I just thought it was so nice that Marijke asked for permission. It really gave me a very pleasant and safe feeling. And everything Marijke did she explained. Jeez, if I had known this earlier I would never have gone anywhere else! Really very professional. Miranda, age 46

Contraception

The Vrouwkundige offers you information on all forms of contraception, the pros and cons and the best option for you. You decide what you feel comfortable with based on the information I offer you. No question or wish is too crazy. Even if you don't want (hormonal) contraception for personal reasons, but still prefer not to get pregnant, I can help you with information about your cycle and about natural ways of contraception.

The prescription, placement and removal of contraception is done for you in a safe environment with all the time and space you need to feel comfortable.

See below for more information on what options are available!

IUD

An often anchor-shaped thingy of a few inches, consisting of plastic with copper or hormones added to it. With the hormone IUD, your periods may decrease or even stay away. With the copper IUD, blood loss and/or pain during periods may very occasionally increase.

Major advantage of this form of contraception is that the IUD can remain in place for 5 to 10 years and you do not have to think about contraception on a daily basis. The copper IUD can also be used as a morning-after method for unsafe sex.

A disadvantage is that it must be inserted and removed by a gynecologist, family doctor or obstetrician and you cannot control the timing of your periods. Also, you are not protected against STDs.

The Vrouwkundige takes her time to place the IUD. Everything at your pace! So if you've had a negative experience with a doctor, know that at the Vrouwkundige you don't have to be out in 10 minutes. We first schedule 45 minutes for a consultation (€ 40,00). During this consultation we take our time so that you can ask all your questions. During the consultation you can see and touch the different types of IUDs and get acquainted with the room and the Vrouwkundige, so that you are as comfortable as possible. We then schedule another 45 minutes for the IUD placement.

Many health insurance companies reimburse (in part) for the placement. You pay at the Vrouwkundige and can afterwards submit the invoice to your health insurance company. However, it can be useful to check in advance whether your health insurance will cover it.

The removal and/or placement of an IUD costs € 65,00. The type of IUD you chose will be ordered and as soon as you pay, will be send to the practice. The cost of the IUD varies by type.

Implanon

A plastic tube the size of a match that is inserted under the skin, on the inside of your upper arm. Sounds scary, but it’s not too bad! The Vrouwkundige prepares you well about the procedure and numbs the area so you don't feel anything. It is a hormonal form of contraception that can last for 3 years. You often continue to menstruate as usual, sometimes lighter than before, sometimes irregularly.

A big advantage is that you can check if the tube is still in place, it does not bother you during sex (which some women experience with an IUD or pessarium) and you are protected for 3 years without having to think about it.

A disadvantage is that this form does not work equally well for everyone. Sometimes, due to symptoms, you may have to decide to have the rod removed before the 3 years are up. Also keep in mind that you are not protected against STDs.

Many health insurance companies reimburse (in part) for the insertion. You pay at the Vrouwkundige and can afterwards submit the invoice to your health insurance company. However, it may be useful to check in advance to see if you will be reimbursed.

The removal and/or placement of an implanon costs € 65,00 at the practice. The implanon will be ordered and as soon as you pay, will be send to the practice. The implanon costs approximately € 130.00.

The contraceptive Injection

Every 3 months you get this shot of hormones. You can continue to menstruate but the hormones prevent (proper) ovulation. You get the shot from the family doctor or gynaecologist in your gluteus or upper arm muscle or just under the skin in the upper arm. This depends on which brand you get.

The advantage is that you don't have to think about it yourself on a daily basis.

A disadvantage is that you can't stop it if you don't like it.... You have to go through the 3 months until the shot wears off. You can do a few things about any symptoms, though! A long-term disadvantage is that this form of birth control accumulates very slowly. The longer you get the contraceptive injection, the more "residual hormones" remain in your blood. It can sometimes take up to 2 years to get rid of them after stopping. So if you want to have children, it can take a while before you have a normal ovulation and are fertile again.

The contraceptive injection does not protect against STDs.

