Birth control pills inserted vaginally?

Originally Published: March 29, 2002 - Last Updated / Reviewed On: March 25, 2015
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Dear Alice,

A friend of mine read in SELF magazine last week that if you do not want to orally take "the pill," it is effective to insert it into your vagina. Is this true?

Dear Alice,

According to the health hint in the December 2001 issue of Cosmopolitan, "If you can't keep your birth control pill down because you're nauseated, insert it into your vagina like a tampon." It seems highly unlikely to me, but it is posted under the "Cosmo Gyno" section (page 92) and is credited to a James Trussel, M.D. Sounds pretty off-base to me. What do you think?

Cosmo Reader

Dear Reader #1 and Cosmo Reader,

Although birth control pills were not intended to be inserted vaginally, numerous studies suggest that inserting them vaginally is as effective as oral administration. In fact, women who took the pill vaginally instead of orally received the same protection against pregnancy while experiencing significantly fewer unwanted side effects like headaches, vertigo, nausea, breast tenderness, and breakthrough bleeding. Vaginal administration of hormone-based birth control may offer advantages over oral administration because the hormones are absorbed gradually and reach the blood without first being processed by the stomach and liver.

But there are still questions remaining about the proper dosage and procedure of vaginal insertion. Health professionals have differing opinions about prescribing vaginal insertion of birth control pills to patients. Some do not recommend this option because information on proper vaginal dosage is limited. Other health care providers may suggest that women who have a temporary illness, nausea, and/or vomiting insert the pill vaginally as an alternative to missing a dose.

Women who prefer vaginal insertion may also be interested in a different type of hormonal contraceptive like the vaginal ring, most commonly known by its brand name, NuvaRing. NuvaRing is a hormonal vaginal contraceptive ring that is inserted once a month to prevent pregnancy. It is kept in place for three weeks, where it releases the same hormones as the pill — estrogen and progestin, and is taken out one week per month, when the women menstruates. Because the ring releases the same hormones as the pill, similar benefits like improvement with acne, menstrual cramps, and premenstrual symptoms commonly come with it. Likewise there are risks associated with hormonal birth control of all kinds, including changes in sex drive, blood clotting, weight, and mood. Because the ring is approved for vaginal use, it may be a more fitting option than pills for women who are interested in getting their birth control without having to swallow.

It's important to keep in mind that while the NuvaRing and the pill both offer very effective protection against pregnancy, they do not protect against sexually transmitted infections (STIs). So unless you're with a partner who has been recently tested for STIs and whom you trust, it would be a good idea to use a barrier system like a condom to make sure all your bases are covered. In more way than one.