Reproductive Health

Birth Control &
Reproductive Health

Contraception as part of comprehensive, individualized gender-affirming care.

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Overview

Contraception & Gender-Affirming Goals

EURA provides contraceptive care via telemedicine for all patients who need it — regardless of how they identify or what hormones they are taking. Eura prescribes all contraceptive options that can be safely managed remotely, and discusses how each option fits your individual goals, including menstrual suppression where relevant.

Important: Gender-affirming hormones — including testosterone — are not reliable contraception. Even if your periods have stopped on testosterone, ovulation can still occur. If pregnancy is a possibility you want to avoid, dedicated contraception is recommended.

Methods We Prescribe

Progestin-Only Pill (Mini-Pill)

Daily oral contraceptive

A good option for patients on testosterone or those who cannot use estrogen-containing contraceptives. Taken daily at the same time each day.

Can help reduce or stop periods over time and is compatible with masculinizing hormone therapy.

Combined Oral Contraceptive Pill

Daily oral contraceptive — estrogen + progestin

Highly effective when taken consistently. May not be appropriate for all patients — Ted will review your health history and hormone regimen before prescribing.

Not typically recommended alongside feminizing hormone therapy or for patients with certain cardiovascular risk factors.

Contraceptive Patch

Weekly transdermal — estrogen + progestin

A patch worn on the skin, changed weekly for three weeks with one patch-free week. Similar efficacy and considerations to the combined pill.

Same estrogen-related considerations apply. Ted will discuss whether this is appropriate for your situation.

Vaginal Ring (NuvaRing)

Monthly — estrogen + progestin

Inserted vaginally and worn for three weeks, then removed for one week. Offers the same hormonal profile as combined pills with less daily management.

May not be preferred by all patients. Ted will talk through comfort and fit for your goals.

Injectable (Depo-Provera)

Every 3 months — progestin only

A progestin-only injection given every 12 weeks. Eura writes the prescription — you receive the injection at a pharmacy or local clinic.

Frequently leads to menstrual cessation and is compatible with testosterone therapy. A strong option if daily adherence is a concern.

Emergency Contraception

As needed — levonorgestrel (Plan B) or prescription

Plan B and generic equivalents are available over the counter. For patients who need a prescription-strength option or guidance on timing and efficacy, Eura can assist via telemedicine.

Effectiveness decreases with time — should be used as soon as possible after unprotected sex.

Methods Requiring In-Person Care

The following require a procedural visit and cannot be provided via telemedicine. Eura is happy to refer you to an affirming provider for these:

Contraceptive Implant (Nexplanon) Hormonal IUD (Mirena, Kyleena, Liletta) Copper IUD (Paragard)

For Patients on Testosterone

Menstrual Suppression

For many transmasculine and non-binary patients, stopping periods is an important part of care. While testosterone often reduces or eliminates menstruation over time, this is not guaranteed — and some patients prefer a dedicated contraceptive option to achieve suppression more reliably or more quickly.

Options for Suppression via Telemedicine
  • Progestin-only pill — can suppress periods and is safe alongside testosterone
  • Depo-Provera injection — frequently leads to full menstrual cessation
  • Combined pill or patch — may be used in specific clinical situations
What to Discuss at Your Visit
  • Current hormone regimen and dosing
  • Whether menstruation has already changed on testosterone
  • Contraceptive need vs. suppression as the primary goal
  • Preference for daily, weekly, or less frequent dosing
  • Any prior experience with hormonal contraceptives

Common Questions

Frequently Asked Questions

Can I get birth control even if I'm on testosterone?

Yes. Progestin-only options — including the mini-pill and Depo-Provera — are safe and commonly used alongside testosterone therapy. Ted will review your full health history to identify the best fit.

If my periods stopped on testosterone, do I still need contraception?

Potentially yes. The absence of periods does not confirm that ovulation has stopped. If there is any possibility of pregnancy and you want to prevent it, a dedicated contraceptive method is recommended regardless of your cycle status.

Which method is best for stopping periods?

Depo-Provera has the highest rate of menstrual cessation among the options Eura prescribes. The progestin-only pill is also effective for many patients. The right choice depends on your goals, current medications, and preferences — Ted will go through this with you at your visit.

Can I get an IUD or implant through EURA?

Not directly — IUD insertion and implant placement require an in-person procedure. Eura can refer you to an affirming provider for these and support your care before and after if needed.

Will contraception affect my gender-affirming hormone therapy?

Progestin-only methods generally do not interfere with testosterone therapy. Estrogen-containing methods require more careful consideration and are evaluated case by case. Eura will never prescribe something that conflicts with your affirming care goals without discussing it first.

Clinical References

Transgender-specific reproductive health guidance on this page — including the relationship between testosterone and fertility, progestin-only contraception in transmasculine patients, and menstrual suppression — is informed by:
[1] Coleman E, et al. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. World Professional Association for Transgender Health (WPATH), 2022. [2] Deutsch MB, ed. Guidelines for the Primary and Affirmative Care of Transgender and Gender Nonbinary People, 2nd ed. UCSF Transgender Care, 2016. General contraceptive method descriptions reflect standard clinical pharmacology and prescribing practice.

Ready to Get Started?

Schedule a visit to discuss your contraceptive options and how they fit your goals.