At Dawnbreaker Health, we’re happy to manage most forms of non-procedural birth control through our telemedicine platform. Contraceptive choice should account for safety, effectiveness, access, affordability, side effects, user control, reversibility, and ease of use, and it should be guided by voluntary, informed decision-making.^2,3 Many women struggle to access contraception due to difficulty scheduling in-person appointments, lack of local providers, cost or coverage concerns, or discomfort discussing reproductive health face-to-face. We provide comprehensive contraceptive counseling and prescriptions that can be filled at your local pharmacy, helping support convenient, ongoing access to the birth control method that best fits your needs and lifestyle.^1,3

Combined Oral Contraceptives (COCs)

Combined Oral Contraceptives (COCs) are pills containing both estrogen and progestin, taken daily. COCs are one type of combined hormonal contraception, along with the contraceptive patch and vaginal ring.^1,3 They are available in multiple formulations with varying hormone types and dosing schedules, including 21-day, 28-day, and extended-cycle regimens. Traditional combined hormonal contraception regimens typically include 21 to 24 days of hormones followed by 4 to 7 hormone-free or placebo days, while extended regimens can be used to reduce or avoid scheduled withdrawal bleeding.¹

We help select the formulation best suited to your needs, whether that means minimizing periods, improving cycle predictability, managing acne, treating premenstrual dysphoric disorder (PMDD), or optimizing side effect profile. Certain drospirenone/ethinyl estradiol formulations have labeled indications for PMDD symptoms and moderate acne in appropriate patients who also desire oral contraception.¹³ With typical use, combined pills, patches, and rings have an estimated first-year failure rate of about 7%, with effectiveness improving when used consistently and correctly.^1,3

Progestin-Only Pills (POPs)

Progestin-Only Pills (POPs) contain progestin without estrogen. They can be useful for patients who cannot use estrogen or prefer to avoid estrogen-containing contraception.^2,3 An important distinction exists between traditional norethindrone or norgestrel POPs and newer drospirenone POPs.

• Traditional POPs, including norethindrone products such as Camila or Nor-QD: These require very strict timing. CDC guidance defines a norethindrone or norgestrel POP as missed if it is taken more than 3 hours late, which makes these pills less forgiving of delayed doses.¹ They are often considered for breastfeeding women or patients with contraindications to estrogen-containing contraception.^2,3
• Newer drospirenone POP, including Slynd: Drospirenone POPs are more forgiving than traditional norethindrone POPs. The Slynd label instructs patients to take one missed active tablet as soon as remembered without requiring backup contraception if only one active tablet is missed, while backup contraception is recommended for 7 days if two or more active tablets are missed.⁴ CDC guidance also notes evidence supporting ovulation inhibition with drospirenone POPs, including data from delayed-dose studies.¹ This makes drospirenone POPs an excellent option for women who cannot or prefer not to take estrogen but want a more user-friendly pill schedule than traditional POPs.

Contraceptive Patch

Contraceptive Patch, including Xulane: The contraceptive patch is a weekly transdermal patch applied to the skin. Xulane is applied to the abdomen, buttock, upper outer arm, or upper torso, and it is changed once weekly for 3 weeks followed by 1 patch-free week.⁵ It delivers combined hormones, estrogen and progestin, through the skin and is considered a combined hormonal contraceptive method.^1,3

Advantages include not having to remember a daily pill and having a once-weekly schedule. Disadvantages include patch visibility, possible skin irritation or application-site reactions, and the possibility that the patch may become loose or fall off, which can reduce medication delivery if not managed properly.⁵

Vaginal Ring

Vaginal rings are flexible rings inserted into the vagina that release combined hormones continuously. Vaginal rings are a form of combined hormonal contraception and typically have an estimated first-year failure rate of about 7% with typical use.^1,3

• NuvaRing and generic etonogestrel/ethinyl estradiol rings: These are inserted for 3 weeks, removed for 1 week, and then replaced with a new ring. The exact position in the vagina is not critical for effectiveness, and most women do not feel the ring once it is properly placed.⁶
• Annovera: Annovera is a reusable vaginal ring used for 13 cycles. It is inserted for 21 days, removed for 7 days, washed with mild soap and water, dried, stored in its case, and then reinserted for the next cycle.⁷

Advantages of vaginal rings include monthly or yearly attention rather than daily or weekly attention, self-insertion, continuous hormone delivery, and convenience for women who prefer not to remember a daily pill.^6,7

Injectable Contraception

Injectable Contraception, including Depo-Provera: Depo-Provera CI is a progestin-only injection given every 3 months, or every 13 weeks.^1,8 We can prescribe this for administration at your local pharmacy when appropriate. Advantages include only needing to think about contraception about 4 times per year, avoiding estrogen, and the possibility of lighter bleeding or amenorrhea. Amenorrhea becomes more common with continued Depo-Provera use, with labeling reporting amenorrhea in 55% of users by month 12 and 68% by month 24.⁸

Disadvantages include possible weight gain, the need for scheduled injections, delayed return to fertility after discontinuation, and potential bone mineral density concerns with long-term use. Depo-Provera labeling reports a median time to conception of about 10 months after the last injection, with a range of 4 to 31 months, and warns that prolonged use may be associated with significant bone mineral density loss.⁸

Emergency Contraception

Emergency contraception can reduce the chance of pregnancy after unprotected intercourse or contraceptive failure, but it is not intended as a routine primary birth control method.^9,12 We prescribe both levonorgestrel and ulipristal emergency contraception when appropriate.

