Question:
Birth Control, specifically Ortho Evra (the patch)
Hello all. I am nine months post-op and currently using depo provera injections for birth control. I have been using this method since August of 2003 (the month before surgery). I am scheduled to get my next injection next week, but I've been feeling like I would like to switch birth control. I'm hearing that it can be extremely difficult to get pregnant later on after being on the injections, and since I want to start having children in about two years, I don't want to do anything to hinder my fertility. I would like to start using the Ortho Evra birth control patch. I talked to my ob/gyn about this and she stated that a person really needs to be under 150 pounds to use that patch for effectiveness. I am currently at 199 pounds (I've lost 133) and my goal weight is 166. So, unless I far surpass my goal, I don't see myself ever weighing under 150 pounds. I checked the ortho evra website and could find nothing regarding a weight restriction for users. Are any of you using the patch and weighing in at more than 150? Should I get a second opinion about using it (maybe from my PCP)? What do you guys think? Thanks in advance. Hugs, Kristy (lap RNY 9/18/03 - 332/199/166) — kristynush (posted on June 30, 2004)
June 30, 2004
My OB says you should weight 190 and below for it to be effective I would
check with another doctor
— Cindi A.
June 30, 2004
I use the patch and weigh 170. I've been using it since I was 190 pounds. I
started it in the beginning of May and I like it a lot. I wear it on my
upper abdomen, alternating sides every week. It stays on really well. The
only annoying thing is if I where a dark shirt, the fuzz from the shirt
gets in any sticky residue surrounding the patch and looks dirty. Oh well,
not a huge deal but annoying. I wore it on my upper buttcheek the first
time I wore it and my jeans took it off. I don't like wearing it on my arm,
either, because I wear a lot of sleeveless shirts. Anyway, almost 2 months
now and no pregnancy-I think I can chalk this up as just fine and dandy!
Also, if you google weight effective ortho evra, you can pull up some sites
(such as plannedparenthood) that can reinforce that yes, this is an
effective form of birth control if you are under I believe 193 pounds. Good
luck!
— jenn_jenn
June 30, 2004
"Ortho Evra may be less effective in women weighing more than 198
pounds."
This is directly from the FDA's site, here's the link:
http://www.fda.gov/cder/consumerinfo/druginfo/orthoevra.htm
— jenn_jenn
June 30, 2004
I LOVED THE PATCH!!!! I used it when I was 250 pounds and never had a
problem. My gyno said it may be less effective if you're over 200lbs.
however the rate of effectiveness is still 90 some percent. I always wore
it on my stomach under my undies and it NEVER came off. But now my husband
just got a Vasectomy so soon I'll need nothing!!!
— Kelly* P.
June 30, 2004
The OB/GYN who works with our bariatric program will not prescribe the
patch for anyone over 170 lbs. I have a personal friend who saw her
yesterday and basically begged and the OB/GYN stood hard and fast and
refused. She said there are too many studies to show that it is not
effective at the higher weights. I haven't every tried this (my plumbing
was removed years ago) but lots of our patients are using the Neuvo Ring.
It's a once monthly form of birth control but I'm not sure if it's what
you're looking for.
Thanks,
Rona
— ronascott
June 30, 2004
I agree with the others on the weight aspect. Just like being overweight
affects birth control medication, it also lowers your chances of
conception, however, there are many women who are obese that conceive with
no problem whatsoever. I was using the pill, and then switched to the
patch too. Unfortunately, after a year of using the patch, I developed
horrible migraine headaches, and had to stop using it. A lot of people
have developed this problem with the patch I find out. After several normal
catscans and other tests with no findings, I gave up, until I stopped using
the patch alltogether, and I stopped getting migraines with the following
cycle. I'm not saying this will happen to you, but just be aware of how
your body reacts to it, because when you think about it, you're essentially
putting 7 days of hormones in one patch, and your body has to metabolize
it, and everyone's metabolism is different. I absorbed it to quickly, and
it was hormone overload. I weigh 262 pounds, and it affected me badly.
