It was thought that being overweight may decreases the efficacy of the combined hormonal contraception – the contraceptive pill which contains oestrogen and progesterone. However, the research is limited and this is not consistently found.
Due to the risk of deep vein thrombosis, the recommendation is that women with a BMI > 30 should consider other contraceptive choices due to the increased risk of deep vein thrombosis (clots that block the veins), which means a risk:balance needs to be considered. If you have a BMI over 40, the combined oral contraceptive would not be offered.
Transdermal Patch & Vaginal Ring
The risks of deep vein thrombosis are as the combined oral contraceptive.
Progesterone-only Pills
There is little information on how weight affects the progesterone only pill, however it is felt that overall the progesterone only contraceptives have lower risks of deep vein thrombosis and other complications so it is felt to be the contraceptive of choice – Cerazette is the pill which would be suggested. They are associated with a small amount of weight gain.
Contraceptive Injection
There is no evidence that being overweight has any negative affect on the contraceptive injection, however it may be associated with weight gain.
Contraceptive Implant
Once again, there is little information available, however in ‘Heavier women’, the implant may need to be removed earlier than the licensed three years (this is a recommendation from the manufacturer but there is no definite evidence for this).
Intrauterine Devices
The copper coil and the Mirena coil have a localised function which is not related to weight, therefore it should work as well, without increased risks. Placement of coils however may be more difficult as your weight increases.
Sterilization
Obesity carries additional risks from general anesthesia and the increased risk of difficulties in the surgery.
Barrier Methods
Barrier methods of contraceptives, include male and female condoms, cervical caps, diaphragms, and spermicides. These methods can be a good option for individuals with a weight problem.
Contraception after weight loss surgery.
Some data suggest that oral contraceptives following surgical weight loss procedures may not be sufficient to protect against pregnancy. This is due to malabsorption problems and therefore the contraceptive does not reach sufficient concentrations in the blood to work.
These recommendations are based on guidelines published by the Faculty of Sexual and Reproductive Health Care.
More information is available: http://www.healthyhedgehogs.co.uk
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