Birth Control Options

i did a search on this on here and a lot of the posts that came up were older. 

When end I started my surgery process last summer my first surgeon was totally against BCP. But I had to switch surgeons after this doctor was found to be dishonest. And my actual surgeons are at the biggest university and teaching and research hospital around. Thier program is much more comprehensive and inclusive. They say two forms of BC. 

At five weeks post op I have just avoided actual "sex". And we stocked up on condoms but I really want to pick a BC before we have sex. 

So so I have done my research and decided as of now the mini pill looks best for me. I can't be on regular pulls with my history of high BP. And mirena was hell to me when I had it after my first daughter. I was going to get the copper iud but my post op periods have been super heavy and that can add to that and I just don't think I can handle that. I am also against using a form of BC that will cause weight gain (the patch and shot my sister used and gained weight with both!)

Any help or guidance would be appreciated! 

I use nuvaring. I don't have to worry about malabsorption issues. 

I use Nuvaring too, but I don't know how the hormone levels stack up vs. typical BCPs, so I can't tell you if that would be a better option with your BP.

Hi, 

So, I know little to nothing about how RNY anatomy affects pill absorption/effectiveness.  So, what I am about to say below doesn't factor that in.  I'm also assuming you are in the US and are referring to the meds I would know here in the US.

I believe that when you say "mini pill" that you mean a progestin only pill.  That is a solid option.  Of note, your old Mirena had a progestin in it too, but it is a different progestin than the minipill so hopefully you would feel better on the minipill.  

There is also an under the skin progestin (Implanon/Nexplanon) that works for 3 years although you can have it removed early if you want and you would be fertile again in 1 month.  Again, it is a different progestin than what was is in the Mirena. Because the under the skin progestin doesn't go thru the gi system, it would seem unlikely that it would be affected by your RNY.        

FYI, none of the progestins above are associated with the massive weight gain that the shot (another type of progestin) is.  

The Nuvaring has both estrogen and progestin in it.  This won't be an option for you if you have to avoid estrogen. 

I am not sure if your doctor has already told you that estrogen containing products are out of the question for you, or, if that was part of your own research.  Depending on your whole health picture, having a history of high blood pressure/being on blood pressure medication is not an absolute reason to avoid estrogen products if the blood pressure is well controlled. I'm not saying I think it is a great idea cause I am not your doctor   Also, as you lose weight, maybe your high blood pressure will disappear (mine did.) 

About weight gain and birth control: they all have the potential to cause some weight gain tho some of that weight gain is water retention rather than fat.  But, the one that is particularly well known to cause a lot of weight gain in the form of fat is the medroxyprogesterone shot which is one of the ones you mentioned your SIL had trouble with.  The patch that your SIL used is an estrogen/progestin combo and isn't particularly well known for weight gain, tho, like I said, the potential is there for any hormonal birth control method.  (I hope your SIL found something better for herself!) But, the patch typically isn't used in pts over about 198lb, anyway. (I don't know what you weigh, apologies if you are already less than that!!!) 

And the copper IUD?  I don't know much about that except to say that as a non-hormonal option, it does not have the potential to cause weight gain which gives it some appeal.

Sorry this is so wordy -- I hope it is helpful.  

~Shel

Thanks Shel! That does kinda weigh it all out on paper. I was worried about rny and absorbtion mainly why I have been hesitant about the mini pill. Though it seems like my best option. 

Many blood pressure went away already!! But in my opinion it is too soon to be tempting fate and using a BC that might raise it again lol!

Two weeks ago I opted for the Skyla IUD (its like Murena, but for people who have not had children... so it is smaller). I was on BCP for many years, stopped a little over a year ago... and once my body "detoxed" from them I decided I would NEVER go back! Having been on a pill or the depo shot from age 18 on I didn't realize how the hormones were effecting my body. Once off I sure did... my peroids became shorter and lighter, less cramps, less bloating, my weight became WAY more stable and my "drive" returned.

My ob says IUDs are much more popular these days and there are a lot more options.. especially with younger patients since they don't have to "worry" about taking a pill etc. There are non-hormonal IUDs (copper) and ones with hormones in it, but they are not the same as taking oral BCP.

The insertion itself was ok, horrible cramps first two days thought I was going to stab somebody. Then it was 10000000000 times better. So far I have light cramping here and there and light spotting here and then but that is normal for the first months. I am super happy so far and highely recommend.