Fat Birth Control

A friend pointed me to this op-ed on making (at least some) birth control pills available without a prescription.   Generally I think that making birth control easier to get is a good thing.  I’d also welcome more research on the efficacy of hormonal birth control in fat women.  Plus something tells me I’m not the only fat woman who found she had trouble inserting/removing things like the sponge — I tried a sponge once and I ended up having to go to the doctor’s office so it could be removed with forceps.

This also got me wondering how other fats manage birth control.  Hey, we haven’t had a poll in a while!

(I did update the poll to add a few more methods)

43 thoughts on “Fat Birth Control

  1. You forgot IUDs. I was on the pill for over a decade, and now I have an IUD. I’ve also used condoms and the sponge (an old favorite!) without problems. I weigh a little over 200 pounds.

    • Yeah…I’ve tried to update the poll, will see if it works :)

      I think part of my forgetfulness is that a friend got Mirena to keep her Endometritis under control, so I associate it with “prevent Endometritis” not “contraceptive”. (Other friends take the pill to keep PMD or Endo under control — for them, the pill being a contraceptive is almost a side effect!)

      Edit: There it is! I see it! :)

  2. Good topic. Thanks for bringing it up.

    You left out cervical cap and Fertility Awareness Methods in your list of choices. You did list “timing/rhythm method” and I’m sure you probably meant NFP/Fertility Awareness by this but they really are not the same at all, and it’s a big mistake to lump in fertility awareness stuff with the rhythm method.

    Fertility Awareness is MUCH more effective and quite good for women of size who have clear fertility signals and are willing to take the time to learn about them. It involves no chemicals or hormones, which some women prefer not to mess around with. You can read more about FA methods in the book, Taking Charge of Your Fertility by Toni Weschler.

    Yes, I would also like to see more study of the efficacy of various birth control methods in women of size. Our Bodies Our Blog recently discussed the new CDC releases on various types of birth control, and they do have some info on obesity and various methods.

    http://www.ourbodiesourblog.org/blog/2010/06/cdc-releases-guide-to-contraception-use-safety

    They also note in a later entry that a new review in the journal Contraception points to the need for more research in “obese” women, particularly on the risk for blood clots and efficacy rates.

    http://www.ourbodiesourblog.org/blog/2010/06/following-up-on-the-cdcs-contraception-safety-guideline

    • I had the cap in last night, then made a user error, lost the poll, got frustrated, and went to bed…

      You did list “timing/rhythm method” and I’m sure you probably meant NFP/Fertility Awareness

      “The pill” covers lots of types of pills, and yes, I meant “timing/rhythm” to cover the various calendar and fertility tracking methods. Since I became aware of birth control (about 30 years ago) I’ve read about different variations on the theme, from simple tracking-on-the-calendar to using other fertility signals like body temp and mucus production. I really have trouble trusting them since I can’t even predict my period all the time — unless “always have period during finals and midterms” or “assume prolonged stress will change the schedule” counts….

      EDIT: Updated the poll to clarify…

  3. I went super crazy on the pill and gained a boatload of weight. I was already a little heavy before the pill, but the weight gain just skyrocketed with pill.

    My husband and I use condoms.

  4. I’m glad you mentioned having trouble with things like the sponge. I have a Mirena IUD, which, after the rather uncomfortable insertion and an adjustment period of a few months, has been completely trouble-free for me. But apparently, some practitioners recommend that you check for the ends of the strings after every cycle. I was glad my gyno did not recommend that, because I cannot reach my cervix. I was afraid to try the sponge or a diaphragm for that very reason.

    • I tried a sponge because it was over-the-counter and I wasn’t happy with the pill’s side effects (worsened my depression AND lowered my libido). But yeah, my experience with the sponge convinced me not to even try a diaphragm!

  5. I’ve been on the pill for only two years and that’s for controlling cramping and clotting during my periods. Unfortunately, the last period came with some heavy clotting on the third to last day. I really want to bring up cauterizing my uterus to my gyno next time I see her, but I doubt the procedure would be approved for me since I’m still of childbearing age and menopause is a good 10-15 years down the line. She didn’t want to increase my dosage, but I think that may also have to be another option as well. Sometimes very fat women need a higher dosage.

    • I can completely relate to you regarding cramping, clotting and additionally heavy periods. I had a large uterine fibroid to “blame” for that, plus a family history of difficult menses. Ever since my period began at the age of 13, every two weeks out of the month, I suffered low back pain, severe cramping, PMS, anemia inducing bleeding, and copious amounts of clotting that decreased the quality of my life as an adult. Pregnancy was a nine month relief for me, but I’ve only been pregnant twice in my lifetime.

