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What is your date of birth?

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ARE YOU CURRENTLY BREAST FEEDING?

HAS IT BEEN MORE THAN 6 WEEKS SINCE YOU HAVE HAD A BABY?

DO YOU SMOKE CIGARETTES?

DO YOU SMOKE MORE THAN 15 CIGARETTES PER DAY AND ARE OVER THE AGE OF 35?

HAVE YOU EVER BEEN DIAGNOSED OR TREATED FOR THE FOLLOWING? PLEASE CHECK ALL THAT APPLY

ARE YOU CURRENTLY TAKING MEDICATION? PLEASE INCLUDE OVER THE COUNTER MEDICATIONS AND HERBAL VITAMINS AND SUPPLEMENTS

IS THERE ANYTHING ELSE ABOUT YOUR MEDICAL HISTORY YOU THINK WE SHOULD KNOW?

ARE YOU ALLERGIC TO MEDICATIONS?

TREATMENT OPTIONS

PLEASE SELECT ONE

FAQ'S

  • Generic vs Name Brand: If a generic version of your preferred birth control exists, we recommend using the generic version. Generics are just as safe and effective as name brands but cost significantly less.
  • Monophasic vs Multiphasic: We prefer monophasic medications for women who are just starting birth control. Multiphasic pills require more careful adherence to taking the right pills. Monophasic pills mean each pill delivers the same amount of hormone in each tablet. In addition to preventing pregnancy, it can help with pre-menstrual syndrome (PMS), acne, ovarian cysts, and can help to decrease blood loss and painful periods.
  • What are Common Side Effects of the Pill? Common side effects from the pill include nausea, breast tenderness, and headaches. These are usually minor, resolve within a few months of starting the medication, and occur in less than 10% of women.

    Women may also experience unscheduled bleeding or break through bleeding. This happens in approximately 50% of women during the first month of starting. Break through bleeding often occurs if you have a “low” estrogen pill such as Loestrin, Lo-Loestrin, Yasmin, Levora, or Orthotricyclin-Lo. Women often take low estrogen pills if they continue to experience nausea, headaches, and breast tenderness. Taking a low estrogen pill DOES NOT affect contraception. Please call or email if you have questions about which medication is best for you. A health care professional will help you choose.

  • How Do I Take the Pill? The pill is a contraceptive medicine that has the hormones progestin and estrogen. It is best to start your pack within the FIRST FIVE days of the START of your period to ensure you don’t need to use another form of contraception. Most packs are on a 28 day cycle which means you take 21 days of active pills and 7 days of inactive pills which is when you’ll get your period. You should take the pill at the SAME TIME every day.

THE PILL

    If you missed a day and it’s been less than 24 hours, take the missed pill right away. This means you may take two pills in the same day. If it’s been more than 24 hours, double up your pill at your normal time.

    Who Should NOT Take the Pill?

  • UNNACEPTABLE RISK: Combination birth control is a great option for many women to help prevent unwanted pregnancy. Some women should not take the pill. Your answers to our specially designed medical questionnaire will allow our health providers to assess your safety for this medication. See below for specific risks:
  • Do Not Take If You Meet Any of the Following:
    1. Women who are over the age of 35 and smoke more than 15 cigarettes per day
    2. High Blood pressure (systolic over 160, diastolic over 100).
    3. Known ischemic heart disease or valvular heart disease
    4. Known stroke or thrombogenic mutation
    5. Current breast cancer
    6. Liver adenoma or liver hepatoma
    7. Migraine WITH aura
    8. Diabetes for 20 years or more WITH nephropathy, retinopathy, neuropathy

    The pill DOES NOT protect against STDs, STIs, or HIV. We suggest using a condom to protect yourself from sexually transmitted diseases.

  • What is the Difference Between Cyclic and Extended Cycle Pills? Cyclic medication means you take 21 active pills and 7 inactive pills and you will have a period once a month. Some women may choose to use a birth control method where you take active pills for three months (84 days) and take inactive pills for 7 days so you have a period once every three months, roughly around week 13. Seasonale and Quasence are two examples of medication with 7 inactive pills and Seasonique and LoSeasonique have inactive pills which actually contain a low amount of estrogen which can help to shorten or lighten your period.

