BWell Health Promotion

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Contraception Connection

Resource

This page is based on the Contraception Connection booklet from SHAG, a resource created and regularly updated for Brown students by Brown students.

Options

Make An Informed Choice

Selecting a contraceptive method can take some research. This resource is intended to help you understand a little bit about each method, including the advantages and drawbacks. All of the methods discussed protect against pregnancy and two (external and internal condoms) offer protection against STIs as well. Keep in mind that condoms can be coupled with another contraception method (like the pill) to increase the overall pregnancy protection effectiveness level at the same time as offering STI protection.

Be Confident About Confidentiality

All Brown students can use Student Health Services and all visits to Health Services are confidential. Health Services staff will never discuss your personal health information with others, including family members, without your express permission or request. If you are concerned about insurance billing and confidentiality, let your provider know and they can help you to understand what information might be shared by an insurance company.

Get Your Questions Answered

Choosing the right method is an important decision and you need and deserve to get your questions answered. A good tip is to write down any and all questions you have before you go to see your medical provider. Bring the list with you to your appointment and that way you won’t forget anything.

If you would rather speak to a peer, but want to make sure you are getting reliable, confidential information, you can text the peer educators of the Sexual Health Awareness Group (SHAG!). Log in with your Brown credentials to get the texting number. You will get a personalized response, written by a SHAG peer educator and reviewed by a Health Promotion staff person, within 24 hours.

Understanding Effectiveness

If a method is 98% effective, this means that out of 100 people using the method for 1 year, 2 would experience a pregnancy and 98 would not.

Cost + Insurance

Student Insurance at Brown

All students can use Student Health Services, regardless of insurance. Visits at Health Services are covered by your Health Services fee and insurance is never billed for your office visit with UHS medical providers, but prescriptions and any lab fees are usually charged to insurance. Prescription contraception methods obtained at the Health Services pharmacy can be paid for out of pocket or you can use your Brown-sponsored student health insurance plan (SHIP) or other health insurance. Many prescription methods are available at low or no cost depending on your insurance coverage.

If you have the Brown Student Health Insurance Program (SHIP) for your health insurance coverage, you will find that paying for contraceptives is most seamless and there are a few extra perks, like free Plan B emergency contraception at the pharmacy. However, no matter what health insurance plan you have, you can see any provider at Health Services without any cost and can use the lab and pharmacy and have any charges billed to your insurance.

Free Birth Control

You can probably get birth control for free. In many cases, if you use health insurance, your birth control will not cost you anything at all. Every student must have health insurance in addition to paying the health fee, either through the Brown-sponsored student health insurance plan (SHIP) or through another insurance company. Under the Affordable Care Act (or ACA), if you have health insurance, your birth control method should be a covered benefit without any out-of-pocket expenses. If you have SHIP or a private health insurance, your birth control will likely be covered without a co-pay. This means that when you walk into the pharmacy to pick up a pack of pills, your receipt would say $0, and when you go to a health care provider to get an IUD, your cost, again, would be $0.

Source

Birth control cost information adapted from materials from Bedsider.

Prescription Methods: LARCs

Long acting reversible contraceptives are highly effective (fewer than 1 in 100 people will experience a pregnancy using these methods) and offer long term protection (3-12 years depending on the method).

Description

The IUD is a small, T-shaped device, placed in the uterus. There are five types currently available in the US: The nonhormonal IUD, Paragard, and four hormonal IUDs, Mirena, Skyla, Liletta, and Kyleena.

Effectiveness

IUDs are more than 99% effective. They provide protection for years (3 years for Skyla, 5 for Kyleena, 8 for Mirena and Liletta and 10-12 years for the ParaGard IUD).

Tips

IUDs can be used by people who have and who have not had children. IUDs provide highly effective pregnancy prevention and can also be used for Emergency Contraception.

Cost

If you pay out of pocket, IUDs range in cost from $900-$1200. If you use health insurance, however, you can probably get an IUD inserted with no out of pocket cost. Available at Health Services.* Call 401-863-3953 for an appointment.

