Contraceptives can be oral, vaginal/inserted, injected or placed under the skin (endo-dermal placement). They are used to help prevent unwanted pregnancy in sexually active women of child bearing age. Weight loss surgery, known as bariatric surgery, is commonly used in cases where the patient is considered morbidly obese by their medical practitioner, and diet and exercise alone haven’t been able to cause significant changes in the patient’s weight. Women who have had bariatric surgery are recommended to not become pregnant for one to two years following the surgical procedure, to make sure their body has a chance to adjust to all the changes going on inside it following the operation, not the least of these being changed nutritional needs, which could adversely affect a developing fetus.
Effects of Surgical Procedures on Fertility
Morbidly obese women of child bearing age show marked levels of decreased fertility when compared to women of normal weight groups. This is due to a variety of reasons, the primary one being that morbidly obese women usually have hormone imbalances which give them irregular menstrual cycles and egg production in the ovaries. There are a number of medical studies that show an increase in the fertility of women between the ages of 18 and 45 after bariatric surgery is performed, due to the fact that the patient’s hormonal balance will be normalized following the surgery.
Studies show that oral contraceptive use alone should be done with care, since most recovery regimens indicate a marked decrease in the contraceptive dosage immediately following bariatric surgery. Another factor affecting the efficacy of oral contraceptives (“The Pill”) is the rate of post surgical absorption of the hormones in the oral contraceptive being used. These lowered absorption rates are due to normal post surgical gastrointestinal disturbances. If endo-dermal placement and injected contraceptives are contraindicated for you and vaginally inserted contraceptives (intrauterine devices and barriers/diaphragms) are uncomfortable or otherwise undesirable, you should consult with your medical practitioner to have tests run to make sure the absorption rate of your oral contraceptive is adequate to provide protection from an unwanted pregnancy.
Depo Provera has been shown to be the contraceptive method of choice for most women where its use is not contraindicated due to other medical factors. This is because the hormones in Depo Provera are more easily and completely absorbed by your body; thus, they are able to enact the hormonal changes required of an effective contraceptive more readily and easily than oral contraceptives.
Barrier/Insertion Type Contraceptives
If you’re comfortable with and can remember to regularly use an inserted or barrier type of contraceptive device, known as an intrauterine device (IUD) or a diaphragm, these are both completely acceptable methods of post surgical contraceptives. If you choose the diaphragm method of contraception, it’s very important to have yourself measured regularly following the surgery to ensure a proper fit.
No matter what method of contraception you choose to use after your weight loss surgery, you should also ask your medical provider for a prescription for emergency contraception, also known as “the day after pill” in case you forget your diaphragm/IUD or your method fails.