    Amenorrhea, or having no period, may occur in some women and is normal. If you have missed a pill and think you might be pregnant, please check with your doctor as amenorrhea may be a sign of pregnancy.

    Taking birth control early in pregnancy has NOT been linked to birth defects.

    Some medications can affect how well hormonal birth control works. These include some medications used to prevent seizures (called "anticonvulsants"), certain antibiotics used to treat tuberculosis (rifampin and rifabutin), and an over the counter supplement called St. John's Wort. Please be sure to answer all our questions completely and honestly so our healthcare team can assess if it’s safe for you to take birth control.

    There are over 85 different birth control pill options! We recommend using common generic forms as they tend to be widely used, little to no side effects, and cost effective. Popular brands include: Ortho-Cyclen ($16), Ortho-Tricyclen ($15), and Loestrin FE ($14). The prices may vary depending on pharmacy and insurance used. These prices are taken from www.goodrx.com without insurance. We recommend using www.goodrx.com to compare prices.

THE PATCH

The patch is applied to the buttock, abdomen, upper arm, or torso (do not place the patch on your breast) A DIFFERENT SITE IS USED EACH TIME A PATCH IS PLACED. Lotions and occlusive dressings should not be used at the patch site. Always change the patch on the same day of the week, i.e. every Sunday. We recommend writing the date in your calendar or setting an alarm on your phone.

If you miss or forget to change the patch exactly one week from when the last was placed change the patch as soon as you can. In order to avoid unwanted pregnancy, you must use back-up contraception i.e. condoms or avoid sex. The day you apply the new patch becomes your new “patch day”.

If there is a delay in removing the third patch this carries less risk than forgetting to change the first or second patch. If there is a delay removing the third patch, this will not affect your “patch day”.

If your patch falls partially or completely off and it has been less than 24 hours reapply the patch to the same part of your body (buttocks, abdomen, torso, upper arm). If the patch is no longer sticky remove the patch and place a new one. Do not try to keep the patch on with tape or other forms of adhesive. If it has been more than 24 hours, replace the patch with a new patch in the same location.

The patch has weekly rather than daily dosing, which appears to result in improved compliance The patch has sustained drug delivery resulting in more steady-state serum hormone levels. The non-oral route of administration is useful for patients who have difficulty swallowing pills. Therapeutic effects are achieved at lower peak doses since first-pass hepatic metabolism and enzymatic degradation in the gastrointestinal tract are avoided. Plasma hormone levels remain relatively constant while the patch is worn (ie, peaks and troughs do not occur)

The patch DOES NOT protect against STDs, STIs, or HIV. We suggest using a condom to protect yourself from sexually transmitted diseases.

In less than 2.5% of patients the patch caused local skin issues such as rash, redness, itching, and skin irritation.

Breakthrough bleeding may occur especially within the first two months of using the patch. By six months most reports of break through bleeding had stopped.

About 20% of women reported headaches, nausea, breast tenderness, and nasal congestion. Only 2% said the symptoms were severe enough to want to change birth control methods.Weight gain and androgenic symptoms ARE NOT side effects

Unacceptable Risk: Combination birth control is a great option for many women to help prevent unwanted pregnancy and improve period symptoms. Some women should not take the pill. Your answers to our specially designed medical questionnaire will allow our health providers to assess your safety for this medication. See below for specific risks:

  • Do Not Take If You Meet Any of the Following:
    1. Women who are over the age of 35 and smoke more than 15 cigarettes per day
    2. High Blood pressure (systolic over 160, diastolic over 100).
    3. Known ischemic heart disease or valvular heart disease
    4. Known stroke or thrombogenic mutation
    5. Current breast cancer
    6. Liver adenoma or liver hepatoma
    7. Migraine WITH aura
    8. Diabetes for 20 years or more WITH nephropathy, retinopathy, neuropathy

The generic version Xualne, without insurance costs anywhere from $98-142, for a one month supply. The prices may vary depending on pharmacy and insurance used. Insurance can drastically reduce the cost of the patch. These prices are taken from www.goodrx.com without insurance. We recommend using www.goodrx.com to compare prices.

