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Is There a Weight Limit for Birth Control Pills? Uncovering the Facts!

Are you wondering about a weight limit for birth control pills or the best birth control for overweight women? Let's chat!

Whether you do not want to get pregnant or are currently planning for postpartum, knowing your options around birth control when you're plus size is essential.

While some forms of emergency contraception and birth control have BMI or weight limits, options are available for people of all sizes.

plus size woman with birth control pills

Does weight affect birth control?

Let's start with a disclaimer! The information in this article is not medical advice. New studies are constantly happening, and data can evolve. The intention is to provide you with some helpful information that can assist you in making an informed decision together with your healthcare provider.

Your care provider is the best resource to offer personalized guidance based on the most up-to-date research for your specific needs.

BMI

As you research birth control methods and weight limits, you'll see BMI limits mentioned far more often than weight limits.

Using a BMI calculator, you can calculate your BMI, which stands for Body Mass Index. However, it's essential to keep in mind that BMI is considered a flawed and outdated measurement that doesn't give a complete picture of health.

So, don't let your BMI number affect your body image and self-esteem. However, knowing your position on the BMI chart can be helpful in certain circumstances, like selecting birth control when you have BMI over 30.

Weight Limit for Birth Control Pills Research

A weight limit for birth control pills or changing the dosing for people with a high BMI hasn't been looked at extensively. Instead, studies suggested a correlation between birth control ineffectiveness and higher BMIs for hormonal contraceptives, such as birth control pills and patches.

So, there has been a long-held belief that these methods of birth control may have difficulty maintaining consistent hormone levels in individuals with higher body weights.

However, when researchers started digging into these studies, specifically around the pill, they found inconsistencies in some of the findings.

New research surrounding if weight affects birth control effectiveness does not show a significant difference in failure rates among body sizes for those who take the pill.

The research did find a link between inconsistency in taking birth control pills and birth control failure. So, this confirms the importance of being on top of our medication and has us questioning BMI limits on hormonal contraceptives.

With this said, some evidence shows weight can impact the effectiveness of some combination birth control pills and there's an increased risk of blood clots.

Combination birth control pills, also known as “combo pills” or “the pill,” are oral contraceptives that contain synthetic estrogen (ethinyl estradiol) and progestin.

So, more research is needed!

Unfortunately, studies examining birth control often have limited inclusion of plus size individuals. And even when included, their weight is rarely taken into account when analyzing the results.

With all of this in mind, be sure to have an open conversation with your care provider when reviewing your options for birth control.

Best Birth Control for Plus Size Individuals 

When selecting the best birth control for your body, there are several factors to consider, all of which play a crucial role. From the duration of effectiveness to the mode of dosing and potential side effects, it's essential to consider various aspects before deciding.

Speaking of the effectiveness of birth control options, the Centers for Disease Control and Prevention (CDC) has a helpful and continuously updated resource showing different types of birth control options and the failure rates.

different forms of birth control

The Pill 

As we shared above, there isn't a weight limit for birth control pills. However, some concerns exist about the effectiveness of combination birth control pills (COC).

As an alternative to the COC, there are progesterone-only pills. However, all forms of birth control come with side effects, and these pills can cause irregular menstruation and weight gain.

IUDs

If you have a BMI over 30, an IUD can be a great birth control option.

In fact, a study showed that both the implant and IUD had failure rates of less than one per 100, and this rate remained consistent regardless of BMI.

It's worth noting that people have different opinions about IUDs. Some folks rave about them, while others may not share the same enthusiasm.

So when talking to your healthcare provider about the potential side effects of any birth control method, remember that your experience might not be the same as that of your best friend or others who have used the same form of birth control.

The copper non-hormonal IUD directly acts within the uterus to prevent fertilization, effectively protecting against pregnancy for up to ten years.

Alternatively, there is another type of IUD that releases hormones. This hormonal IUD, such as the levonorgestrel-releasing IUD, works by continuously releasing a small amount of progestin hormone into the uterus. This IUD prevents pregnancy from three to eight years, depending on the brand.

During an IUD insertion, your care provider will start by doing a pelvic exam to check the size and position of your uterus. If needed, they may apply a local anesthetic or give you pain medication to minimize any discomfort.

Next, the IUD, a small T-shaped device with strings attached, will be inserted through your cervix and placed in your uterus. The strings are left hanging from your cervix, allowing for easy removal of the IUD whenever you decide to do so.

The whole procedure usually takes just a few minutes. Some people may experience mild cramping or discomfort during or after the insertion. Always speak up if you're experiencing any pain!

The Implant

As noted above, research shows the implant is effective for plus size individuals.

The implant is a small, flexible rod inserted under your upper arm's skin.

Once in place, it continuously releases a synthetic hormone called progestin into your body, stopping ovulation and preventing pregnancy for up to three years.

The Ring

Compared to oral contraceptives, the vaginal ring exposes people to lower estrogen levels while maintaining effectiveness in preventing pregnancy.

The vaginal contraceptive ring is a small, flexible ring inserted into the vagina and prevents pregnancy by releasing a combination of hormones, typically estrogen and progestin, that inhibit ovulation.

The ring is left in place for three weeks, followed by a one-week break for bleeding.

To remove the ring, insert a finger into the vagina and gently hook the edge of the ring. Be sure to pull it out slowly and carefully.

Address any concerns with your care provider, including your ability to remove and replace the ring on your own.

The Shot

The contraceptive shot, often called Depo-Provera or Depo-subQ Provera 104, is a form of birth control that involves receiving an injection from your care provider of the hormone progestin every 12 to 14 weeks.

It works by suppressing ovulation, preventing the release of eggs from the ovaries.