      Finally, after my second, and last, child, my doctor removed the fibroid (and other smaller ones) in the hopes that it would relieve my painful and heavy periods. Since I was finished having babies, she also performed a tubal ligation. Six months later, no difference in the pain, only slight difference in bleeding. Her next recommendation was a full out godsend. She offered to perform a uterine ablation and I am a changed woman! To ensure the lining was completely destroyed, she used the copper mesh method, as well as the roller ball method. The whole thing took 30 minutes and recovery was less than a week, but very little pain.

      It has been nearly 2 years since I had that procedure and I have not had one single period. Initially, I had some PMS symptoms (mostly the moodiness) but they have decreased over time, and I still have breast sensitivity during ovulation. I am 44 and perimenopausal, so I’m sure that has an impact as well. I have no low back pain related to my period whatsoever and that has greatly increased my lifestyle. I can honestly say I do not miss having a period. I have no female nostalgia for my menses! I do not miss the pads, Depends pads at night, pain, discomfort, packing a change of clothes, fear of hotel stays, double-padding during the day, daily ibuprofen/tylenol, interrupted sleep, continuously buying new underwear…and on and on. Just the mental relief of not having to deal with something that gave me such angst–physically, mentally, emotionally–has made me a different person.

      I wrote all this to tell you that if you have the chance to have this procedure, and your periods are reminiscent of mine, then don’t hesitate. This procedure should only be done if you are through having babies, of course. Also, if you opt to do this, make sure your surgeon rechecks the lining during the procedure and is willing to go back in with the roller ball to get any remaining lining. My sister and also a neighbor had the mesh only procedure and within 6-8 months, both of them saw their periods return, albeit to a lesser degree. My insurance didn’t flinch paying for this procedure either, since you must be through having babies to get it.

      Anyway…sorry for the derail. I just wanted to share how soemthing like this can really change a person’s life for the better, and hope that you can find relief for yourself. :)

      • I’m 34, single and have chosen not to have children. I’ve heard of other women having this procedure done and it’s been the best thing that’s happened to them, so we’ll see if my doctor thinks it’s a good idea.

      • Oh, it is most definitely a GREAT thing! The non-invasiveness of the procedure is one of the main reasons I decided to get it done. It was over in about 15-20 minutes. Also, no need to be put under general anesthesia! :)

  6. Hormonal birth control was extra effective for me: when I tried it I had no libido *and* I was completely crotchety so no-one could stand me. Lack of sex is pretty good BC ;).

    So I went to the diaphragm, which worked well for me. When I had my last child, I got my tubes tied and this is much the best of any method.

  7. Also….@Living400lbs (god, I wish I knew your first name–at least your initial?!?!) Thanks for posting this poll. I didn’t think anyone I knew had even heard of the Sponge, let alone use it, as I did back in the day. Is it even available anymore? The last time I used it I was an in-betweenie, and it took me forever to remove it. Let’s just say, I got creative with the shower sprayer and contortionist poses! I swear to Maude I was going to have to take an embarassing trip to the doctor! Forceps…*cringe*.

    Prior to my tubal ligation in 2008, our preferred method was condoms. I always enjoyed the uncomfortable awkwardness at the checkout counter whenever I bought the 40 pack of Trojans. That look they give me as if it’s not possible that I could be having sex! Condoms have always worked best for me. I got pregnant on the pill in 1984 as an inbetweenie, too. I was 19, unmarried, and abandoned shortly afterward by the sperm donor as well. More research would definitely most likely decrease unplanned pregnancies for people of size, and others. Actually, more accurate information, sex education, and destigmatization (ie. cutting out the shameful moralization) of sex and birth control would very well serve the people of our world a whole lot better than politicizing it does.

    As an aside…..Isn’t it interesting that FAT PEOPLE think of birth control methods just as much as THIN PEOPLE do???? It’s as if we’re almost HUMAN! *sarcasm*

  8. Ah, the sponge. Brings back such vivid memories of the 80s for me. I found the sponge to be very effective. However, I did have to become a contortionist in order to remove it (insertion was never a problem, just removal). I gave up on it when I pulled my back out while trying to remove it. Thankfully, I had the best roommate in the world at that time. She un-pretzeled me, AND took the sponge out, dressed me and took me to the hospital (yeah, it was pretty bad). She never said a word of complaint or even laughed at me. When we got back from the hospital, she grabbed my sponge supplies and said, “I’m pretty sure you’ll be ok with me throwing these out, right?” :)

  9. Thanks for adding the cervical cap, Nuvaring, and IUD.

    I still hate seeing Fertility Awareness listed in the same slot as Rhythm Method, which conflates them in people’s eyes, when they are not *remotely* the same in efficacy. I can see to an onlooker that they look similar, but they have very different results.

