Consider getting an intrauterine device (IUD)—once inserted, these are effective for years and reduce reliance on medical birth control. You can read about the basic types of IUD and their pros and cons in Bedsider’s overview, but here is the short version:

The ParaGard (copper IUD) is approved for 10 years and lasts up to 12, and is hormone free.

Pros: This option is free from the general mood consequences that hormonal birth control can cause.

Cons: This option can cause heavier periods, especially in the first few months.

The Mirena (progestin) IUD lasts 5 years and lasts up to 7 and treats heavy/painful periods.

Pros: A common side effect of Mirena is lack of periods, this may be something to consider as prices for menstruation products could increase. Mirena and other amenorrhea-inducing forms of birth control are also used to manage other health issues relating to menstruation.

Cons: A common side effect of Mirena is lack of periods, which some people find disquieting or uncomfortable

The Liletta is a generic alternative to the Mirena.

The Skyla lasts 3 years and is specifically intended for uterus owners who haven’t had kids. (But you can get the longer lasting ones if you have not had kids too.) Also, the Skyla can be used if you have had children and are sensitive to hormonal contraceptives, since it’s a lower dose of hormone than the other hormonal IUDs.

The Kyleena lasts for five years and does not impede menstruation.

Insertion of an IUD can be painful, but the process lasts about ten minutes. Taking an NSAID about half an hour prior to insertion may help some people with pain.