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 visit 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 visit 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 visit See response times

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 times apply 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 a few questions to check that this visit fits you, and choose how fast you want an answer (the response window). If your concern still fits this service, a physician reviews it and sends you a secure update after you 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.

Your physician

Every visit is personally reviewed by Ankur Fadia, MD. He is board-certified, has extra training in heart care (a cardiology fellowship), and is a member of Alpha Omega Alpha, a medical honor society. He is licensed in Virginia and West Virginia, and your care is never handed off to someone else.

Verify Virginia medical license Verify West Virginia medical license Verify board certification

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

Estrogen can raise blood pressure and clot risk, so national birth control guidance requires a verified reading below 140/90 from the last 3 months before you start estrogen. An online visit cannot take your blood pressure, so you send a recent reading from a pharmacy machine, a home cuff, or a 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 birth control pill, the patch (Xulane), or the vaginal ring (NuvaRing or Annovera), whichever the doctor decides fits you best once the safety check is clear. This visit does not place an IUD (a small device placed in the uterus) 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.

Other conditions we treat

Not quite what you have? Here are other conditions we treat.

Birth control Bacterial vaginosis Delay your period Morning-after pill Heavy menstrual bleeding Menopause hormone therapy (systemic)