THE RING

The ring has weekly rather than daily dosing, which appears to result in improved compliance. The ring has sustained drug delivery resulting in more steady-state serum hormone levels. The nonoral route of administration is useful for patients who have difficulty swallowing pills. Therapeutic effects are achieved at lower peak doses since first-pass hepatic metabolism and enzymatic degradation in the gastrointestinal tract are avoided. Plasma hormone levels remain relatively constant while the patch is worn (i.e., peaks and troughs do not occur) Helpful for women is sensitive skin or skin disorders who can’t tolerate the patch.

You can start use of the ring the first day you get it or you can wait to start the FIRST day of your period. If you start the ring the first day you get it and your period was MORE than 5 days ago you should use another form of contraception (we suggest condoms) for ONE WEEK.

The ring does not need to be fitted to patients. To use, find a comfortable position and pinch the sides of the ring together. Place the ring as high into the vagina as possible. This will improve comfort and prevent it from falling out. The position of the ring does not affect contraception.

Keep the ring in place for THREE WEEKs and then remove for one week. During this week you will get your period. Please remove the ring on the same day it was placed i.e. change on a Sunday. You should periodically check to see if the ring is still in place during the three weeks of use.

Occasionally your ring may fall out, especially if straining. Take the ring and wash it with warm water and mild soap and pat dry. Reinsert the ring how you normally would.

If you forgot to remove the ring after three weeks and it has been LESS than 5 weeks since you placed the ring, you should remove the ring. You should go one week without the ring and you will get your period. If you place a new ring immediately after ring removal it will not affect contraception, but you may experience breath through bleeding.

If it has been MORE than 5 weeks since you placed the ring you need to change the ring. Since it has been 5 weeks or more you need to use another form of contraception for ONE WEEK. To start a new ring you can either wait one week (to get your period) and then place a new ring or place a new ring immediately.

Rarely, the ring may break at the weld joint. This does not affect contraception but may increase the chance of it falling out. If the ring breaks, please remove the broken ring and replace with a new ring.

The ring DOES NOT protect against STDs, STIs, or HIV. We suggest using a condom to protect yourself from sexually transmitted diseases.

Break through bleeding may occur especially within the first two months of using the ring. By six months most reports of break through bleeding had stopped.

About 10% of women reported headaches, nausea, breast tenderness, and nasal congestion.Weight gain and androgenic symptoms ARE NOT side effects

UNNACEPTABLE RISK: Combination birth control is a great option for many women to help prevent unwanted pregnancy, decrease duration and painful periods, improve acne, and improve PMS symptoms. Some women should not take the pill. Your answers to our specially designed medical questionnaire will allow our health providers to assess your safety for this medication. See below for specific risks:

  • Do Not Take If You Meet Any of the Following:
    1. Women who are over the age of 35 and smoke more than 15 cigarettes per day
    2. High Blood pressure (systolic over 160, diastolic over 100).
    3. Known ischemic heart disease or valvular heart disease
    4. Known stroke or thrombogenic mutation
    5. Current breast cancer
    6. Liver adenoma or liver hepatoma
    7. Migraine WITH aura
    8. Diabetes for 20 years or more WITH nephropathy, retinopathy, neuropathy

The NuvaRing does not have a generic version currently available. The cost of the NuvaRing without insurance is anywhere from $167-183, for a one month supply. The prices may vary depending on pharmacy and insurance used. Insurance can drastically reduce the cost of the ring. These prices are taken from www.goodrx.com without insurance. We recommend using www.goodrx.com to compare prices.

Yes, other forms of birth control include sterilization, intrauterine devices (IUD), shots, implants, and barrier devices such as condoms. Immediate Care Online does not provide services for these birth control options. If you have questions about services we do not offer please contact your doctor or visit www.womenshealth.gov for more information.

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