We’re back with another Roe Report, and this time we’re focusing on your birth control options. Dr. Sophia Yen, MD MPH, CEO and co-founder of Pandia Health, walks us through everything you need to know about accessing contraception, including Qs on getting your tubes tied and pain management during IUD insertions.

Is it possible to order birth control pills in bulk, and if so, how many can you get at a time?
Having more birth control pills on hand can be helpful. A 2011 UCSF Bixby Center study found that a 12-month supply of birth control decreased unplanned pregnancies by 30%, compared to a supply of just 1 or 3 months. The study also found that giving women a 1-year supply of birth control reduced the odds of an abortion by 46%. But access is individual to each state. Some states limit you to 3 months at a time, but 20 of the 50 states have laws in place that require insurance companies to cover up to a year’s supply. You can find more information on those states here.

I’ve heard IUD insertion is painful. Is there anything I should know ahead of my appointment, especially about pain management?
Yes, you can ask your provider to give you something for the pain or anxiety. However, 600 mg of ibuprofen with food, 30-60 minutes before the procedure should be enough. You should also ask for a paracervical block, which will numb your cervix. I also suggest scheduling your appointment on the last day of your period, if possible, because then your cervix is already open.

What about tubal ligation? Is there anything keeping me from getting my tubes tied?
Most providers will be hesitant to do a permanent procedure like tubal ligation in someone who has never had a child and/or who is under 40 (which is an arbitrary age). If you ask your doctor and they won’t do it, ask for a referral to another doctor or go to a different practice. Tubal ligation is generally done by an OBGYN, but some family practice doctors may also be trained to do them.

Can I get birth control that will help me skip my period? Will not having a period lower my chances of pregnancy?
​​Hormonal birth control can definitely help you make #PeriodsOptional. With the implant or hormonal IUD, about 30% of women will have no monthly bleeds and the other 70% will have lighter bleeds. On the shot, 70% of women will have no bleeds by the 3rd shot. If you use the pill and skip the bleeding week (aka the placebo pills), 80% have no bleeding by 13 months.

I like the pill because there are 40 different types, so if one doesn’t work for you, know that there are others to try. We should be able to find one that works for you so that you have no bleeds, or at least, fewer bleeds, and no side effects, or at least fewer side effects. At Pandia Health, we have come up with an algorithm that results in fewer side effects, if any, based on your age, BMI, race as a proxy for genetics, and your past medical history/family history.

More info on contraception below:
–Twilight sedation for IUD insertion
–The best birth control delivery services
–Tubal ligation demand is high, but not always accessible