    BTW, I still recommend you go read Taking Charge of Your Fertility by Toni Weschler. If you learn your fertility signs, you will usually be able to predict when your period will arrive. You’ll also have a better idea of whether or not you are fertile. Even if you decide not to use Fertility Awareness for birth control (perfectly fine, no method is for everyone), it’s AMAZING to learn this kind of specific information about your own body’s cycle and fertility signals.

    FWIW, it’s a great method of birth control too, because you are not exposing your body to hormones and chemicals and don’t get side effects from those, nor do you have to pretzel yourself to use it. If you do decide to have children someday, the knowledge in Fertility Awareness can help increase your chances of getting pregnant. It’s useful for both avoiding and achieving pregnancy, depending on how you use it.

    It’s not for everyone as a method of birth control, but the knowledge about fertility awareness would benefit pretty much EVERY woman, whether she wants to have children or not. I highly recommend the book for all women.

    • Every woman who actually has a ‘normal’ endocrine system, maybe. And some of us need our hormones and chemicals to have quality of life.

  10. I wish they would do more studies on birth control in fat women as well. I take Seasonale to prevent catamenial seizures, and it’s wonderful. No more having seizures for a solid week every month! Now it’s a solid week every three months, but I can deal with that.

    But is it effective as, you know, birth control? I don’t know, I’ve never met a man I liked well enough to have sex with. (What can I say, I’m picky.) My last gyno told me that if I became sexually active I should tell her, because the low-dose pills might not be enough to perform their primary function in a woman my size. For real? I’m on the upper end of inbetweenie-ness, around a size 18 in most brands. You’d think that drug companies would be aware of how common that is and make their product accordingly.

  11. I just went off BC for the first time after being on it for almost 15 years. Holy hormone crash Batman! I’ve lost a lot of weight over the past two years and that mixed with cutting the artificial hormones out cold turkey have thrown my system into overload. Hopefully my body can find a normal rhythm soon, the husband and I would like to be pregnant. As for being on the pill at any weight I was (anywhere from 275-427lbs), my doctor and I always were checking to make sure the amount of hormones from the pill were doing what they should be. If you choose to use the pill and are a larger woman, talk to your physician. There are a ton of different doses that you can try until you find the one that work for you.

  12. Though it would be wonderful if birth control pills were more affordable I don’t think they should be available without a prescription. There are just too many side effects that should be discussed with your doctor.

    When I was of the age to become pregnant I used the pill at first. Got pregnant on them and had the most god awful spontaneous (sp) miscarriage. Tried a diaphragm and had too many mishaps trying to insert the damn thing. Hello? Can you say flying saucer?
    Afterwards I decided on an IUD, best birth control method for me.

  13. Im on the pill.. I asked my gyno about an IUD (I like the idea of birth control that lasts ten years) and she basically made a really dodging the question response along the lines of “we sometimes have problems with that.. wait until after you have kids.. ” yes Im eighteen but that doesnt mean you have to treat me like im stupid and not explain why I cant have a very reliable from of birth control. arrgh..
    Ive had various sideeffects on the pill but no weight gain or much by way of mood swings-however breakthrough bleeding (the pill im on eliminates your period more or less)is not fun at all and makes me wonder why im taking the things at all..

  14. I have used:

    IUD (it worked for 6 years but then I got pregnant)

    diaphragm + fertility awareness + condom (i.e., I would use a diaphragm all the time and my partner would add a condom if I was ovulating)

    condom only (during a time when I was willing to take the risk of getting pregnant)

    A few years ago I had uterine ablation for fibroids so I’m extremely unlikely to get pregnant now. My male partner actually prefers using a condom so we still use that.

    I tried the pill once to control excess bleeding. It made me really sick. I went back to the doctor and said “the cure is worse than the disease.”