Sterilization

This form of contraception is a definitive form and therefore only appropriate when you are sure you do not want children (anymore). Sterilization can take place in both men and women. The vas deferens or fallopian tubes are then tied or cut. This is done at the gynecologist's office. The Vrouwkundige can tell you a thing or two about it, though, and explore if this might be an option for you.

The advantage of sterilization is that it is 100% reliable and you never have to think about contraception again.

The disadvantage is that it cannot be reversed (there are exceptions) and that it does not protect against STDs. By the way, you also continue to have all the hormonal fluctuations as a woman because ovulation is still there. So you just have a period with everything that goes with it.

Contraceptive Ring (‘NuvaRing)

This is a soft, flexible ring about 5 cm long and you can insert it yourself. You basically don't feel it and can play sports and swim. You remove it after 3 weeks, menstruate and then insert a new ring again. So you don't have to think about it every day! Another advantage is that you can take it out for up to 3 hours, this can be nice when you have sex. Then don't forget to put it back in!

A disadvantage is that you may suffer more from vaginal yeast infections. These fungal infections are treatable but you may have symptoms. Also with this form of contraception you are not protected against STDs.

The Vrouwkundige can prescribe the ring after an interview if desired.

Contraceptive patch

The name says it all: it's a band-aid. A skin-colored, flexible, square patch measuring 4,5 cm. You stick it every week on a new piece of dry, clean and intact skin on your buttock, back, upper arms or abdomen. After 3 weeks you have a patch-free week and then start again. So the hormones are absorbed through the skin and you don't have to take anything. The amount of hormones entering your blood is constant and you don't have to think about it daily.

One disadvantage of the patch is that it can come off or become irritated if you have an allergic reaction to brown patches. When the patch comes off, you have to put on a new patch within 24 hours to be adequately protected against pregnancy. The patch will stay on just fine when exercising or swimming!

For women who are over 90 kilograms, the patch can be less reliable.

You are not protected against STDs with the patch.

The Birthcontrol Pill

This form is the most commonly used in the Netherlands. It contains hormones that keep you from getting pregnant. There are many types of birth control pills and what most women don't know, sometimes one Pill can work better for you than another. For example, if you suffer a lot from hormone fluctuations (PMS/PMDD) then one Pill is more suitable for you, but if you suffer more from a lot of bleeding, then the other Pill is more suitable.

An advantage of the Pill is that you have influence on the duration of your cycle, you can swallow the Pill when your period does not fit well into your schedule.

A disadvantage is that you have to think about it every day and use an additional form of birth control when you forget the Pill. Also, you can't always take hormones so the Pill may not be allowed or may not be appropriate at that time. Know that the Pill does not protect you from STDs.

The Vrouwkundige can help you find the right Pill. Using a questionnaire and conversation, we can look at the most appropriate form of birth control for you. You can get a prescription from your family doctor or gynaecologist.

Barrier methods

The word says it all: you prevent sperm from entering the uterus, thus preventing fertilization. You have the condom for the man and the woman and you have the cervical cap (pessary).

The condom has the big advantage that it also prevents you from getting STDs and contains no hormones. The disadvantage is that you have to interrupt sex while putting it on and the condom can tear or come off.

The cervical cap you can insert yourself as a woman and should always be used in combination with spermicidal cream. You must leave the cervical cap on for at least 6 hours after sex to be sure it is safe. The advantage over condom is that you can insert it 2 hours before sex and you can use it for up to 2 years as long as you clean it properly. The cervical cap does NOT protect against STDs.

Natural forms of contraception

In addition to all the options mentioned above, there are also methods of contraception in which you watch your bodily signals and can find out when your fertile days are. So you use all the knowledge you would want to apply to get pregnant but then to keep this from happening. These methods are somewhat less reliable because every body is different and reacts differently to outside stimuli. Think irregular cycle, stress, illness, etc.

Still, this can be an appropriate form for you if, for example, you are in a steady relationship but a pregnancy is not currently planned. Or when your partner lives abroad and this already reduces the chances of becoming pregnant because you don't see each other much.

With the natural forms of contraception it is very important to be well informed and to know what your pitfalls are. This is why the Vrouwkundige recommends that you talk to any good health care provider before using this method. Definitely do not rely on an app on your phone because it is not custom designed for you!