* Depending on your insurance coverage, Health Services may be able to offer you these methods on site and without cost, or may refer you to an outside provider if that will allow you to get the method without cost.

Description

The implant is a tiny rod which is inserted under the skin of your upper arm. It will be almost invisible once inserted. The implant releases hormones which suppress ovulation.

Effectiveness

The implant is more than 99% effective and can be left in place for up to five years.

Tips

To insert the implant, your medical provider will numb a small area of your arm. Insertion takes only a few minutes and can be done in your provider’s office.

Cost

If you pay out of pocket, the full price of the implant can range from $450-$800. Removal can cost up to $300. If you use health insurance, however, you can probably get an implant inserted and removed with no out of pocket cost. Available at Student Health Services.* Call 401-863-3953 for an appointment.

Prescription Methods: Hormonal

Effectiveness

91% effective, on average. 99% effective if used perfectly.

Pros

Can regulate your period each month,making it lighter (reduced bleeding and cramps) and more regular. Can be used to suppress or stop your period if you do not
take the placebo pills.
Can decrease the likelihood of developing severe acne, uterine cancer and ovarian cancer.
There are many types available, so you will have a good chance of finding one that works well for you.

Cons

Possible side effects include nausea, breast/chest tenderness, headaches, irregular/missed periods and Increased risk of blood clots.
Some users say that the pill changes their mood or sex drive.
Must be taken daily.

SHAG! Tips

Talk to your provider about trying a different pill if you’re experiencing uncomfortable side effects.
Birth control pills can be paired with condoms or internal condoms to be even more effective. Condoms offer the STI protection that the pill does not.
Don’t forget to take the pill every day! This is how to get the most effective protection.
An over-the-counter pill is also now available, including at the Student Health Services pharmacy.

Available at Student Health Services

Talk to a provider to get, renew or change a prescription or pick up a refill of your existing prescription at the pharmacy.

Cost

If you use your health insurance, in most cases the monthly cost will be $0. If you pay out of pocket, a monthly supply will cost between $18 and $175 (average of $15-$30) at the UHS pharmacy.

Effectiveness

99% effective with perfect use.

Pros

Inserted into the vagina and left in place for 3 weeks; less possibility of user error (forgetfulness) than with a daily method.
Can regulate your period each month, making it lighter (reduced bleeding and cramps) and more regular.
Can decrease the likelihood of developing severe acne, pelvic inflammatory disease, uterine cancer and ovarian cancer.

Cons

Possible side effects include headaches, nausea, breast/chest tenderness and breakthrough bleeding.
Depending on the type of sexual activity, your partner may or may not feel the ring. (8 out of 10 partners report they don’t feel the ring during penis-vagina intercourse.)

SHAG! Tips

To insert the ring, squeeze it between the thumb and index finger and gently insert it into the vagina. (Can also be inserted using a tampon applicator.) It will bend to fit and the muscles of the vagina will hold it in place. You should not be able to feel the ring once it is in place.
If the ring slips out, or if you remove it (it can be removed or left in for intercourse), if it’s out for less than 3 hours, it remains effective. If it is out for more than 3 hours, effectiveness may be compromised.

Available at Student Health Services

Talk to a provider to get, renew or change a prescription or pick up a refill of your existing prescription at the pharmacy.

Cost

If you use your health insurance, in most cases the monthly cost will be $0. If you pay out of pocket, a monthly supply (1 ring) will cost $186 at the UHS pharmacy.

Effectiveness

98-99% effective in preventing pregnancy with perfect use.

Pros

Worn for 1 week and replaced each week for 3 consecutive weeks, with the 4th week “patch free,” there is less chance of user error (forgetfulness) than with a daily method.
Can regulate your period, making it lighter (reduced bleeding and cramps) and more regular.
Can decrease the likelihood of developing severe acne, pelvic inflammatory disease, uterine cancer and ovarian cancer.