  15. Well, I marked “other” because, though I’ve been taking a progesterone-only mini pill for 6 weeks now, my boyfriend and I haven’t gotten to the point where we’ve tested it out yet. Now, suddenly, I am nervous about possibly needing a higher dose because of my weight. We plan to use condoms as well, because I am a “two forms!” freak due to years of working for the WIC program, so I think I’ll be ok to ask my MD about it at my next visit. For the record, six weeks on the mini pill has produced no change in my moods, though my pants are a little tighter than before — I’m choosing to blame that on it being my summer sedentary season.

  16. Yes, the sponge is so hard to get out – I had to go to the doctor too!
    Nuvaring is so convenient, but I did feel like it was adding to my depressing/seriously lowering my libido/possibly making me gain weight! Also, I sort of wonder about the effects on my period – shorter, sort of brownish flow – doesn’t seem good. No more hormones for me.
    I used a diaphragm when I was younger (I just recently started dating bio-guys again) but the silly thing is prescription, so right now it’s condoms and additional spermicide.

  17. “Plus something tells me I’m not the only fat woman who found she had trouble inserting/removing things like the sponge — I tried a sponge once and I ended up having to go to the doctor’s office so it could be removed with forceps.”

    I’ve never used the sponge, but when I tried the Diva Cup for my period I had a hell of a time getting it out. It hurt terribly and I wondered if I’d have to go to hospital. Plenty of my skinny friends just *love* their Diva Cup. I wonder if this is related to your experience, and if so I wonder what the reason is.

    I’m a not-super-sexual lesbian so I don’t use birth control for birth control purposes, however I do take the pill (Diane 35) for Hhdradenitis suppurativa.

    • I’m pretty apple-shaped with a big belly, so I assumed it was a reach problem. I can’t get a no-applicator tampon in, either.

      On the other hand, I don’t have a problem reaching my vulva or inserting a tampon with applicator.

      • It can also just be the length of one’s fingers &/or depth of vagina I guess – I’m not particularly big in the stomach, but have short fingers and wide hands, so it’s hard to reach inside.

  18. Purely anecdotal, but all three of my children are birth control babies (both mothers are BMI > 40), so we are of the belief that birth control does not work for us.

    My wife recently got an IUD and loves it. No more periods and (relative) certainty that we’re protected.

    Peace,
    Shannon

  19. I’m in a hetro relationship, could possibly be fertile (have never been pregnant and not seeking to be) and have a Mirena for my endo, but mostly I don’t do penetrative sex because of my various gynae and endocrine issues. So while the Mirena is technically birth control, I don’t primarily use it for that purpose. And it could be irrelevant anyway because there’s a big chance I’m not fertile.

  20. I first used birth control pills, and they failed, resulting in a terrible miscarriage. After the birth of my first child, I used mini-pills (no estrogen, just progesterone) b/c of breastfeeding and became pregnant once my cycle returned after nursing 14 months. My second child is still nursing at 19 months, but my cycles just came back so idk how “safe” we are (but we are always happy with an addition, planned or not…) I’d tried an Iud after my second child and had to get it removed b/c I lost my vision, bleed excessively and got a severe headache. I found I couldn’t tolerate the mini-pill afterwards well either, so it was the hormone most likely. We just use timing (charting/cervical checks) and spermicide and that’s all folks (and no I’m not pregnant yet).
    *Speaking on birth control issues in general*One thing I miss is that (seemingly) few fat women have big happy families. I guess most women on average aren’t really driven to large families but I can’t seem to find ANYONE built like me who wants that.

  21. I know I’m late on this, but thought I’d chime in anyway.

    I’m a lesbian, but I have PMDD and endometriosis, so I’m on the Pill for hormonal reasons, not contraception. I have no idea if it’s effective for preventing a pregnancy, but it has saved my life–literally. I can be on the pill instead of anti-depressants, which means I’m no longer suicidal (yay!), though I hate that it lowered my sex drive. Also, it does make me gain weight, but..eh. I’d rather be fatter and happy than thinner and dead.

    And for Erica–I want a big happy family! So you’re not alone!

  22. I’ve been on hormonal birth control for 2 years now, and have tried two different pills. Both worked very well for me in preventing pregnancy, but I did have side effect troubles with one of the pills I tried. I have to say though that I think it is a good thing that women have to go through their doctors to get birth control.. I know many women who hate to get a yearly pap smear, myself included! It does need to be done though, and since many women go to the gyno just to get prescribed birth control, I think that has a huge impact on the amount of yearly pap smears performed. Both my cousin and aunt found that they had cervical cancer from pap smears.. and both of them were going to the gyno to get birth control when they had the test performed. It definitely saves lives!

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