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.
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 days and days until an egg appears.
Condoms are another cheap and readily available form of birth control. In reality, though, condoms are only about 85 per cent 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 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.
Birth control pills in Singapore
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, buttocks or arms. You only need to replace it weekly. For each monthly cycle, you wear it for three weeks and leave it off for the fourth week.
It’s quite low maintenance, yet 91 per cent to 99 per cent effective. However, it can be uncomfortable to wear.
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.
ALSO READ: The pros and cons of 8 different birth control methods
Pros and cons of the ring (NuvaRing)
The NuvaRing is a soft plastic ring inserted into the vagina once for three weeks. You remove it in the fourth week and replace with a new one next month.
Like the patch, it’s 91 per cent to 99 per cent 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.
Pros and cons of birth control injection
This is a shot of hormones given by your GP or gynae every three months to prevent ovulation. Like the pill, hormones are introduced to prevent ovulation and thicken the cervical mucus.
It’s 94 per cent to 99 per cent 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 three months as your body adjusts. Should you decide to have kids in the future, it also takes a long time to regain fertility – usually six to 12 months.
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 three to five years and is 99 per cent 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 they cost?
If you’re committed to being kid-free in the long run, the implant is the most cost-effective option as it’s a one-time payment of $400 to $600 for three 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.
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 two 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 three to six 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 per cent 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 three 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 six 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.
Ligation or vasectomy in Singapore
The only truly 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 permanent. Once it’s done, you can go ahead and do your thing without ever worrying about making babies by accident.
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 (as women may make mistakes or simply neglect to maintain the other forms of birth control).
Cons of vasectomy/ligation
Again, it’s permanent. Should you change your mind, it’s possible to surgically reverse sterilisation, but there is no guarantee that fertility will be restored.
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.
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.
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
|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
|$400 to $500
|99per cent effective. Lasts three to six years (hormonal IUD) or up to 12 (copper IUD)
|$400 to $600 (works out to about $11 to $17 per month)
|99 per cent effective. Lasts up to three years
|$25 to $40 per month
|91 per cent effective, best to combine with another method e.g. condoms. Must remember to take the pill daily. Short term, easy to reverse
|$36 to $50 per month
|91 per cent to 99 per cent effective. Need to change patch weekly. Short term, easy to reverse
|About $60 per month
|91 per cent to 99 per cent effective. Inserted into vagina once a month. Short term, easy to reverse
|$150 to $200 for three months (works out to $50 to $67 per month)
|94 per cent to 99 per cent. Must remember to go for jab every three months. Takes quite long (six 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.
ALSO READ: A guide to which foods improve (and hinder) sperm production
This article was first published in MoneySmart.