Cons

Possible side effects include nausea, breast tenderness, breakthrough bleeding, and skin irritation where the patch is applied.
Using creams, oils or powders near the patch may cause it to become loose.
The patch may carry a higher risk of blood clots.
Less effective if you weigh more than 196 lbs.

SHAG! Tips

You can wear the patch on your buttocks,abdomen, upper torso (front and back, excluding the breasts/chest) or upper outer arm.
Don’t decorate or cut your patch.
In the rare case that your patch falls off, call Health Services to request a replacement patch.

Available at Student Health Services

Talk to a provider to get, renew or change a prescription or pick up a refill of your existing prescription at the pharmacy.

Cost

If you use your health insurance, in most cases the monthly cost will be $0. If you pay out of pocket, a monthly supply (3 patches) will cost $143.25 at the UHS pharmacy.

Effectiveness

99% effective with no missed or late shots.

Pros

Depo-Provera, the birth control shot, can be great for people who may not remember to take a daily pill.
You need to get a shot every 12-13 weeks or about every 3 months.
Contains only the hormone progesterone, so is an option for those who can’t take estrogen.

Cons

May cause temporary bone thinning, which increases the longer you use the shot. Bone loss is recovered when you stop using it.
There is no way to stop any side effects until the shot wears off in 12-14 weeks.

SHAG! Tips

After your last shot, it takes an average of 9 to 12 months to become pregnant.
Since the shot has been associated with bone thinning, you can help protect your
bones by getting regular exercise, and extra calcium and Vitamin D.

Available at Student Health Services

Talk to a provider to get, renew or change a prescription or pick up a refill of your existing prescription at the pharmacy.

Cost

If you use your health insurance, in most cases the monthly cost will be $0. If you pay out of pocket, each shot will cost $61.75 at the UHS pharmacy.

Non-Prescription Methods

Effectiveness

If you abstain from any form of penis-vagina sex, there is a 0% risk of pregnancy.

Pros

Abstinence is the only birth control method that is 100% effective against pregnancy.
There are no physical side effects for abstinence.

Cons

Studies show that teens who take virginity pledges are less likely to use condoms or other contraception if/when they do have sex. If you are currently abstinent, also consider what method you would use if you do have sex in the future.

SHAG! Tips

Abstinence can be an empowering way for you to think about what you want from a sexual relationship.
Abstinence should be an informed decision that you make for yourself.
Abstinence can have different meanings for different people (ex. abstaining from kissing, oral sex, anal sex, etc.)

Availability at Brown + Cost

Abstinence is free and available anywhere, including at Brown. According to surveys, 1 in 3 Brown students are abstinent.
Providers at Student Health Services are available to discuss options related to abstinence and you can also text SHAG with any questions.

Effectiveness

When condoms are used perfectly for vaginal sex the chance of becoming pregnant is less than 3%. The average risk is 12%.

Pros

Latex and polyurethane condoms are effective in preventing pregnancy AND are currently the best method of STI protection.
There are a variety of specialty condoms: different shapes, colors, sizes and flavors. Choose from latex and non-latex options too.
Easy and quick to put on.

Cons

Must be put on when an erection is present but before sexual activity.
Low possibility of condom tearing/breaking/slipping off. (Condom breakage is rare: 1 in 165 during vaginal sex and 1 in 105 during anal sex.)

SHAG! Tips

How to use an external condom

Open carefully. Check the expiration date and ensure the package has not been punctured.
Pinch, place, & roll down. Pinch air from the tip of the condom with your thumb and forefinger to prevent condom breakage.
Withdraw. Immediately after ejaculation and while the penis is still erect.
Don’t Flush! Condoms can clog the toilet.

Availability at Brown + Cost

Lubed condoms, non-lubed condoms, flavored, non-latex and magnum condoms are free from BWell Health Promotion, at BWell On the Go stations, or via online ordering from Ship n SHAG. At drugstores, a box of 12 standard latex condoms costs around $10 to $12.

Effectiveness

When internal condoms are used perfectly for vaginal sex the chance of becoming pregnant is 5%. The average risk is 21%.

