Birth Control in Singapore—Cost Guide to Contraception Options

If you’re in a committed relationship and don’t want kids, or if you simply want to keep your family size modest, you might want to know: What are the birth control options in Singapore?

How readily available are these contraceptives, how much do they cost, and how effective are they? Here’s what every responsible man and woman should know.

 

Birth Control in Singapore—Cost Guide to Contraception Options

1. Overview of birth control options
2. Birth control pills in Singapore
3. Patch, ring and implant
4. Getting an IUD
5. Ligation or vasectomy
6. Emergency contraception (morning after pill)
7. Conclusion: which method is the most cost-effective?

 

1. Overview of birth control in Singapore

Many committed couples practise the rhythm method (sex only while you’re not ovulating) and withdrawal (a.k.a. pull out) “method”, which are a bit of a gamble. Sperm, after all, can be extremely tenacious—they can literally lay in wait for up to 5 days in one’s uterus until an egg appears.

Condoms are another cheap and readily available form of birth control. In reality, though, condoms are only about 85% effective in preventing pregnancies. Think about it—out of 100 times you have sex, there are 15 times when you may get pregnant. That’s a pretty high risk if you don’t want a baby.

There are other birth control methods that have higher success rates, but they also require more money, more discipline to use or more commitment (since they’re harder to reverse). All require a doctor’s prescription.

These contraception options can be split into a few categories.

• Hormonal birth control works by releasing hormones into the woman’s body to stop ovulation so there are no eggs to fertilise. You can take them in pill form (common in Singapore), or as an injection, patch, implant or ring in your body (less common).
• Intrauterine device (IUD) is a non-hormonal form of birth control that’s not for the faint of heart. It’s a small object that’s inserted and left inside the uterus to physically stop sperm from having their way with the egg.
• Surgery (ligation or vasectomy) is an option if you confirm guarantee plus chop don’t want a baby, ever.

We’ll also touch on emergency contraception (the morning after pill), a last recourse if you forgot to take your pill. But it’s obviously not a sustainable birth control method.

Let’s jump into the options one by one.

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2. Birth control pills in Singapore

The most common form of hormonal birth control in Singapore, contraceptive pills are taken by women not just to prevent pregnancies but even for things like controlling acne.

They contain hormones (estrogen and progestin) that stop ovulation so there are no eggs for the sperm to fertilise. At the same time, they thicken the mucus on the cervix, making it harder for sperm to move, and thin the lining of the uterus, making it difficult for a fertilised egg be implanted.

You take 1 pill a day, preferably at the same time. Typically there will be a week each month where you don’t take the pill. This is when you get your “period”, which is usually just a small amount of blood. If you get a 28-pack, you continue taking the pill everyday, but you’ll be taking a placebo “sugar tablet” for 7 days.

Pros of birth control pills

Considering how easy they are to use, birth control pills are highly effective (over 90%) when used correctly. They’re also very easy to reverse—just stop taking them and your fertility will return immediately.

The side effects of birth control pills can vary a lot. One of the good side effects is that it can help control acne (which is why even sexually inactive people sometimes take them). My roommate used to say her skin was perfect only when she was on the pill.

For women with menstrual-related issues, it is also a godsend. The pill can help regulate menstruation so the flow is less heavy and more regular, improve PMS symptoms, and even reduce fibroids, endometriosis and the risk of ovarian and endometrial cancers.

Cons of birth control pills

While they’re easy to take, pills are also easy to mess up. Medication or alcohol may interfere with the pill’s effectiveness. So does simply forgetting to take your pill that day.

They can just as easily have negative side effects, and a whole range of them at that—bloating, headaches, nausea, mood swings, weight gain, depression, fatigue, irregular vaginal bleeding, sore or tender breasts, and (ironically) decreased libido are just some. These unsexy side effects usually go away when the dosage is adjusted or if you change brand. Try it out for 3 months before you adjust.

Do birth control pills cause cancer? According to this report from the National Cancer Institute, US Department of Health and Human Services, the use of oral contraceptives is associated with a greater risk of cervical cancer, but a lower risk of endometrial, ovarian and colorectal cancer.

Birth control pills are not recommended if you’re over 35 and smoke. The chance of blood clots, stroke or even heart attack increases with your age and how heavily you smoke. They’re also not for you if you have pre-existing medical conditions or are on long-term medications that might interact with the contraceptive pills. Consult your doctor if you’re unsure.

How much do birth control pills cost?

You need to get a prescription from a GP or a gynaecologist. However, no doctor in Singapore will prescribe the pill to a girl under 16 because it’s illegal.

The 3 most common brands used in Singapore are Microgynon 30 (from polyclinics), Yasmin, Yaz and Diane-35. They range from $35 to $50 for a month’s supply. The cheapest is Microgynon 30 and Diane-35, while Yasmin (often called the branded birth control pill) is the priciest.

