it removed for free!

    Luckily I found a walk in clinic with an adventurous (previously military) doctor who charged me a total of $100 to take it out. I have a 3cm scar on my arm and he spent almost half an hour rooting around in my bingo wing looking for it, lol, but I feel much better.

    I’m not saying the implant is bad, for almost 2 years I loved it (no periods, no worries about sex, i even lost ten pounds) but be aware, it’s not an internationally known device and you might have problems if you change your mind.

    • July 14 2015

      Hmm I wonder if it’s available under another name? My friend in the comments below mentioned Implanon, and one of my cousins also had an implant but like you she had to remove it because it seriously started screwing with her body. That sounds awful! Yikes.

  • July 14 2015

    So interesting! I was wondering about this the other day and realized what limited options there are when you’re travelling. In the future, I may end up being reassigned somewhere out of country with my employer so this is something I have thought about.

    I’m on birth control now and am happy to stock up on pills before I go but there has to be a better long term solution. The IUD looks good but I have (probably unnecessary) fears about having issues with it and having to go to the hospital somewhere random to get it removed. Since I’ve been on the pill for 6 years, I’m used to it and it’s in my control so I’m sticking with it for the time being. It’s good to explore all options though!

    • July 15 2015

      Right?! I totally took for granted that I even have access to birth control.

  • July 14 2015

    Do they even still prescribe the patch? I used it in college and LOVED it (you only have to remember it once a week!), but then I had to stop using it because there was like mega-increased chances of blood clots. Maybe they’ve rejiggered it?

  • July 14 2015
    Lauren @BonVoyageLauren

    I didn’t know the patch was still a thing either! “Not having babies is expensive, but you know what’s more expensive? Having babies.” AMEN!

  • July 14 2015
    Terri Lynn Grothe

    I tried all the above, the patch made me nauseas all the time, the ring was just gross to me and it kept falling out ( LOL), the pill I always forgot so I took the IUD 6 years ago, I just got a new one a couple months ago, I had my first in for 5 years then took a year off to get my body regulated again and it is back in and I love it… don’t know it is even there

    • July 15 2015

      That’s awesome! I’m so happy there are so many positive comments about the IUD here

  • July 14 2015

    It’s surprisingly difficult to sort out birth control at home, and even more so abroad. I lived in London UK for 2 years, and I remember how much of a pain in my butt it was when I ran out of my Canadian pills. They didn’t have the brand I was using, so I tried one that was supposed to be similar but I ended up being on my period for 3 months. 3 months! In the end it kind of sorted itself out, but none of the British pills I was given really worked for me.

    • July 15 2015

      Ughhh holy heck. I asked my pharmacist if a friend could pick up my prescription and mail it to me, and she said it was totally fine, thankfully.

  • July 15 2015

    Thank you so much for this post! I was digging around the interwebs for something like this a while back but you know what, no one writes about contraception from the travel point of view. It’s not ideal if they just tell you to take condoms when you’re travelling with a boyfriend. I wanted to get the implant or the IUD, but there were horror stories about period that lasted for half a year… plus inserting the IUD is supposedly super painful. I also kept imagining accidentally tugging the strings or something or it just getting dislocated on its own when I’m somewhere two day’s hike from civilisation.

    I ended up getting the ring and it is the best, although it is STILL almost too difficult to remember… and it freaks me out to take it with me to India because it should be stored in max 30 degree temperature (not sure what that is in Fahrenheit… does Canada even use Fahrenheit?) I’m still gonna risk it because it’s just a short trip. However, after I’ve used up all of the twelve-month prescription I’m probably gonna look into getting the implant. Maybe.

    Do you know if any other travel bloggers have talked about this stuff? It would be great to read what others think.

    • July 15 2015

      I honestly haven’t seen any other posts about this around the web! I was researching myself, but not for long, haha. That’s my issue with the ring as well — what if you can’t find a cool spot to store it?

  • July 15 2015
    Adelaide Haynes

    I use the implanon and it’s been awesome!

