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Combined birth control guide

Combined birth control online in Virginia and West Virginia

This guide is for adult women who want a combined (estrogen + progestin) method — the combined pill, the patch, or the vaginal ring — after a full safety screen. It's not for anyone the screen flags for an estrogen-related risk; our progestin-only mini-pill lane may fit instead.

Start online

Start a $59 online review for Combined birth control.

Combined methods add estrogen to progestin, so this visit runs a full safety screen (the same one used in clinics) before the physician decides whether starting or continuing one is appropriate for you. Starting estrogen requires a blood-pressure reading you provide from the last 3 months, showing below 140/90 — the visit cannot start estrogen without one. The screen also checks for migraine with aura, a clot history, smoking at age 35 or older, uncontrolled blood pressure, and several other factors that would make estrogen unsafe; when the screen flags one of those, the physician does not prescribe a combined method, and our progestin-only mini-pill lane may be the safer fit instead.

If treatment is appropriate, your physician can send a non-controlled prescription to your pharmacy and provide portal instructions for the next step.

Start this visitSee response windows

Quick facts

  • You must be physically located in Virginia or West Virginia at the time of request.
  • Starts at $59
  • No insurance needed
  • No app download
  • Physician review around the clock
  • Non-controlled prescriptions can be sent to your pharmacy when appropriate
  • A work or school note can be included when medically appropriate
  • Response windows: 24/7, every day

Common symptoms

  • Want to start a combined pill, the patch, or the ring for the first time
  • Restarting a combined method you've used safely before
  • Switching from the progestin-only mini-pill to a combined method
  • Have a recent blood-pressure reading and no history the screen would flag

May fit online care

  • Adults 18 and older
  • Adult woman requesting pregnancy prevention with a combined method
  • Have a blood-pressure reading from the last 3 months below 140/90
  • No migraine with aura, blood-clot history, or smoking at age 35 or older
  • No history the safety screen flags — see the full list below

Look for another care setting

  • Possible current pregnancy, or a blood-pressure reading of 140/90 or higher, or no reading from the last 3 months
  • Migraine with aura, smoking at 35 or older, or any personal history of a blood clot (DVT/PE), clotting disorder, heart attack, stroke, or TIA
  • Current or past breast cancer, severe liver disease, or lupus with positive or unknown antiphospholipid antibodies
  • Recent childbirth (under 3 weeks, or under 6 weeks while breastfeeding), or taking rifampin, certain seizure medicines, or St. John's wort

What to have ready

  • A blood-pressure reading from the last 3 months (pharmacy machine, home cuff, or clinic reading all count)
  • Your current or most recent birth-control method, if any
  • Any personal or family history of blood clots, migraine with aura, or the other screened conditions
  • Medication allergies and a complete list of current medications and supplements

What happens next

Standard

$59

Within 6 hours

Priority

$99

Within 3 hours

Rush

$149

Within 1 hour

Start the request on the website, answer the fit questions, and choose the response window you want. If the concern still fits this service, a physician reviews it and sends a secure update after sign-in. When appropriate, non-controlled prescriptions can be sent to your pharmacy, and a basic work or school note can be included at physician discretion.

Why do I need a blood-pressure reading before I can even start?

Estrogen can raise blood pressure and clot risk, so national contraception guidance requires a verified reading below 140/90 from the last 3 months before estrogen starts. An async visit can't take your blood pressure itself, so you provide a recent reading from a pharmacy machine, home cuff, or clinic visit.

What disqualifies someone from a combined method?

The screen checks for migraine with aura, a blood-clot history or clotting disorder, smoking at age 35 or older, uncontrolled blood pressure, a history of heart attack, stroke, or TIA, current or past breast cancer, severe liver disease, lupus with certain antibodies, recent childbirth, and a few interacting medications. Any one of those is a reason the physician will not prescribe a combined method here — it doesn't mean birth control is off the table, since the progestin-only mini-pill often fits those situations instead.

Read the progestin-only mini-pill guide

Which combined products can be prescribed here?

A combined oral contraceptive pill, the patch (Xulane), or the vaginal ring (NuvaRing or Annovera) — whichever the physician determines fits you best once the safety screen is clear. This lane does not place an IUD or implant.

When does this need in-person or emergency care instead?

Severe chest pain, shortness of breath, a severe headache with vision or speech changes, or new pain or swelling in one leg are emergencies — call 911. A positive pregnancy test or unexplained abnormal bleeding needs an in-person evaluation rather than a combined-method start.

Related conditions we treat

Not quite what you have? These are the closest concerns this service covers.

Birth controlBacterial vaginosisDelay your periodMorning-after pillMenopause hormone therapy (systemic)Menstrual cramps