Birth Control Choices Other Than The Pill

I'm 38 and have been in a relationship for three years. I've been on the pill for 20 years and don't want more kids, but I don't like the melasma side effect of birth control pills. I've considered an IUD but know someone whose device migrated. Options?

If your major goal, in addition to reliable contraception, is to reduce the menstrual flow and frequency of periods, then a Mirena IUC, which secretes progesterone-like hormone locally in the uterine cavity with relatively little systemic effect, may be your best choice.

With Mirena, many women have no periods at all and it is effective in reducing heavy menses as long as there is no anatomic abnormality, such as a polyp or fibroid. Dislocation of an IUD is a rare event.

Depo Provera also eliminates periods in most users but some women experience spotting. It is a systemic medication, which may have some of the same side effects you have with the pill.