    It’s cheap and lasts for 3 years! I was on the pill whilst trying to travel and it was just impossible to try and take it regularly.
    Great post, but I guess everones different.

    http://aworldlyaddiction.com

    • July 15 2015

      Implanon wasn’t even an option with my doctor! I don’t think it’s available everywhere. I may look into it in Germany though.

  • July 15 2015

    I have a Mirena IUD – specifically because I didn’t want to mess with pill refills abroad or taking it at the same time every day when frequently crossing time zones, etc. Yup, the insertion is painful (mostly the cramping afterwards), I won’t lie about it. But I never think about it and I never get a period. So, 24 hours of true sucking is made up for by 5 years of feminine bliss. FYI, for those of us in the USA, it can cost about $1000 (for the device itself + doctor insertion) though my insurance covered about 80%.

    • July 15 2015

      Whooooa! $1000! That’s insanity. But that’s all really awesome to hear, thank you.

  • July 15 2015
    Jenna Thomas

    I got the Mirena IUD last year, and yes, the insertion was a total bitch–curled up on the couch for the rest of the day, moaning and groaning. But the next day I was fine, and it’s been smooth sailing since then! So nice not having my period while traveling (minus some lower back pain, but a little back pain is a major upgrade from what I was dealing with). I was on the pill for almost ten years before that!

  • July 15 2015
    Angela

    I got the Copper IUD in November and no regrets! Yes, as others mentioned, it is painful after insertion, but I was back to normal by the 2nd or 3rd period and the reduced stress of not worrying about it and no hormones can’t be beat. Additionally, the copper IUD can last up to 12 years and in the USA it was free with health insurance (no co-pays or anything).

  • July 15 2015

    I’m a lesbian. End of birth control discussion for me. :)

    Seriously though, I used to work in a midwifery clinic and we inserted IUDs like they were going out of style. It was basically like Oprah, “You had a baby? You get an IUD! You get an IUD! Everyone gets an IUD!!!” I think the Mirena is the most common in the US, though the copper version is better for you since it does not have hormones (I have seen some not so nice side effects from the both types of IUDs). I also worked in an ER and in those small cases where there was a side effect, we would remove them for ladies.

    I think whatever you decide, it’s important to have a good relationship with your doctor and to pick what will work best for you. Condoms are still important though! STIs and STDs are no fun either. Especially in a foreign country where you don’t speak the language.

    • July 20 2015

      Yes, condoms = essential! Haha. I just don’t trust them entirely for preventing pregnancy.

  • July 23 2015
    Brittany Bell

    The Implanon rocks if you have access to it. I am on my third, you replace it every three years and for most people you don’t get a period. Which is a total bonus, I haven’t had any other issues with it at all.

    • July 24 2015

      Would looove to never have periods hahaha but definitely want to try the lower hormonal thing for awhile

  • July 25 2015
    Michelle

    I’ve had the Mirena IUD for about 3 years now, in Canada it cost about $400 including insertion, painful to put in but it’s been amazing and worth it and my period stopped completely…. Up until this year where I’ve ended up with ovarian cysts and painful cramps and ever-lasting periods. Thankfully I had health insurance when I had to get it checked out overseas, cost over $500 to find out it was “nothing, just cysts caused by the IUD”. Very frustrating but I’m hoping the periods go away again, it’s only been about 3 months since they started back up but I would hate to get it removed. I guess it’s a bit of karma for bragging about not having a period in years hahah. And I’ve heard from friends that getting it removed is extremely painful too…not looking forward to that haha.

  • January 09 2017

    I’m not sure if this post is still active… Another Canadian here. I’ve been living in Japan for the last five years, and after all that time debating about the IUD I finally got the copper one. The initial pain was the worse, and the first couple months were an adjustment. It’s only been eight months, but so far I’m pleased. Wish I had made the decision sooner. Hope you figured out which option was the best for you!

    • January 09 2017
      Candice

      I JUST got health insurance again for the first time in years, so getting an IUD is my number one priority. Glad you’ve found it to be a good experience!

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