Supporting our Women Veterans and their reproductive needs

The VA Women’s Health team feels strongly about supporting Women Veterans and their reproductive health goals. If you are a woman of childbearing age who is not considering a pregnancy at this time, the VA can offer a wide range of contraceptive options both hormonal and non-hormonal to meet your unique needs and preferences. Approximately half of all pregnancies that occur in the United States are unintended. The VA’s goal is to partner with women to discuss options that are right for them. Our primary care providers at the VA are equipped to counsel women on many different types of contraception taking into consideration individuals health conditions, lifestyle preferences, and future pregnancy goals. The VA offers a wide range of contraceptive options including hormonal, non-hormonal, long-acting reversible contraception (LARC), permanent sterilization procedure, and emergency contraception.

Hormonal options include: Combined oral contraceptive pills, progestin only pill, Nuva Ring, Contraceptive patch, Depo Provera injection, Nexplanon, and Progestin IUD (Mirena). Some considerations when choosing hormonal birth control is to review your medical conditions and smoking history. For example, some women who have history of blood clots, high blood pressure, migraine with aura, smoking over the age of 35, or currently breast feeding, may not be a good candidate for contraception that contains estrogen including combined oral conceptive pills, nuva ring, and patch. Progestin only pill or the Depo Provera injections may be a good option for women who are breastfeeding or cannot have estrogen due other health conditions or smoking.

Non-hormonal options include: male condoms, female condoms, and diaphragm. Both male and female condoms can be ordered through the VA pharmacy and many primary care clinics keep them stocked in clinic check in areas. Diaphragms do require specific fitting by a gynecologist and can be ordered through the VA prosthetics department. Some considerations for barrier options like condoms (male/female) and diaphragms are that they do need to be used every time to be effective and do have a failure rate of 14-21%.

Long Acting Reversible Contraception options include: Progestin IUD (Mirena), Nexplanon (arm implant), and Paragard (Copper/nonhormonal) IUD. Mirena IUD can remain in place for up to 7 years and many women do not have a period while this is in place. The Nexplanon is small rod-like device that is placed in the upper arm and can remain in place for 5years. The Paragard IUD can remain in place for up to 12 years. These are good options for women who are not planning to achieve pregnancy in the near future and/or those who have difficulty remembering to take a pill daily.

Permanent sterilization options include: Tubal ligation, this option is a surgical procedure that is generally considered permanent although in some cases it can be reversed. This would be an option for women who are confident that they no longer wish to achieve pregnancy.

Emergency Contraception options include: Plan-B and Ella. Emergency contraception including Ella and Plan B can be prescribed by your primary care provider to have on hand at home to use when needed. It can be taken up to 5days after unprotected intercourse but is most effective if used within the first 72hrs. These options work by preventing ovulation and/or preventing implantation of the embryo. It can cause some side effects after use including nausea, headache, and dizziness.

This is just a brief summary of the contraceptive options available through the VA. If you are interested in contraception, please contact your primary care team for more detailed information and to review which option may be the best fit for you!

For more information about the Madison VA Hospital, visit www.madison.va.gov www.facebook.com/MadisonVAHospital and subscribe to our newsletters.