I thought this deserved its own post.
Today I went to the family planning clinic, which is run by awesome women. I am taking the mini-pill, which is progestogen-only. The doctors there informed me that women who weigh over 70kg (155lbs) should actually be taking two pills a day to ensure effectiveness. It’s in the new Australian medical guideline on contraception and reproductive health, so if your doc isn’t up to date, tell them to get hold of a copy.
And they managed to do it in a way that was completely non-judgemental and cool, as in “Hey, did you know this?” rather than “You are OBEEEEESE so you have to take two pills HAR HAR” attitude so many of us fat women have experienced. Family planning doctors are the best. There were two attending my appointment, as one was training to be full-time at the clinic. The trainee doc was pregnant and very sweet, and the other one was a Hell-Yes-I’m-A-Feminist. Awesome.
Anyway, if you’re fat and taking hormonal contraception you might want to discuss it with your doctor. I don’t think you can take double doses of the combined estrogen/progestogen pill because of the side effects of estrogen. If you’re OK with taking medication on a schedule the mini-pill might work better for you. The progestogen-only implants like Implanon are supposed to be OK for fat women, but you might need to get it replaced a little earlier than usual. And apparently you’re not supposed to use Nuva-Ring if you are over 90kg/200lbs. Hopefully you can find yourself some great doctors at a friendly clinic like I did!
7 comments ↓
I’d also like to give a nod to copper IUDs, which are a non-hormonal option. The adjustment period is uncomfortable at best, but it’s 10 years of nearly perfect pill-free birth control.
Given how popular the mini-pill is with breastfeeding moms, and given how new moms tend to be heavier for awhile even if they are usually “regular sized,” I hope this bit of news gets around fast.
Very interesting. I weigh about 170 lbs and use Nuvaring. I’m glad to know I’m still within their weight guidelines, since I’ve tried taking pills and all have had rather unpleasant side effects. Do you know if the guidelines are in respect to safety or effectiveness?
Holy crap. I got pregnant on the mini-pill and while breastfeeding, at around 170-180 pounds. I always wondered why. There you go.
I am heavy and there’s only one brand of pill that stops my bleeding – it costs $70 and I have no insurance. I finally figured out that I should get myself over to Planned Parenthood and made an appointment. I’ve already been told they don’t carry my brand (too expensive, no doubt), so I’m thinking I’ll end up being given Depo-Provera. That also works for me, but there are side effects (it makes me crabby, it’s bad for your bones if you’re on it too long). I’ll ask them about what you’re saying here – it could be worth a try.
@Shoshie I’ve wondered about using an IUD, but was kind of worried about the “uncomfortable adjustment period”. I might have to go back to the FP clinic and ask about it.
@friendlydaughter, @car I certainly hope it gets around too. I couldn’t find any information on north American sites like Planned Parenthood, but maybe they haven’t put that online or something.
@Rebecca I found I had those effects with Depo-Provera, along with very hevy bleeding. I didn’t get those when on the progestogen-only implant (Implanon, don’t know if it’s called that over there). I had some very light bleeding now and then, but that’s all.
@meems The guidelines for the mini-pill are in respect to effectiveness. The FP docs said it wouldn’t cause extra side effects. As for Nuva-Ring, I believe that’s also to do with effectivenesss, but my GP (not the FP docs) did mention something about the effects of the estrogen in it being greater in fat women.
I recently had a termination. I was prescribed the mini pill by the doctor at the clinic because of previous side effects from the combination pill. He never once mentioned the need for a higher dose, despite mentioning at least 5 times in our 10 minute consultation that I am “a bit overweight”. Mind you, I am considerably overweight so I guess he was being quite tactful about it. But I am horrified to read this. I had a termination for god’s sake. It was not an easy choice for me and I am still trying to deal with that choice and now I find out I am not taking enough contraception to prevent another pregnancy?! FML.
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