Complex Contraceptive Counseling

AHN Complex Family Planning and Contraceptive Program

When you choose a birth control method, you need to feel confident that it's safe and effective, and that it comes with minimal side effects.

If you are a gender-diverse individual, transplant recipient, or have certain medical conditions, traditional birth control methods may be dangerous to your health or may not work as intended, which can lead to an unplanned pregnancy. That's why AHN offers complex contraceptive counseling.

Who is complex contraceptive counseling for?

There are some situations where you may need more advanced counseling on the contraceptive options available to you. We offer evidence-based contraceptive counseling that is designed around your unique needs.

You may benefit from complex contraceptive counseling if you have:

A heart condition
Diabetes
Obesity, or if you've had bariatric surgery
An autoimmune condition like systemic lupus or multiple sclerosis
Epilepsy or other neurological conditions
Received an organ transplant
A tilted uterus, fibroids, or a past surgery that changed the position of the uterus
A history of blood clots or a clotting disorder
A history of cancer or current cancer
A history of difficult IUD/implant insertion or removal

Experts in complex contraceptive counseling

AHN has six OB-GYNs who are specially trained to help patients who have health conditions that limit their birth control options. Whether you have concerns about medication interactions, you've had previous bad reactions to birth control, or you've had a difficult or painful IUD or implant placement procedure in the past, our doctors can help you find a safe birth control option that's right for you.

Tracy Chen, MD

Grace Ferguson, MD, MPH

Colleen Krajewski, MD, MPH

Ruchika Vij, MD

Sonia Aneja, MD

Kerry Ellenberg, MD

Complex contraceptive options

Depending on your needs, we can recommend the following complex contraceptive options:

Over-the-counter (OTC) birth control pill

This contraceptive option does not require a prescription. It uses a synthetic form of progesterone to thicken your cervical mucus, which helps block sperm from reaching an egg. It may also keep your ovaries from releasing an egg in some cycles. While most birth control pills have a combination of estrogen and progestin, this pill does not have any estrogen. It needs to be taken once a day at the same time and starts working after three days of taking it.

Intrauterine device (IUD)

An IUD is a small, T-shaped device that is put into your uterus to prevent pregnancy. It's the most commonly used type of long-acting reversible contraception and can be used for three to 10 years, depending on the type of IUD. There are IUDs that release hormones to prevent pregnancy and a nonhormonal IUD made with copper.

Contraceptive implant

Nexplanon® is a small, flexible implant that is put into your upper arm. It releases a steady dose of progestin to stop ovulation, thin your uterus lining, and thicken your cervical mucus to prevent pregnancy. It works for up to three years and can be removed at any point during that period.

Pain relief for device insertions and removals

We provide pain relief in our office when inserting and removing IUDs and arm implants. We know that IUD insertions in particular can be painful, so in some cases we may recommend options such as a paracervical block for pain relief. This is an injection of a local anesthetic to numb the nerves around your cervix. Other options include placing the IUD under sedation or in the operating room.

Nonhormonal contraceptive methods

There are several contraceptive options that don't use hormones to prevent pregnancy. One of these is a cervical diaphragm, which is a barrier method of contraception. It prevents pregnancy by blocking sperm from entering the cervix.

Tubal sterilization

This is a surgical procedure that permanently prevents pregnancy. During this procedure, a physician blocks or removes the fallopian tubes, which connect your ovaries to your uterus. This prevents eggs from your ovaries from reaching your uterus and sperm from reaching the eggs. Removing your fallopian tubes also decreases your risk of ovarian cancer.

What to expect at your appointment

You'll meet with one of our experts in complex contraceptive counseling to go over your medical history and current medications. Your provider will talk thoroughly through your existing health condition or other unique needs as well as your previous experiences with contraception.

If needed, our providers will also consult with the other specialists on your care team. We'll work to understand your specific wants and needs when it comes to contraception to make sure we understand your current preferences as well as your future family planning goals.

We'll talk through each type of contraception option available to you to make sure you're well-informed about your choices. Our contraceptive counseling experts can work alongside your current AHN OB-GYN, or they can provide you with all of your OB-GYN care.

Nexplanon® is a registered trademark of Merck & Co., Inc. and is used with permission.