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3. Patch, ring, injection & implant in Singapore

These less-common hormonal birth control devices are either worn outside the female body, or implanted into it. They all work like the pill. They release hormones into the body to prevent ovulation and thicken cervical mucus to make it tougher for the sperm to get to the egg.

The difference is that these birth control methods require less attention than the pill, which needs to be taken daily and at the same time every day.

Pros and cons of the patch (Evra patch)

Also known as Ortho Evra or Evra patch, this is a thin patch worn on the abdomen, thigh, upper back, or upper outer arms. Pick a spot that won’t have you constantly rubbing against it with tight clothing. To reduce skin irritation, rotate the patch to a different spot each time.

You only need to replace it weekly. For each monthly cycle, you wear it for 3 weeks and leave it off for the 4th week, during which you’ll get your menses.

It’s quite low maintenance, yet 91% to 99% effective. However, it can be uncomfortable to wear, and yes, it can fall off. HeathHub has detailed guidelines on what to do if your Evra patch falls off.

In terms of side effects, it tends to have the positive side effects of the pill. But you can get nausea, tender breasts and bleeding between periods.

The patch will cost you around $50 per month.

Pros and cons of the ring (NuvaRing)

The NuvaRing is a soft plastic ring inserted into the vagina once for 3 weeks. You remove it in the 4th week and replace with a new one next month. While it’s in there, it’ll continuously release oestrogen and progestogen to prevent pregnancy.

Like the patch, it’s 91% to 99% effective and has similar side effects to the patch, both positive and negative. Other negative side effects associated with the ring are vaginal irritation, increased vaginal discharge, infection and changes in sex drive.

The NuvaRing is more popular in other parts of the world like Europe. In Singapore, it’s best you call your women’s clinic ahead of visiting and ask if they have it. Prices will vary, but it’ll roughly be at least $60 per month.

Pros and cons of birth control injection

This is a shot of hormones given by your GP or gynae every 3 months to prevent ovulation. Like the pill, hormones are introduced to prevent ovulation and thicken the cervical mucus.

It’s 94% to 99% effective and easy to use (as long as you remember to go for your jab!), and non-invasive too.

However, possible side effects include weight gain and irregular periods in the first 3 months as your body adjusts. Should you decide to have kids in the future, it also takes a long time to regain fertility—usually 6 to 12 months.

This option will cost you about $150-$200 per jab, and you need 4 injections a year.

Pros and cons of the implant

A soft plastic rod inserted (by your doctor) under the skin of the upper arm. You can’t remove it yourself—you need a doctor to do it.

It lasts 3 to 5 years (for $400-$500) and is 99% effective, so it’s definitely a commitment. On the other hand, it’s the most cost-effective of the hormonal birth control options if this long commitment period suits you (i.e. you’re SUPER sure you won’t want a baby in the next few years).

Side effects include weight gain, bloating and irregular periods.

How much do female birth control methods cost?

If you’re committed to being kid-free in the long run, the under-the-skin birth control implant is the most cost-effective option as it’s a one-time payment of $400 to $600 for 3 years, which works out to about $11 to $17 per month.

As a lower-commitment option, the patch can be quite affordable, just slightly more than the pill at $36 to $50 a month.

The NuvaRing and BC injection are the most expensive of the lot. The NuvaRing is about $60 per month, while the jab is $150 to $200 per injection, which works out to be around the same.

They all require a doctor’s prescription so you’ll need to factor in the cost of consultation and any fees as well.

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4. Getting an IUD in Singapore

IUD is short for “intrauterine device”, which is exactly what it sounds like—a small, T-shape device that’s inserted and sits inside the uterus.

There are 2 kinds of IUDs—hormonal and non-hormonal.

The hormonal ones work just like the pill, releasing hormones to prevent pregnancy. Common brand names are Mirena and Jaydess, and they last about 3 to 6 years.

The non-hormonal ones (copper IUDs) work by changing the way sperm move because it releases copper ions, which are toxic to sperm. Even if fertilisation happens, the copper environment makes implantation difficult. Copper IUDs are super long-lasting, effective up to 12 years.

Pros of IUD

In its ease of use, an IUD is very similar to an implant. They’re both put in by doctors, then left to do their work. The difference is that hormonal IUDs use the synthetic hormone, levonorgestrel, while implants use the synthetic hormone, etonogestrel.

Like the implant, IUDs are long-term and 99% effective. As a bonus, they can’t be felt and don’t require any maintenance or changing throughout the period. They’re also easy to reverse.

For people who don’t want hormonal birth control, IUDs are one of the few forms of non-hormonal birth control (along with condoms and surgery).

Cons of IUD

The major con of the IUD is that there’s literally something sitting in your uterus. If you don’t appreciate a deep probe down there, then an implant would be better for you.

