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 lead 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 of 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 an essential tool in promoting sexual health and preventing unplanned pregnancies and the transmission of sexually transmitted diseases (STDs). These thin latex or polyurethane sheaths are designed to be worn over the penis during sexual intercourse, acting as a barrier that prevents direct contact between sexual fluids, skin, and mucous membranes. In addition to preventing pregnancies, condoms are also highly effective in reducing the spread of sexually transmitted infections (STIs) or STDs. STDs are infections that are primarily transmitted through sexual contact, and they can have serious health consequences if left untreated. Condoms act as a barrier that prevents the exchange of bodily fluids, including semen
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
Early postoperative pregnancy refers to a situation where a woman becomes pregnant shortly after undergoing a surgical procedure. This can pose various complications and risks for both the mother and the developing fetus. One of the potential complications is pre-mature delivery, where the baby is born before reaching full term. This can lead to numerous health issues for the newborn, including respiratory problems, underdeveloped organs, and difficulties regulating body temperature. Additionally, early post-operative pregnancy can result in abnormal growth of the baby, potentially leading to low birth weight or developmental delays.
The mother may also experience nutrition deficiencies, as her body may struggle to absorb essential nutrients due to the recent surgical intervention. Miscarriage, the loss of the pregnancy before the 20th week, is another risk associated with early post-operative pregnancy. The mother may also be at a higher risk of developing high blood pressure during pregnancy, a condition known as preeclampsia, which can have serious implications for both the mother and the baby’s health. In some cases, a cesarean birth (C-section) may be necessary if vaginal delivery is deemed too risky. Lastly, early post-operative pregnancy can increase the chances of newborn birth trauma, including injuries during delivery such as fractures, nerve damage, or head trauma. It is crucial for women who have recently undergone surgery to consult with their healthcare provider regarding the potential risks and necessary precautions if they are planning to conceive soon after the operation.
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