Best of luck!
— StephanieF
June 30, 2004
Your OB/GYN is wrong about one having to be under 150. I've heard many say
you have to be under 170 pounds, but FDA states 198 pounds. You are almost
there now. Maybe you can start some birth control pills and then switch to
the patch after you've lost more weight. I loved the patch too for the
convienence of having to only change it once a week, but had to go off it
because I stayed on my period for over a month after being on the patch a
year. I don't think it was the patch, I have that problem with birth
control pills too.
— Lisa N M.
June 30, 2004
My surgery was set for May of 2003 and I switched from the Pill to the
Patch in March of 03 - at 336 pounds! My PCP did not know that there was a
problem with overweight people using the Patch. A nurse from my surgeon's
office actually was the one to bring it to my attention - I was MANY months
post op by then and around 230+ pounds at that time. After discussing with
my PCP (and she felt so bad about not knowing)alternative methods of BC, we
decided to continue on the patch. I was only 30 some lbs from the 198lb
recommendation and it had worked effectively for me when I was 330+ lbs.
Thank goodness that an unwanted pregnancy did not occur. So, if you were my
PCP's patient, based off of your weight, she would prescribe it to you. I
have had little problems with the patch - occasionally my period starts
during the 3rd wk instead of the 4th. I like the ease and the week long
effect. Good luck whatever your decision. Jodie LAP RNY 05-02-03 336/166/??
— Jodie P.
June 30, 2004
I'm on the patch now and I've heard 190 pounds is the limit. I wouldn't
worry about being 199. I love the patch. I've had no side effects and
it's so easy. It's been working for several months now!! :)
— emilyfink
June 30, 2004
Per my instructions in the patch book it says "To have the full
effectiveness the patient should weigh less than 198lbs" I have been
on it for over a year now and love it, though its a good idea to keep some
extra patches in case they do start to fall off. I mostly wear mine on the
buttock.. cus its easy to conceal. Good luck!
— Sunny4x4chick
July 1, 2004
YOu should probably print out the info from the FDA and take it to your
physician. Seems like incontrovertable info to me. However, I'd like to
comment on the DEPO you're going off of. Honey- It's my opinion after
having taken depo that NO OBGYN should be recommending this drug to any
woman who has plans of future pregnancy. There are SOOOO many horror
stories out there about this, and too many unanswered questions. I,
unfortunately, am one of them. I had normal cycles before starting Depo. I
took 3 cycles of Depo and never had a problem with it, it did exactly what
it was supposed to...stopped my periods. I started reading up a little
more on it and what I read, especially about it's lasting effects, scared
the heck out of me. So, I stopped it. That was back in March of 2003. I
have yet to get my periods back. Seemingly, there is no reason for it. 2
doctors have told me that they blame it on the depo, but have no scientific
proof. I am completely normal in every other way and have been checked by
specialists too. There is seemingly no explanation. So- RUN to the dr and
get yourself off Depo, no matter what you replace it with, it's better than
Depo!!!
— LMCLILLY
July 1, 2004
I have taken Depo on and off for about 8 yrs. I love it, it is my prefered
method of birth control, due to the fact that I can take 4 BC Pills a day
and still not stop bleeding. Personally, I do not want to have a period
EVERY day, so I chose Depo.
I have been off Depo a couple of times due to employer/insurance changes.
Each time it took 18/24 months for my period to return.
This last stint, It did not return on its own, and my OBGYN prescribed 10
days of Progesterone and Viola! a period. Now, of course 20 days later, it
won't go away.
My OBGYN will prescibe Depo and the Patch for her obese paitents. Under 200
is the rule for the Patch and for patients over 200 with Depo, they get it
every 11 wks, not 12.
My OBGYN and Surgeon both agree NO hormones 2 wks prior to surgery. It can
cause blood clots.
So I personally do not have enough time before surgery to get Depo and for
it to wear off. So I am stuck bleeding.