• Levonorgestrel, including Plan B One-Step: Levonorgestrel emergency contraception is available over the counter, but we can prescribe it for insurance coverage or advance provision when appropriate. It should be taken as soon as possible within 72 hours after unprotected intercourse or contraceptive failure, and it works best the sooner it is taken.^10,12
• Ulipristal acetate, including ella: Ulipristal is prescription-only emergency contraception taken as soon as possible within 120 hours, or 5 days, after unprotected intercourse or contraceptive failure.¹¹ CDC guidance notes that ulipristal is more effective than levonorgestrel 3 to 5 days after unprotected intercourse, and levonorgestrel may be less effective among women with obesity compared with ulipristal.⁹

Our Approach

We help you select contraception based on multiple factors, including safety, effectiveness, access, affordability, side effects, user control, reversibility, ease of use, and your personal preferences.^2,3

• Frequency of attention required: Options range from daily pills to a weekly patch, monthly or yearly vaginal ring options, and quarterly injections.^1,3,5,7,8
• Estrogen tolerance: Some patients are candidates for combined estrogen-progestin methods, while others are better suited to progestin-only options because of medical history, side effects, breastfeeding, or contraindications to estrogen.^2,3
• Cycle control preferences: Some women prefer regular withdrawal bleeds, while others prefer extended-cycle options, fewer periods, or amenorrhea when appropriate.^1,8
• Medical contraindications: Medical history matters, including history of blood clots, migraine with aura, cardiovascular disease, hypertension, smoking status, postpartum status, and other conditions that affect method safety.²
• Additional benefits desired: Some methods or formulations may help with acne, PMDD symptoms, lighter bleeding, fewer withdrawal bleeds, or menstrual suppression in appropriately selected patients.^1,8,13
• Cost and insurance coverage: We consider generic versus brand options, pharmacy availability, and practical access issues when helping select a method.^1,3

We also provide guidance on starting new methods, managing side effects, switching between methods, and what to do with missed doses. CDC guidance supports counseling patients about correct use, missed-dose management, side effects, switching methods, and follow-up based on patient needs rather than unnecessary routine in-person visits for straightforward contraceptive management.¹ Our telemedicine model makes it easy to check in if you’re experiencing issues, need to adjust formulations, or want to discuss switching methods without the hassle of scheduling an in-person appointment for routine contraceptive care.

We do not provide procedural contraception, including IUDs or Nexplanon implants, because these require in-person insertion. IUDs are placed inside the uterus by a clinician, and contraceptive implants are inserted under the skin of the upper arm by a clinician.³ These long-acting reversible contraceptive options are highly effective, and we’re happy to refer you to local providers if that is your preference.³

References

1. Curtis KM, Nguyen AT, Tepper NK, et al. U.S. Selected Practice Recommendations for Contraceptive Use, 2024. MMWR Recomm Rep. 2024;73(RR-3):1-77. doi:10.15585/mmwr.rr7303a1. Link. Accessed June 6, 2026.
2. Nguyen AT, Curtis KM, Tepper NK, et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2024. MMWR Recomm Rep. 2024;73(RR-4):1-126. doi:10.15585/mmwr.rr7304a1. Link. Accessed June 6, 2026.
3. Centers for Disease Control and Prevention. Contraception and birth control methods. Updated August 6, 2024. Link. Accessed June 6, 2026.
4. DailyMed. SLYND—drospirenone kit. National Library of Medicine. Link. Accessed June 6, 2026.
5. DailyMed. XULANE—norelgestromin and ethinyl estradiol transdermal system. National Library of Medicine. Link. Accessed June 6, 2026.
6. DailyMed. Etonogestrel and ethinyl estradiol vaginal ring. National Library of Medicine. Link. Accessed June 6, 2026.
7. DailyMed. ANNOVERA—segesterone acetate and ethinyl estradiol vaginal system. National Library of Medicine. Link. Accessed June 6, 2026.
8. DailyMed. DEPO-PROVERA CI—medroxyprogesterone acetate injection. National Library of Medicine. Link. Accessed June 6, 2026.
9. Centers for Disease Control and Prevention. Emergency contraception. Updated November 19, 2024. Link. Accessed June 6, 2026.
10. DailyMed. PLAN B ONE-STEP—levonorgestrel tablet. National Library of Medicine. Link. Accessed June 6, 2026.
11. DailyMed. ELLA—ulipristal acetate tablet. National Library of Medicine. Link. Accessed June 6, 2026.
12. US Food and Drug Administration. Plan B One-Step, 1.5 mg levonorgestrel, information. Content current as of December 23, 2022. Link. Accessed June 6, 2026.
13. DailyMed. YAZ—drospirenone and ethinyl estradiol kit. National Library of Medicine. Link. Accessed June 6, 2026.