Living and Wellness What You Should Ask About Birth Control and Weight Loss Surgery By Bariatric Surgery, January 10, 2017 Bariatric surgery and changes in your weight can have a major impact on your fertility — and even alter the effectiveness of some popular forms of birth control. Women of childbearing age who are considering weight loss surgery should talk with their doctor about options for birth control before undergoing the procedure. Fertility and Obesity: What’s the Connection? Obesity can decrease fertility, as well as cause irregular periods and less frequent ovulation. Many women who are obese have trouble conceiving because of hormone changes triggered by excess fat. However, when you lose weight, your hormones begin returning to normal, which can, in turn, boost your fertility. Birth Control After Weight Loss Surgery Most doctors advise women to wait at least two years after bariatric surgery before trying to become pregnant. As you lose weight and your fertility returns to normal, you may need to reconsider your birth control methods. Some birth control, including birth control pills, may be less effective after bariatric surgery, but it depends on the type of procedure you have. The American Society for Metabolic and Bariatric Surgery recommends that women who undergo bariatric surgery use an IUD (intrauterine device) or condoms and spermicide in addition to oral contraceptive. Forms of hormonal birth control that do not go through the digestive system are expected to work as normal after surgery. These include IUDs, the ring, the patch, the shot, and the implant. Fertility and Bariatric Surgery: Know Your Options An increase in fertility can occur very quickly after your weight loss surgery, even before you experience significant weight loss. So, it’s important that you have a birth control method in place prior to your procedure. Note that you may be unable to take certain hormones in weeks leading up to your operation, so alternative forms of birth control may be needed. Talking To Your Doctor About Birth Control It’s best to have a detailed discussion with your doctor about birth control before making a decision to undergo weight loss surgery. Many clinical trials for birth control have excluded obese women, so the effectiveness of these drugs based on weight isn’t fully known. Because your fertility may increase as you lose weight, talk to your doctor about your desires for pregnancy. Some topics to discuss with your doctor include: Effectiveness of different types of birth control based on your surgery Your preferences for convenience of taking birth control Side effects of each type Whether you want to become pregnant in the future and when Choosing contraception is a personal decision and should be based on your preferences, lifestyle, and values. You can use barrier methods if you prefer to avoid hormones. To learn more about weight loss surgery, visit the UPMC Bariatric Surgery Center for Excellence and get insight on contraceptive options from the Gynecology, Family Planning, and Women’s Health Services Department at Magee-Womens Hospital of UPMC.