[Brandye]

It is worth trying the ring. I have several patients who did not tolerate the pill well who are fine with the lower hormone level from the ring. A prescription is required but fitting, for most, is a non-issue. Some very few women do expel them. Coming from the pill, adaptation is almost immediate.

I believe the IUD to be underused in modern society. It is the most common birth control in China and that represents a lot of women! It got a bad rap from one brand twenty years or so ago and the mothers are passing on the negatives to their daughters. It is as effective without hormones as the hormonal methods and is well tolerated by most women. It does require professional insertion and most women have some breakthrough bleeding, cramps and other minor side-effects for a few months.

The diaphragm is an old, well established system and I have some patients who still use diaphragms or cervical caps. Their effectiveness is not much better than using spermicide alone and there are many jokes about diaphragms springing around the room whilst being inserted. The modern flat spring models are much better than the older coil spring rims. These do require professional fitting and a prescription.

I would recommend these choices in the order I have responded.