My sis wears the patch and she is about 175. She has not had any problems.
If you can remember to take a pill every day, you should look into the NEW
BC Pill that only makes you have a period 4 times a year.
If you aren't trying to get pregnant right this second, there is no need to
have a period.
Good Luck!
— Lelandmm
July 1, 2004
I was an OB/Gyn nurse until 3 mo. ago and it seems to me that the studies
on Ortho Evra showed an increased rate of pregnancy in women over a certain
weight. I was thinking that it was 175 pounds but I can't remember for
sure. It is made by the Ortho Pharmaceutical co. They may have a consumer
phone number you could call listed on their web site. Good luck to you.
— Susan F.
July 1, 2004
Try the Nuva Ring!!!! It is wonderful. Took me 2 yrs to get Pregnant with
my little guy after coming off of Depo, and my cycles were a mess. Now,
once a month I switch rings and are good to go! I don't feel it, he
doesn't feel it and no worrying whether I remembered my pill or not.
— AJ N.
July 2, 2004
DO YOUR RESEARCH, ASK A DOCTOR. I FOUND GOOD INFORMATION ON THE PLANNED
PARENTHOOD WEBSITE:
http://www.plannedparenthood.org/bc/030109_OrthoEvra.html
HERE IS PART OF WHAT I READ:
You should not use the Patch if you
smoke cigarettes and are 35 or older,have had a heart attack or certain
kinds of stroke,have uncontrolled high blood pressure have controlled high
blood pressure and smoke more than 15 cigarettes a day have a history of
blood clots or vein inflammation have unexplained bleeding from your vagina
have had an abnormal growth or cancer of the breast or uterus have a severe
liver disease or have had growths on the liver, have certain vascular
conditions associated with diabetes mellitus, are or think you might be
pregnant, need prolonged bed rest after major surgery
are allergic to the products that make up the Patch
experienced jaundice (yellowing of the skin) during a previous pregnancy or
use of birth control,have migraine headache with aura, weigh more than 198
pounds
— CAYA M.
July 2, 2004
I am an OB/GYN Nurse Practitioner. The current weight limit for the patch
is 198 lbs. I will give it to patients who weight more than that and
explain that the pregnancy risk is increased. (It is double, but still
pretty low) and I tell them to use a spermacide as a back up. I like VCF
(Viginal Contraceptive Film)and they are available down the condom isle of
any drug store. I am using the patch and I love it!
— Kerijohnson
July 7, 2004
I've been using the patch for over 2 years now and would NEVER go back to
pills. It's is soooooooo convenient and the same effectiveness as the pill,
probably even more so because with pills, for them to be as effective as
they say, you can never miss one or take one too late in the day, etc. With
the patch, you just change it every Sunday for 3 weeks, then on the 4th
Sunday, take it off and go without during that week (you'll have your
period that week) and put a new one back on on Sunday. Piece of cake! Good
luck!
— Lynette B.
July 9, 2004
My body stopped "absorbing" the Loestrin b/c pill I was taking.
How do I know this? I was put on b/c pills as a teenager to control my
raging hormones. My PMS & migranes & cramps were unbearable, so a
very nice ob/gyn put me on the pill. Before my surgery, I had been over 7
years intentionally w/o a period. Then, after my RNY, I started getting a
period like every other week. Hell on earth. I was furious. So I went to
my ob/gyn & together we determined that the hormones from the b/c pill
weren't being absorbed. The solution: the patch. I started on it at
about 280#, and guess what? The periods went back to the way they should
be. Interesting. The hormones were effective enough to control my cycles,
moods, migranes, cramps, etc. all while keeping me from not getting
pregnant when I was over their "approved" weight. I'm not a
medical person, but you are so close to the weight they would consider
"safe". I would go for the patch. If it makes you feel better,
use a back-up method until another 5 or 10# come off. Sorry to bore you
with my gynecological history. Hope it helps.
— klinzey
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