Pros

Provides an opportunity for receptive partners to share responsibility for the use of condoms.
One size fits all.
Protects against most STIs and covers skin surrounding the vagina or anus for additional protection.
May stimulate the clitoris during vaginal intercourse.
Can be inserted up to 8 hours or just a few moments before sex.

Cons

Higher failure rate for pregnancy prevention than methods like the birth control pill or IUD (But can be used with these methods)
Like external condoms, can be used only once.
Usually more expensive than external condoms.

SHAG! Tips

Internal condoms can be an option if you or your partner have a latex allergy (the condom is made of nitrile).
Use extra lubricant to decrease any crackling noises during intercourse.
Don’t use internal condoms and external condoms together! The friction may cause the condoms to break or cause the internal condom to become dislodged.

Availability at Brown + Cost

Internal condoms are available to Brown students for free from BWell Health Promotion, at BWell On the Go stations, or via online ordering from Ship n SHAG. They typically sell for $2-3 each at drugstores.

Just In Case

If you don’t think your contraception method has been effective (for example, if the condom breaks or if you forgot your pill for 2 or more days) or if you did not use any, consider the following:

Emergency Contraception (EC)

Also known as the “morning after pill,” EC is most effective at preventing pregnancy 72 hours (3 days) after unprotected sex, but may be effective up to 120 hours (5 days) after. Plan B (and generic versions) and Ella are medications which can prevent pregnancy and are both available at Health Services. The IUD is a device which is inserted into the uterus. IUDs are available at Health Services. Be sure to mention that you need a timely appointment. Read more about your EC options on BWell's Emergency Contraception page.

Pregnancy Testing

You can take a pregnancy test as soon as your period is late. Some tests can work a few days before a missed period. You can buy a DIY test at any drugstore or see a provider to be tested. Pregnancy tests at Student Health Services are free if you see a provider or can be purchased in the Health Services pharmacy if you would prefer to do the test yourself.

Questions?

Make a Sexual Health Appointment with BWell

BWell offers confidential educational opportunities to discuss questions and concerns related to sexual health, partner communication, safer sex, or related topics, and to get information and referrals. These are not medical appointments. Request an appointment.

Ask Health Services

For medical advice, you can call Brown nursing at 401-863-3953. For medical appointments at Student Health Services, including STI testing and contraception, please call 401-863-3953.

Ask SHAG!

If you would like to speak to a peer about contraception or other sexual health questions, but want to make sure you are getting reliable, confidential information, you can text the peer educators of the Sexual Health Awareness Group (SHAG!). Click here to log in with your Brown credentials to get the texting number. You will get a personalized response, written by a SHAG peer educator and reviewed by a Health Promotion staff person, within 24 hours.

The questions below are some examples of the common types of questions about contraception Brown students have asked SHAG’s Q&A Texting Service.

Health Services is convenient (right on campus) and will definitely offer you counseling about the different birth control methods available. With the help of a health care provider, you will become more than knowledgeable about your options and be able to make the right choice for you. And, if your needs or preferences change, remember that you can always choose a different method in the future.

If you need the condoms right now and you live on campus, your CCs offer safer sex supplies on their doors. If you live off (or on) campus, you can pick up supplies in the LGBTQ Center, Sarah Doyle Center, the BCSC, the UFli Center, the Global Brown Center, Engineering’s Relaxation Room, Career Lab, the lobbies in 450 Brook St, or at the School of Public Health in the student lounge. If you can wait a few days, go online to order free supplies via Ship n SHAG. You will get your safer sex materials delivered to your campus mailbox in a discreet package.

Your parents will probably not know if you go to Health Services to get a prescription for birth control. All visits to Health Services are confidential. Medical privacy laws also help to ensure that no information would be released to your parents unless you specifically request it. The only way your parents might find out would be if you told them or if you use your insurance to get your birth control and your insurance company lets them know that they paid for a prescription. If you’re worried about the insurance issue, let your doctor or nurse know when you go into Health Services. You can also call the customer service number on your health insurance card and ask them about their policies. Most insurance companies don’t send information home about prescriptions, but some might.