Contraception for Overweight Women

Contraception for overweight women poses some challenges. Determining which form of birth control is right for you begins with assessing the different methods as well as their effectiveness.

Are hormones effective for overweight women?

There is a wide spectrum when it comes to weight issues. Some women consider themselves overweight when they have ten pounds to lose. However, a person has to be at least 30 pounds over their ideal weight in order to be classified as obese. Those who are morbidly obese are at least 100 pounds over their ideal weight.

Women who are within the obese or morbidly obese range may experience difficulty finding an effective form of birth control. This is especially significant when it comes to methods that change hormone levels in the body. One study explains the reasons behind the potential failure of oral contraceptives in obese women, including:

• It takes nearly twice as long for hormones to reach the pregnancy-preventing level in the blood
• Drugs are made for people of normal weight, making dosage inadequate for women who are significantly overweight
• The metabolic rate may be slower
• She may not absorb enough hormones
• Hormones may be distributed ineffectively in an overweight woman

Obesity also carries health risks that patients need to consider. Obese women may experience intensified side effects from oral contraceptives. This often leads physicians to prescribe low dose hormones in order to avoid complications like venous thrombosis. The lower dose of hormones may take considerably longer to become effective in overweight women.

Other hormone-based contraception may be ineffective in women with significant weight problems.

• The birth control patch is not adequately effective in women who weight more than 190 pounds.
• The Evra birth control patch carries a significantly higher risk of developing blood clots in overweight women.
• The Nuvaring has increased potential for side effects in overweight women including:
  • Jaundice
  • Liver tumors
  • Blood clots
  • Gallstones
  • High blood pressure

Hormonal contraception for overweight women carries risks, as it does for women of normal weight. However, the risks are greater in cases of obesity. In addition, these forms of birth control may be less effective for women who are significantly overweight. Other forms of contraception can be very effective with fewer side effects.

The diaphragm is a small disk made of latex. The disk is reusable and it is used in combination with a spermicidal agent for full effectiveness. This device serves as a barrier that prevents sperm from reaching the egg and should be left in for at least six hours after intercourse to ensure effectiveness.

A physician fits the device specifically to the woman's body. The device is 85 percent effective in preventing pregnancy and it is important to note that sometimes unexpected pregnancies can result due to unknown reasons other than simple human error.

Male and female condoms can be effective in preventing pregnancies as barrier methods. Many choose to use these devices in conjunction with spermicidal agents. These non-prescription methods are available in many stores, making them convenient options. When used properly, female condoms are 79 percent effective and male condoms are 89 percent effective.

An intrauterine device (IUD) is placed in the uterus by a physician. The devices prevent the sperm from reaching the egg and they prevent the egg from attaching to the uterine wall. There are two types for women to consider:

• ParaGard IUD is effective for up to 12 years. The product contains copper and some studies suggest that women who use this device tend to gain weight over a period of time.
• Mirena IUD is effective for up to 5 years. This device contains progesterone that is slowly released into the body, which brings up the same potential problems found in hormone-based contraception.

In addition, properly inserting an IUD can be challenging with an obese patient. The chances of improper insertion increase with overweight women.

Some overweight women can benefit from exploring natural methods of contraception. The approaches typically require regular monitoring and testing and they are usually less effective than man-made forms of birth control.

Permanent birth control is another option to consider. Procedures include:

• Tubal sterilization
• Essure

Male partners can opt to have a vasectomy, offering reliable contraception no matter what the woman's weight is.

More studies are necessary to determine whether higher doses of hormones are appropriate for obese women during the first few weeks of using this type of birth control. The increased risk of side effects is a major obstacle to overcome. In addition, more research is necessary to determine which contraception for overweight women is most reliable.

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