Birth Control Pills

Hello everyone, Are birth control pill effective in WLS women due to the malabsorption factor? I know that WLS patients don't "absorb" everything that we consume, so I am wondering if the pill will be effective. Any feedback will be appreciated. Thanks.

There are many WLS babies because people fail to realize that we malabsorb medications as well as foods and nutrients. I would look into the patch or the nuvaring, which doesn't depend on ingestion.

Yepper - Birth control pills (or the Depo shot) are effective in packing on the pounds! If you are weight-sensitive to chemical birth control methods, you might want to consider something else! That depo shot put 15 pounds on me in a few short months. Just my opinion, though!! Hugs! Kristi

My doctor said there is no scientific reseach done on this subject (that she was aware of). I wasn't taking any chances though, I switched to the ring and love it. I was on the pill for a year and didn't get pregant, but the pill was just my "back up" birth controll method.

I think each person can be different as with other things. I for one kept taking my birth control pill per my surgeon and it worked fine. I had my surger 12/05 and went off the pill 1/06 and gave birth 10/27/07. Though now that the baby is born we don't want any more and until we get something permanent done we don't want to take any chances and have switched to something else even though the pill worked for me before. Michelle

I am 14mths postop and my pills work fine. I was also on pills for 6yrs straight before my surgery. My surgeon said that in his thousands of surgeries, he has never had anyone get pregnant while resuming birth control pills. Some people get pregnant while on birth control pills after WLS, and they blame it on the WLS, but it could very well be that they missed a pill or two No research has been proven, but when in doubt-use another method. Pills are working great for me though.

I am not technically a grad until the 15th [or the 16th, I guess] but I will share what I've found out on this subject [I continue to do quite a bit of research because it interests me]. There isn't a whole lot of hard research on oral contraceptives post-WLS. One doctor [who claimed to do a "mini-bypass"], reported on his website that his patients had as much as a 12% failure rate on oral birth control alone. Most WLS surgeons will recommend a back up method, or another method entirely during the first 12-18 months because pregnancy is not advised during rapid weight loss. It's also interesting to note that there is a study that shows that oral contraceptives [OC] are NOT as effective in overweight women. According to the authors, this is could be due to metabolism or OC being absorbed in fat. The study states that the failure rate was higher in overweight women, especially if they were on a low-dose birth control. "Because contraceptive steroids are lipids and can be absorbed in fat, it is plausible that, among women with high fat levels, decreased circulating steroid levels may contribute to the decreased effectiveness of OCs." And concludes that weight should be a consideration when prescribing an OC. You can have your blood tested to check the concentration of the hormones in your bloodstream after being on the pill for a while. Many people who are not absorbing the pill well for whatever reasons will report break thru bleeding and cramping as their first sign that it may not be working correctly for them. Studies show birth control pills WHEN USED CORRECTLY [same time every day, never miss a dose] are about 99.5% effective. IMPROPER USE is shown to reduce the effectiveness as much as 5-10%, this is for the general population. So first and foremost, unless you can be dedicated to taking them properly, [which I believe many post ops can because we are already dedicated to taking our vitamins and supplements regularly] oral birth control is not a good choice. From everything I read and after talking with my surgeon AND OB, the malabsorption factor post RnY for the pill *may*** reduce the effectiveness about 1-2 percentage points. That means instead of being 99.5% with effective with compliance, it may be 97-99% effective. This could be because our digestive tract is altered and/or because of our metabolism, [it is not for the same reasons that vitamins like B12 are not absorbed - that being that the section of the small intestine bypassed is specifically where this vitamin is absorbed]. Either way, the possibility of reduced effectiveness should be understood and factor into your final decision on birth control. **I say *may* because you may not necessarily absorb it less, everyone is different. It's a pretty small pill and not super dense so it doesn't have to be inside you long to dissolve and start dispersing into your bloodstream. Personally I have had no problems absorbing any other meds I take including Tylenol, Ambien, Xanax, oral antibiotics, or oral pain killers like Darvocet or Tylenol 3. I also have not had any problems absorbing capsules [for one, my Midrin for migraine works fine], or larger, solid pills like my Calcium Citrates. I started swallowing pills at about 3 months out and I started on oral birth control about 5 months out. Also, I am in a position where one or two percentage points less in effectiveness is not a huge worry for me. IF I got pregnant, I am in a good place in my life to deal with it. This was another part I considered in making MY decision. I had been on Depo prior to WLS and when I discussed that with my OB he did not advise continuing because I DID want to be able to get pregnant [after at least 18 months post op] and he advised that the Depo takes longer to wean off. So all of these factors went into my decision for birth control and I chose Seasonale - an extended cycle oral contraceptive. I know a lot of women, post-op and non-op who are happily using the Nuva Ring, with a published effectiveness of 99% [by comparison, the condom effectiveness is only about 80%]. IMO it's really important to remember that nothing, even sterilization, is 100% effective except abstinence, and we all know none of us want that Good luck with your decision. xosm

Thanks so much for all of this good information!!!!!!