Effective Birth Control Methods for Overweight Women

There are several factors that can compromise your birth control method's effectiveness. One characteristic that could cause birth control failure is a woman's weight. Obese or overweight women may not realize that their weight may be making their birth control method less effective. Research on available birth control methods usually does not include obese and overweight women in clinical trials. Because of this, there is a limited amount of information regarding birth control method effectiveness in overweight and obese women.

Even though there is evidence to suggest that hormonal methods like the pill, Nexplanon, and the patch may be less effective in obese women, several methods have been shown to be effective alternatives if you are overweight.

Tubal Ligation

Tubal Ligation
Tubal Ligation. Science Picture Co/Getty Images

Tubal ligation is a permanent birth control option. Often referred to as having your tubes tied, this is a surgical procedure that closes off a woman's fallopian tubes. Once the tubes are sealed, the sperm will not be able to fertilize an egg, so pregnancy can't take place. There are several types of surgical sterilizations.

There is no evidence to suggest that your weight will compromise the effectiveness of a tubal ligation. But some tubal ligation procedures can more difficult to perform on obese and overweight women. They are usually also associated with longer operating times, more anesthetic and surgical complications, and prolonged hospitalization. Typically, if you are overweight, your doctor may suggest you undergo a laparotomy (open tubal ligation) procedure.


Essure Procedure. Photo © Dawn Stacey

An alternative to surgical sterilization is the Essure procedure (also called) hysteroscopic sterilization. This birth control method is also permanent and involves "plugging up" the fallopian tubes to prevent fertilization. This is an effective birth control method for obese and overweight women. This may be the safest sterilization procedure for obese women because it can be done without general anesthesia and doesn't require entrance into the abdominal cavity.

With Essure, two small metal springs (known as micro-inserts) are placed in each fallopian tube. Over time, the coil implants will trigger scar tissue to grow around them and permanently block the tubes.


IUDs: Skyla, Mirena & ParaGard. Photo © Dawn Stacey

IUDs, including the ParaGard (copper) IUD, as well as Mirena and Skyla (levonorgestrel-releasing) IUDs, are very effective birth control methods for overweight women. The only issue regarding IUD use has to do with the IUD insertion. If you are a very obese woman, it may be more difficult to locate your cervix and determine the size and direction of your uterus. Your doctor can overcome this challenge by using special equipment or ultrasound to assist in the IUD insertion.

Research also suggests that IUDs seem to be the best and most effective birth control method for obese women who have no conditions or factors that make this procedure inadvisable. Also, since obesity is a risk factor for endometrial cancer and hyperplasia (when the lining of the uterus or endometrium grows too much), a non-contraceptive benefit of IUDs is that they can help lower these risks.

Depo-subQ Provera 104. Photo © Dawn Stacey

This is the newer version of the original Depo Provera shot and is a reversible birth control method. The Depo-subQ Provera 104 injection slowly releases 104 mg of medroxyprogesterone acetate (a synthetic form of progesterone -- 31% less hormone than the original Depo shot). The "subQ" stands for subcutaneous, so this shot only has to be injected under the skin (not into a muscle). You'll need to have an injection four times a year (every 12 to 14 weeks).

Two major studies on Depo-subQ Provera 104 reveal that none of the obese women in one study who used this birth control method became pregnant. The other study showed that the median medroxyprogesterone levels of the study participants remained above the level needed to prevent ovulation, even in overweight women.

One common issue with Depo Provera use, regardless of weight, is that it can take an average of 9-10 months (or even longer) to regain fertility after receiving your last shot. It is now believed that how long ovulation is suppressed after stopping Depo-Provera is related to weight. That means that it may take overweight women longer to ovulate/conceive once stopping Depo-Provera than women with lower body weights.

Another side effect of Depo-Provera is weight gain. This may worry you if you are already overweight. Research shows that obese and overweight teens gain more weight when using Depo-Provera than when using other birth control methods. A study with adults suggested that normal and overweight women gained weight with Depo Provera but obese women did not.


Barrier Birth Control Methods

Barrier Birth Control
Barrier Birth Control and Traveling. Photo © Dawn Stacey

If properly used, these birth control methods should be effective in obese and overweight women. Because they have do not have any hormones, barrier methods also have fewer side effects.

A barrier birth control method is a device that physically blocks sperm from entering the opening of the uterus. Though these contraceptives can be very reliable -- they can become less effective if you do not use them the correct way. Because of this, you may be more likely to experience birth control failure (maybe due to not being inserted correctly, at the right time, etc).

Making sure that these methods work as effectively as possible is even more important given the fact that obese and overweight women are at greater risk of pregnancy-related complications. You can increase the effectiveness of these birth control methods by using a double barrier method (such as a condom and spermicide or a diaphragm and a condom -- but do NOT use male and female condoms or two condoms).

Barrier methods include:

Where to Purchase These Birth Control Methods?

Purchasing Birth Control Methods. Photo © 2011 Dawn Stacey

Some prescription methods may require you to see a doctor. You may need to be fitted for a diaphragm. Your doctor needs to insert and IUD or Essure. The Depo-subQ Provera 104 is provided as an injection at your doctor’s office or family planning clinic.

Over-the-counter methods can usually be found in the family planning aisle at your local grocery store or convenience/drug store. You can also buy these methods online.


Edelman, Alison and Kaneshiro, Bliss. "Contraception counseling for obese women." UptoDate. Accessed May 2011 via private subscription.

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