Hi all!

I'm a 31-year-old woman who is 10 months post-op. I started around 318 lbs. and am now around 183 lbs. Most of my weight is off now, and I have about 40 left to go to goal; these last pounds are going more slowly, which is fine, that's to be expected. I'm hoping to be at goal by the end of 2018.

I have had my period for 20 years and had never been regular until my pre-op diet started last April. Since then - clockwork. It's amazed me how much my surgery has helped this area of my life. It's astonishing to me that I can predict when a period is coming after years of not having one at all, getting one every two weeks, etc. and being told nothing appeared wrong with my hormones or ovaries. It's been a blessing, really! I'm glad to be regular for the first time ever.

I had never had sex before in my life, but I recently started a relationship and we're sexually active. The first couple of times, we used only a condom, since it was the least fertile part of my cycle. Then I went to the doctor and got on the birth control patch, which has been going well for me. I did the first three weeks as instructed, used it perfectly, had sex about ten times with a condom as well, and I got my period right when I was supposed to. I'm coming off of my period right now, so I am not pregnant.

I have read/have been advised to use two forms of birth control for the first 18 months post-op. But I also read that that is because of the increase in fertility associated with rapid weight loss/hormone expulsion. Since I am done with that rapid weight loss time in my life, am I okay to just use the one form of birth control? I realize we're not doctors here, and surprise pregnancies can happen in any kind of birth control situation, but what do you guys think about it? I'm just kind of looking for anecdotes and personal opinions. I would really love to not use condoms and also not worry! lol

Thanks!

Talk to your OB, not your primary, about all of the options out there.

I am a nurse, but this is not my area of expertise. What I do know for sure is that the patch is not as effective as other methods of birth control. Patches 91% effective, while many other things are 99% effective. Condoms are 85% effective- condoms are more effective if used properly, but no one does. So the real world rate of condom effectiveness to prevent pregnancy is 85%. (Sorry, had to add that in case anyone wanted to argue about the number compared to what it says on the box)

So you are combining 2 of the least effective methods of birth control during the post-op phase of increased fertility. Increased fertility is supposed to last from 15-18 months after surgery.

Sounds like you might be a mommy soon if you don't figure out another combination. ?

Definately talk to an OB.

My primary is a family doctor, so she's my GYN as well. I was told patches are 91% when used averagely, 99% when used perfectly. But considering the use of two options - physical barrier and hormonal barrier - the odds have got to be greater than 91% or 85% when combined - doesn't that make sense? I mean, I know all it takes is one swimmer, but there's no way the statistics don't combine in some way when using two methods.

I won't use an kind of insert or implant, and I can't take birth control pills, unfortunately, due to my malabsorption. My options are slim.

2 hours ago, passion4film said:

But considering the use of two options - physical barrier and hormonal barrier - the odds have got to be greater than 91% or 85% when combined - doesn't that make sense?

OK, found a use for all the statistics I took in college (6 classes)

Odds of pregnancy using stated odds = (1-.91) x (1-.85) = .0135 or 1.35%, so 98.65% effective.

But are you going to be happy if you're part of the 1.35% just because the numbers worked for you?

Personally, I was ultra cautious. My husband and I used 2 methods a lot of the time if we really wanted to make sure we didn't get pregnant.

Edited May 29, 20188 yr by Orchids&Dragons

1.35% with 2 methods is still technically less effective than an IUD, which is over 99%.

Please also remember that these percentages don't apply to you after weight loss surgery bc you are more fertile. The increase in fertility comes from hormones, so you should have the most effective hormonal birth control out there.

If your goal is to not use condoms, then I would definately get on something besides the patch. I totally understand, condoms literally ruin sex for me. I hate them.

You also mentioned that you were new to sexual activity. Trust me when I say that there is a learning curve to managing birth control and we have all had a few scares over the years. (Missing a pill, period late a day or 2, condom broke/expired)

Do some research and reconsider an IUD.

34 minutes ago, Orchids&Dragons said:

OK, found a use for all the statistics I took in college (6 classes)

Odds of pregnancy using stated odds = (1-.91) x (1-.85) = .0135 or 1.35%, so 98.65% effective.

But are you going to be happy if you're part of the 1.35% just because the numbers worked for you?

Personally, I was ultra cautious. My husband and I used 2 methods a lot of the time if we really wanted to make sure we didn't get pregnant.

Thank you! Getting pregnant right now wouldn’t be the worst mistake I’ve ever made in life, but I’m trying not to if I can help it!

Edited May 29, 20188 yr by passion4film

5 minutes ago, Sleeved36 said:

1.35% with 2 methods is still technically less effective than an IUD, which is over 99%.

Please also remember that these percentages don't apply to you after weight loss surgery bc you are more fertile. The increase in fertility comes from hormones, so you should have the most effective hormonal birth control out there.

If your goal is to not use condoms, then I would definately get on something besides the patch. I totally understand, condoms literally ruin sex for me. I hate them.

You also mentioned that you were new to sexual activity. Trust me when I say that there is a learning curve to managing birth control and we have all had a few scares over the years. (Missing a pill, period late a day or 2, condom broke/expired)

Do some research and reconsider an IUD.

I’m just so incredibly worried about scarring/permanent infertility due to an IUD. That would be far worse than an unplanned pregnancy. I’ll continue to look into them.

Edited May 29, 20188 yr by passion4film

I understand the concern about IUDs, but why are you against the implants? I've had one for going on three years (will get it replaced in August) and it's been a godsend. No periods (other than at first, while my body was getting used to it) and no hassle.

When they say two forms they usually mean back up your birth control with a condom or other barrier method. My patients always forget that a condom is a form of birth control.

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On 5/29/2018 at 9:11 PM, istytehcrawk said:

I understand the concern about IUDs, but why are you against the implants? I've had one for going on three years (will get it replaced in August) and it's been a godsend. No periods (other than at first, while my body was getting used to it) and no hassle.

I'm looking into it now! I'm not a fan of the idea of something permanently inside my body like that, but it seems to be safer (re: infertility concerns) than IUDs. Do you use a second method, too, as backup, post-op? Thank you!

5 hours ago, debbie89 said:

When they say two forms they usually mean back up your birth control with a condom or other barrier method. My patients always forget that a condom is a form of birth control.

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Right, that's what I mean. Hormonal + condom. That's what we've been doing. I'd love to ditch the condoms, though I know that adds risk.