Disclaimer! I am not a medical professional. The following post is based on my experience and personal research alone.
Many people are on birth control for one reason or another. In addition to preventing pregnancy, these hormone therapies can regulate menstruation, treat a host of medical conditions like PMS, and even reduce acne. If you want to travel the world and don’t see yourself having a baby any time soon, it’s probably a good idea to research your birth control options before going abroad. Of course, foreign countries have their own clinics and healthcare providers who can assist you. But it’s definitely nice not to worry about scheduling an appointment in another language while adjusting to a new life and culture. Getting your contraceptives well before you disembark can buy you some time and peace of mind during this exciting transition. If you’d like to know my thoughts and experience, please keep reading.
When I first started taking birth control in high school, I was content with the dirt-cheap pack of pills I could pick up from the local pharmacy. The continuous (no placebos) supply of hormones helped relieve the horrible symptoms my doctor speculated were possibly caused by endometriosis. (I didn’t have the time or resources to justify the biopsy for an official diagnosis.) Over the next several years, I tried two different contraceptives. The first worked well for a while until I started to experience a significant amount of breakthrough bleeding. My doctor switched me to a pill with higher estrogen levels just before I left for Japan to study abroad in 2017. Although I didn’t plan on having intercourse overseas, I wanted to continue the period-free life my prescription allowed me. Yes, people, it’s safe to delay or stop your period for prolonged periods! (No pun intended, I promise! Just make sure to consult with your doctor first.)
For short-term trips, travelers can usually bring a limited supply of their prescription contraceptives with them without needing to obtain special permission. Every country has its own unique policies, so it’s important to check before flying. Japan specifically allows foreign tourists to bring up to one month’s supply of any permitted medication. Keep in mind that certain drugs commonly prescribed in the U.S are prohibited, and visitors who intend to stay longer than one month must fill out a special form to import any medications that exceed the aforementioned limit. I completed the necessary documents with relative ease, and my request was approved. I had no issues whatsoever at the airport. However, it doesn’t make sense for everyone to import their medications when moving abroad. Fortunately, there are a few alternative birth control methods that eliminate the need for extra paperwork and hassle.
In 2019, about two months before I was scheduled to return to Japan on the JET Program for an indefinite amount of time (1-3 years), I decided to look for a birth control option that was longer-lasting and more reliable. The previous year, I had stopped taking my pills altogether because I was afraid the hormones were causing some negative side effects in my body. Also, I’ll admit I was a bit tired of remembering to take them every single day. In my hunt to find a better option that suited my travel needs, Planned Parenthood offered me three recommendations: a hormonal IUD, a non-hormonal (copper) IUD, and the implant. Each has its own set of pros and cons, and you can read more detailed information on their website, but all three options are over 99% effective at preventing pregnancy and last over a year. Research what works best for you and talk to your healthcare provider to find the best fit for your body. My first choice was the hormonal IUD, but my doctor recommended the implant, Nexplanon, since I have never given birth. He also told me that similarly to my continuous birth control pills from before, there was a high possibility the implant would lighten or stop my periods. That sounded good to me!
After reviewing my options, I agreed with my doctor’s suggestion and scheduled the procedure just two weeks before my flight. The nurse reviewed my chart and then injected a numbing agent into my left arm. Then, the doctor easily inserted a long device into my skin that clicked the small, hormone-releasing rod into place. I didn’t experience much pain at all. After the procedure my arm bruised a bit, and I was advised not to lift anything heavy for a few days. The doctor told me I might experience some common side effects that included irregular bleeding, but he assured me my body would likely adjust after a few months. Initially, the implant worked like a dream. I experienced no acne or weight gain and only had some light bleeding after insertion that went away in a few days. As I adjusted to life in Niigata, it was easy to forget about the little device.
However, after about six months with the implant, my periods unexpectedly returned with a vengeance, recurring like clockwork every two weeks. They were also longer than my periods before the implant. I was going through more pads and tampons a month than I could afford. Even worse, I started to notice some pretty significant hair loss. Strands of my hair were all over my pillow each morning, my ponytail was thinner than it had ever been, and my anxiety worsened each time I showered and noticed the large, black clumps forming in the drain. My mood also shifted like it once had years ago on the pill—I felt more depressed and anxious than I had in a long time. As if to mock me further, my hormonal acne started cropping up again in angry clusters around my chin and jawline. I felt like I was going crazy sometimes!
It’s difficult to say if these side effects were caused by the implant, the various stressors in my life, or even a thyroid deficiency. I’m hoping these issues eventually clear up, but I am taking steps now to relieve some of the symptoms. Because Japan doesn’t have as many birth control options as we do in America, there are no doctors here qualified to remove Nexplanon if things continue to worsen. Fortunately, I have the option to have it removed when I return to the States in August, but I’d like to keep it the full three years if I can because of how convenient it is. While I still think it is a great option for many people, in hindsight, I wish I had researched more about the possible side effects before the procedure and given my body adequate time to adjust to the new hormones.
If you are considering a long-term replacement for your pills or patches before moving abroad, talk to your doctor early. Don’t wait until the last two months or so to start the process like me. Ideally, I would have explored my options even further and decided to get the implant an entire year before going abroad. Yes, this would have shortened its lifespan while overseas, but it would have given me time to gauge my body’s reaction to the hormones and allowed me to work with my doctor and make any necessary adjustments (or remove it and try something else). Also, two years of its impressive three-year lifespan would still have afforded me plenty of time to find my next method after getting settled into my new routine.
I hope this article helps you research your options and find a solution that works for your health! Do you any experience with one or more of these birth control methods? How do you handle your reproductive health while working abroad? I’d love to hear your thoughts or questions!