Going from being morbidly obese with a BMI of 48…
*Please note I am a lay person and am certainly not a doctor/health professional. This post is purely my thoughts and opinion and if you need to discuss it further please talk to your surgical team or GP.
I chose to have a gastric bypass because having the restrictive (smaller stomach) and malabsorptive (bypassed intestine) functions together was going to give me the best chance at long-term weight maintenance. As well as weight there are wider physiological effects to be considered and for females post-op contraceptive choices is one of those things.
The malabsorptive aspect of gastric bypass and duodenal switch helps us to reduce the amount of calories and nutrients we absorb. When it comes to things like oral contraceptives this is something that needs to be considered because you may not get the same efficacy as you did previously. I’ve done a bit of haphazard internet sleuthing/research for this post but there is heaps of non specific information out there and it doesn’t seem like there have been many reliable studies done on this topic.
The general consensus is that because the malabsorptive procedures change the way the digestive tract works and the potential for the drugs to be absorbed you probably shouldn’t rely on oral contraceptives after procedures like gastric bypass or duodenal switch. Especially in those first couple of years after surgery and if not adding to your family again is important to you. You gastric sleeve lovelies are in the clear you don’t have any malabsorptive aspect so for you that’s great.
It occurred to me while writing this post that the malabsorptive aspect is also going to affect the efficacy of the morning after pill too. It’s important to remember that this may not be a suitable, reliable option after gastric bypass or duodenal switch.
It is recommended that you don’t fall pregnant for about two years post weight loss surgery because especially while you are in the rapid weight loss phase it’s not really the right conditions for you to be growing a person. Since this rapid weight loss may resolve any fertility issues that could have been present and may present more opportunity for that kind of activity we need to be a little bit more careful to avoid getting pregnant.
Luckily for us there are far more options than oral contraceptives these days. You need to assess all options and it’s probably best talked over with your doctor but some of the things available in New Zealand are contraceptive implant, IUDs such as the Mirena (my method of choice at the moment), barrier methods such as diaphragms and condoms (which should be used regardless of other options in most cases anyway) and the depo shot
The contraceptive that is right for you depends on many different things and a lot of time comes down to personal choice. I switched to using a Mirena after having my son because the oral contraceptives I preferred were not able to be taken while I was breastfeeding. For me the Mirena has been a really good choice and I love how once it’s in you don’t have to think about it on a daily basis and there’s no room for user error! Since I had it in before I even started considering weight loss surgery I didn’t have to think about it in relation to my surgery but if you are in the lead up to surgery it’s well worth thinking about and sorting out beforehand.
Had you considered how gastric bypass or duodenal switch could impact on things such as oral contraceptives before? Comment below and let me know.