Studies show it's effective for plus size individuals. However, it is important to note that a significant drawback of this contraceptive is the potential for weight gain.

The Patch

While the patch has become increasingly popular, it's often not recommended for people who weigh over 200 lbs or have a BMI over 30.

The patch is usually applied once a week and remains effective for that entire week before replacing it with a fresh patch.

To use the patch, you'll apply it to clean, dry skin on specific body areas like the lower abdomen, buttocks, upper outer arm, or upper torso. It's a weekly routine, so you'll keep the patch in place for the entire week and then replace it with a new one to maintain continuous hormone release for pregnancy prevention.

Barrier Methods 

Using condoms and diaphragms, along with Spermicide, can prevent pregnancy without hormones. However, the effectiveness of each method varies, and correct use is critical.

Fertility Awareness-Based Methods

Fertility Awareness-Based Methods, often called Natural Family Planning, work by closely tracking fertility and avoiding unprotected sex during ovulation to prevent pregnancy.

According to the CDC, this method of birth control has a 2% – 23% failure rate. So it requires a strong connection and understanding of your body to be successful.

If you have an irregular menstrual cycle due to hormonal imbalances or a condition like Polycystic Ovarian Syndrome (PCOS), this method might have an even higher chance of not working.

Plan B Weight Limit 

You might also wonder about Plan B if you're concerned about a weight limit for birth control pills.

The data shows that Plan B may be less effective for those weighing more than 165 pounds.

An alternative form of emergency contraception is often recommended, such as a copper IUD or ulipristal if you have a BMI over 30.

We'll note here that the effectiveness of the abortion pill is not influenced by weight.

Best Birth Control After Bariatric Surgery

Gastric bypass surgery changes how the body absorbs food and medication. And because of this, oral birth control pills may be less effective. So, people should consider using other birth control methods like the implant or IUDs. 

On the other hand, weight loss surgeries like Sleeve gastrectomy or gastric banding don't change how you absorb medications, so you have more options.

Permanent Methods of Birth Control

Permanent Methods of Birth Control include tubal ligation or vasectomy.

For those with a penis, a vasectomy is considered a minimally invasive surgical procedure. It is typically performed under local anesthesia and is generally well-tolerated with minimal discomfort.

On the other hand, tubal ligation, also known as “getting your tubes tied,”
far more invasive.

It's a surgical procedure that permanently sterilizes a person and is typically done under general anesthesia. The fallopian tubes are surgically blocked, cut, or sealed to prevent pregnancy,

A higher BMI may present extra factors to consider during surgery, such as potential anesthesia and surgical access challenges. However, it doesn't mean individuals with a higher BMI cannot undergo tubal ligation.

Your care provider will assess your situation and determine your best approach.

We hope you found this information helpful and that it addressed that there isn't a weight limit for birth control pills, but there are things to keep in mind.

Remember, there are risks and benefits to each method of birth control. Finding the right one for you may take some trial and error. So talk to your care provider about the best option for your family planning needs.

Weight Limit For Birth Control Pills Article References

  • HalesRobinson JA, Burke AE. Obesity and Hormonal Contraceptive Efficacy. Women’s Health. 2013;9(5):453-466. doi:10.2217/WHE.13.41
  • Westhoff, Carolyn L. MD, MSc; Torgal, Anupama H. MPH; Mayeda, Elizabeth R. MPH; Stanczyk, Frank Z. PhD; Lerner, Jodi P. MD; Benn, Emma K. T. MPH; Paik, Myunghee PhD. Ovarian Suppression in Normal-Weight and Obese Women During Oral Contraceptive Use: A Randomized Controlled Trial. Obstetrics & Gynecology 116(2 Part 1):p 275-283, August 2010. | DOI: 10.1097/AOG.0b013e3181e79440
  • Brynhildsen J. Combined hormonal contraceptives: prescribing patterns, compliance, and benefits versus risks. Ther Adv Drug Saf. 2014 Oct;5(5):201-13. doi: 10.1177/2042098614548857. PMID: 25360241; PMCID: PMC4212440.
  • Rosano GMC, Rodriguez-Martinez MA, Spoletini I, Regidor PA. Obesity and contraceptive use: impact on cardiovascular risk. ESC Heart Fail. 2022 Dec;9(6):3761-3767. doi: 10.1002/ehf2.14104. Epub 2022 Sep 14. Erratum in: ESC Heart Fail. 2023 Apr;10(2):1497. PMID: 36103980; PMCID: PMC9773763.
  • Xu H, Wade JA, Peipert JF, Zhao Q, Madden T, Secura GM. Contraceptive failure rates of etonogestrel subdermal implants in overweight and obese women. Obstet Gynecol. 2012 Jul;120(1):21-6. doi: 10.1097/AOG.0b013e318259565a. PMID: 22678035; PMCID: PMC4043143.
  • Reifsnider, E., Mendias, N., Davila, Y. and Bever Babendure, J. (2013), Contraception and the obese woman. Journal of the American Association of Nurse Practitioners, 25: 223-233.
  • Cleland K, Raymond EG, Westley E, Trussell J. Emergency contraception review: evidence-based recommendations for clinicians. Clin Obstet Gynecol. 2014 Dec;57(4):741-50. doi: 10.1097/GRF.0000000000000056. PMID: 25254919; PMCID: PMC4216625.
  • Seyni-Boureima R, Zhang Z, Antoine MMLK, Antoine-Frank CD. A review on the anesthetic management of obese patients undergoing surgery. BMC Anesthesiol. 2022 Apr 5;22(1):98. doi: 10.1186/s12871-022-01579-8. PMID: 35382771; PMCID: PMC8985303.
Jen McLellan, CBE
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