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?