Patients often ask if they need to stop taking birth control before weight loss surgery. Depending on the type of birth control that you’re using, you may need to steer clear of it before your surgery date.
Oral birth control (OBC) must be stopped two weeks before and after bariatric surgery. All contraceptive injections, rings, and patches must be halted one month before surgery and wait six weeks after surgery to continue. The most preferred forms of birth control for bariatric patients are intrauterine devices (IUDs) or implants as they don’t interfere with the operation.
Timeframe for Birth Control: Pre-Op/Post-Op
Depending on the type of birth control you use or plan to utilize, the time to end and resume use is unique to each method. The window period of stopping and starting birth control in preparations for obesity surgery is outlined in the table below:
| Type of Birth Control | Brands | Pre-Op (stop use) | Post-Op (start use) |
|---|---|---|---|
| Pills | Brevicon, Modicon, Wera, Zenchent, Estarylla, Previfem, Yasmin, Yaz | 2 weeks | 2 weeks |
| Shot | Depo-Provera, Noristerat | 1 month | 6 weeks |
| Ring | Nuvaring, Annovera | 1 month | 6 weeks |
| Patch | Xulane, Twirla | 1 month | 6 weeks |
| Implant | Nexplanon | No interference | No interference |
| Intrauterine Device (IUD) | Skyla, Mirena, Liletta, Kyleena, Paragard | No interference | No interference |
*After stopping any short-acting hormonal birth control, you can switch to a long-lasting reversible contraceptive such as a non-hormonal IUD or birth control implant.
Birth Control Patient Questions & Answers
Q: I am getting ready to start my menstrual cycle. My weight has made the start date change these past months. If I do start, I fear it will be close to surgery. Will that affect things?
A: No, this is very common. Many patients have surgery while menstruating. Unless menstruation causes anemia then the surgery will not be affected.
Q: How does surgery affect the menstrual cycle and fertility?
A: Studies measuring menstrual cycles in bariatric patients displayed significant improvements in regularity and length. Improvement in hormonal balance and ovulation cycle increases the chance of pregnancy. Bariatrics also cures conditions like PCOS (Polycystic Ovary Syndrome) that leads to spontaneous fertility.
For 85% of women who had gastric bypass, the menstruation cycle became regular at 12 months. Additionally, irregular periods improved from 60% to 20% following gastric sleeve surgery. Menstrual dysfunction was reduced by 12.4% after various bariatric surgical procedures.
Birth Control Effectiveness for Bariatric Patients
– Highly Effective: IUD & Implant
The IUD is typically placed in the uterus while the implant is inserted in the arm and has few hormones. Both methods are the most effective, sharing a 99% success rate, with low maintenance and minimal side effects. Active users of IUDs or implants avoid interruption since they don’t interfere with the pre-op, intra-op, or post-op stage.
– Effective: Shot, Patch, & Ring
Other considerably effective forms for birth prevention are the birth control shot, patch, and ring.
The main concern about the injection is that it can cause weight gain among women but is 94% effective. The birth control patch and ring both have a 91% efficient rate, but all three methods shouldn’t be considered until six weeks after surgery to avoid blood clots.
– Less-Effective: Pills
Gastric sleeve surgery (VSG) is the only procedure that does not affect the absorption of pills as a result of it only being a restrictive method. Birth control pills are not recommended for bariatric patients who have had a duodenal switch or gastric bypass. Rerouting the intestines prevents the pills from properly digesting.
– Extra Precaution
Condoms are another preventative layer that can help avoid unplanned pregnancies and reduce the spread of sexually transmitted diseases (STDs).
Risks of Taking Birth Control Before/After Surgery
Short-acting hormonal contraceptives like pills, patches, shots and vaginal rings have profound implications before and after weight loss surgery. These methods increase the risk of a post-operative blood clot which can be dislodged and travel to the brain, causing a severe stroke. A blood clot that travels to the lungs and legs can also be fatal a side effect of continuing birth control during bariatric surgery.
WebMD states, “The rate for getting clots is about 0.3% to 1% over 10 years for a woman on the pill – a lower rate than that of the vaginal ring and patch.” However, weight loss surgery can drastically increase these rates.
When Can I Get Pregnant After Weight Loss Surgery?
Remember both men and women become more fertile after receiving the bariatric procedure and more prone to get pregnant. Our doctors recommend a waiting period of a minimum of 18 months up to two years before trying to conceive. The longer you wait, the better your chances of having a healthier baby while giving yourself time to fully recover from the surgical procedure.
Early Post-Operative Pregnancy: Complications and Risks
- Pre-mature delivery
- Abnormal growth of the baby
- Nutrition deficiency for the mother and fetus
- Miscarriage
- High blood pressure during pregnancy
- Cesarean birth (C-section)
- Newborn birth trauma
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