The Centers for Disease Control and Prevention (or CDC) released Friday the 2010 US Medical Eligibility Criteria for Contraceptive Use. In the document, US health officials issued safety guidelines and warnings regarding contraception use for millions of women who have had weight loss surgery.
In the guidance, the CDC issued recommendations concerning the use of specific contraceptive methods by women who have certain characteristics or medical conditions. As for the safety of birth control methods, the CDC stated it is safe for women with medical conditions to use most contraceptives.
For women who have a history of bariatric surgery, however, the CDC issued warnings about the effectiveness of certain methods, including the use of birth control pills, the most popular form of contraception for women in the United States.
The types of birth control methods considered included:
- COC (combined oral contraceptive)
- P (combined hormonal contraceptive patch)
- R (combined hormonal vaginal ring)
- POP (progestin-only pill)
- DPMA (depot medroxyprogesterone acetate)
- Implants
- LNG-IUD (levonorgestrel-releasing intrauterine device)
- Cu-IUD (copper intrauterine device)
Of the above methods, the summary of recommendations stated there were no restrictions for the use of birth control method if the bariatric surgery was a restrictive procedure, such as vertical banded gastroplasty, laparoscopic adjustable gastric band, or laparoscopic sleeve gastrectomy.
For malabsorptive procedures (such as gastric bypass and biliopancreatic diversion/duodenal switch) the guidelines categorized birth control pills (both COCs and POPs) as “a condition for which the theoretical or proven risks usually outweigh the advantages of using the method.” In other words, since the digestive system has been shortened the body is less able to absorb the active ingredient and the pill might be less effective for these women.
Following bariatric surgery, women are recommended to wait at least 18 to 24 months before getting pregnant. This is the time of great weight loss and providing adequate nutrition to the body is challenging even without the added demands of pregnancy. Pregnancy after bariatric surgery would defeat weight loss benefits and could jeopardize the health of mother and baby.
Women who have had weight loss surgery should discuss birth control methods with their doctor to determine the appropriate contraceptive choices for their individual circumstances.
Source: CDC Contraceptive Guidelines