There might be quite a lot of bleeding in the first 3 months, and it may be difficult to remove after long use. On very rare occasions, it may fall out.

How much do they cost?

An IUD costs around $400 to $500 in a go. But considering it can last a really long time—as long as 6 years (hormonal IUD) or 12 years (copper IUD), this actually works out to be a very cost-effective long-term birth control method.

Since you need a doctor to prescribe and insert it, remember you’ll need to factor in doctor’s fees too.

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5. Ligation or vasectomy in Singapore

The most permanent form of birth control is sterilisation, and that involves surgery—either vasectomy (for men) or ligation (for women).

Vasectomies involve cutting the ducts that carry sperm. Given the male anatomy, this is actually a very simple a fuss-free day procedure that doesn’t require hospitalisation. It’s also cheaper than ligation.

Ligation involves keyhole surgery to close the fallopian tubes (usually using clips) so eggs can’t travel to the uterus. Similarly, it’s a day surgery, but given the female anatomy, ligations need to be more invasive.

Pros of vasectomy/ligation

It’s super effective! And also quite permanent. Once it’s done, you can go ahead and do your thing without ever worrying about making babies by accident (although you have to wait out the first 2 months for sperms to clear out from his system).

It is one of the very few birth control options available to men. If you really do not want to father any children, a vasectomy is the only way to guarantee that.

Cons of vasectomy/ligation

Again, it’s as permanent as it gets. Should you change your mind, it’s possible to surgically reverse sterilisation, but there is no guarantee that fertility will be restored. There is a 60% to 95% chance of a successful reversal.

How much do they cost?

There’s a huge difference between doing these procedures in public and private hospitals.

At a public hospital, a vasectomy costs only about $200, while the cost inflates 10x to about $2,000 to $3,000 if you opt for a private hospital. (Hurry up and get on that waiting list!)

Similarly, ligation costs about $1,000 at a public hospital, but in a private hospital, the cost shoots up to $10,000 to $14,000.

If you opt for either of these procedures, you’re likely to be done with procreation and probably in your early 40s. This means you would have had about 15 baby-bearing years left. If you took the cost and divided it by those years, what seems like an expensive choice isn’t really that expensive after all.

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6. Emergency contraception (morning after pill)

This is contraceptive taken by the woman after, rather than before sex. That’s why it’s also called the “morning after pill”. It can be used up to 120 hours after unprotected sex. The pill works just like a birth control pill—it prevents ovulation, thickens cervical mucus and thins the uterine lining.

Cons of emergency contraception

If you’ve already begun ovulation, it may not work. That makes it rather risky. (Not to mention it’s also an unsustainably nerve-wracking form of birth control!)

Emergency contraception isn’t meant to be a BC method, but it does provide an alternative if you have not been using regular methods properly. For example, if you discovered a tear in the condom or forgot to take a pill.

How much do they cost?

Again, you can only get them from your GP or gynaecologist. Only those above 16 will be prescribed the pill. It’s very expensive at $40 to $50 a pill—you definitely don’t want to take that every time you have sex.

There are actually alternatives to emergency contraception (EC) which your doctor can recommend. For example, you can take a higher dose of your regular birth control pill, or you may insert a copper IUD.

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7. So, which birth control method is the most cost-effective?

Okay, so you’ve seen it all. Now what? Here’s a chart to help you compare the cost of each type of birth control method so you can decide:

Birth control method	Cost	Notes
Vasectomy (male surgery)	From $200 (public hospital) / $2,000 (private)	Permanent one-time procedure
Ligation (female surgery)	From $1,000 (public hospital) / $10,000 (private)	Permanent one-time procedure
IUD	$400 to $500	99% effective. Lasts 3 to 6 years (hormonal IUD) or up to 12 (copper IUD)
Implant	$400 to $600 (works out to about $11 to $17 per month)	99% effective. Lasts up to 3 years
Pill	$25 to $40 per month	91% effective, best to combine with another method e.g. condoms. Must remember to take the pill daily. Short term, easy to reverse
Evra patch	$36 to $50 per month	91% to 99% effective. Need to change patch weekly. Short term, easy to reverse
NuvaRing	About $60 per month	91% to 99% effective. Inserted into vagina once a month. Short term, easy to reverse
Injection	$150 to $200 for 3 months (works out to$50 to $67 per month)	94% to 99%. Must remember to go for jab every 3 months. Takes quite long (6 to 12 months) to reverse

Oh, and in case you’re wondering, these treatments are not covered by health insurance in Singapore except in very, very unusual circumstances (e.g. you have been hospitalised for a medical condition and contraception is deemed medically necessary).

However, our national health insurance scheme, MediShield Life, does cover certain pregnancy complications — useful to know if you plan to have kids in the future. You can boost your MediShield coverage with an Integrated Shield Plan.

 

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