Of all the things I’ve had to do to prepare before moving from Canada to Germany, I did not expect birth control to be one of the most difficult things to sort out.

Full disclosure: this post discusses birth control for women. I’m not a doctor, and options will differ per person. I’m just speaking from personal experience, and as a Canadian. Men, your options are even more limited than ours, congratulations. Condoms for everyone!

I’ve been on the pill since I was about 14 years old, which means I’ve been pumping hormones into my body since I was barely a teenager. This is because I had the kind of painful menstrual cramps that made me want to scoop out my uterus with a spoon. I used to have to leave school to come home and curl up on the bathroom floor, pressing myself into the cold tiles, because the cramps made me violently ill. I called it the “Cycle of Pain” because even if I did puke my guts up, there’d be no relief.

When I briefly came off the pill in my early 20s, the results were the same. I’d miss work, and I simply couldn’t afford to do so. There are other options out there but this one also controlled my flow.

But the pill is expensive if you’re paying for personal drug insurance — we live in a world where things like not ruining your life by getting pregnant aren’t considered much of a priority. And since I do have the immense privilege of living in Canada where birth control is even an option for me, and I can consult a doctor for free, I wanted to take care of it all before moving to Berlin. And I didn’t want to be on the pill, I wanted to try something different — what would my body be like without all those extra hormones after 15 years? Would I be a whole different person? The pill is so hard to stay regular with when you’re traveling non-stop and your schedule is totally erratic.

Long story short: I got off the pill and then got back on it. So what’s the best birth control for long-term travel?

1. The IUD

After exploring all my options (all four of them), I made an appointment with a doctor regarding getting an IUD. An IUD is a t-shaped device that’s inserted into your uterus in what apparently feels like the most painful process on the planet. This was the best option for me. Why?

  • They’re low hormonal — You can get a copper IUD that’s not hormonal at all, or something like Mirena that releases a small dose of progestin.
  • Once inserted, you can leave it in for five years. You don’t have to mess around with anything for five long years. Glorious!
  • It’s one of the most effective methods for preventing pregnancy.
  • Usually, your period slows down drastically, or sometimes even stops. This is especially helpful when it comes to traveling through countries that may not even have the kind of feminine hygiene products you need.
  • It’s relatively affordable, somewhere between $200-$400. Although if it falls out (happened to a friend), you’ll have to pay to reinsert it.

The only reason I did not go with this option is because I stupidly put off my appointment and didn’t have enough time to go through with it before leaving for Germany. And honestly, I’ve heard a few horror stories. Although apparently only 1 in 100 people get pregnant from the IUD, I know of at least three people who have. Another friend had to have hers surgically removed because the strings got lost, and so on.

Basically, there’s no perfect form of birth control other than abstinence. But this article is not about abstinence. Also, if you knew how fertile my huge family is, you’d know I can likely get pregnant just by looking at some dude the wrong way.

2. The pill

So we’re back at the pill. I used to be on Triphasil and Triquilar because their high hormone dosages helped with the menstrual cramps. But in this new birth control quest of mine, I ended up going back to the doctor and requesting a lower dosage. She gave me Alysena, which is apparently just as effective as the others in preventing pregnancy.

While the pill isn’t the greatest of options while traveling long-term, since schedules are erratic and not taking the pill on time every day means its effectiveness is lowered, it’s also easier to get in most countries. I know a girl who used to order her pills online, and somehow it worked. You can also usually stock up beforehand. I bought a six-month supply because that’s all I could afford at the time, and then had my friend pick up another prescription for me and mail it to Berlin. Yeah, there’s no real easy way to do this, I admit. Not having babies is expensive, but you know what’s more expensive? Having babies.

3. The ring

The NuvaRing is a vaginal ring that’s inserted for three-week periods at a time, then removed for the fourth week. You insert it yourself and remove it yourself. If you don’t like digging around in your vagina, this is not for you. But when inserted properly, you won’t feel it and neither will your partner.

In my opinion, this is the third best option. You can leave it in for three weeks and not think about it. The only thing it doesn’t really have going for it is that it’s bloody expensive in most places. In the US it can be upwards of $100/month. In Canada, it seems to be about $85/3 months, but my pill is much cheaper. The ring needs to be refrigerated, so if you’re traveling in developing countries, that can be a pain in the ass.

It also poses the risk of falling out sometimes, say, if you’re straining too hard on the toilet. Yes.

4. The implantation

Implantation is a little rod that’s inserted under your skin to release progestin for up to three years. Implanon is the most common, but for some reason, it wasn’t an option with my doctor and I’m not sure it’s available everywhere (plus it can cost up to $800 in Canada — but it lasts for two years or so).

5. The patch

This lovely little unsightly devil is slapped to your skin for a week at a time and then removed for the fourth week. It’s just as effective as the IUD, though, and costs anywhere between $0-80 a month.

Those options were the best options I found as I prepared to move abroad. The others are less appealing: Depo-Provera has to be done every 12 weeks by a doctor, the sponge isn’t as effective, and who uses female condoms?

This article originally appeared on Free Candie and is republished here with permission.