The Patch & Weight

[purplefirsts.livejournal.com]

I am thinking about maybe starting HBC, and have been looking into the patch...just because I hate pills.

I was reading about it tonight, and read that it is less effective for women over 198 pounds. I am wondering -- how legit do you think this is? Do you really think protection will be compromised if one weighs more than the said 198 pounds?

Have any of you who weigh over 198 been on the patch?

Comments

[crw008.livejournal.com]

5'9", 205...never had any problems, going on 4 years.

[paper-machete.livejournal.com]

I asked my doctor about this. She told me that a potential high blood pressure for women over 198 lbs was the concern, not the weight.

[queensugar.livejournal.com]

While your doctor's concerns are valid, the prescribing info for the patch says otherwise. Specifically, the current prescribing info approved by the FDA says: (http://www.fda.gov/medwatch/safety/2005/Nov_PI/OrthoEvra_PI.pdf)

With respect to weight, 5 of the 15 pregnancies reported with ORTHO EVRAuse were among women with a baseline body weight greater than 198 lbs. (90kg), which constituted less than 3% of the study population. The greater proportion of pregnancies among women at or above 198 lbs. was statistically significant and suggests that ORTHO EVRAmay be less effective in these women.

I don't know if there is more recent data than that (this is from late 2005), but essentially, in trials 3% of the sample group accounted for 30% of the pregnancies. While there may be other factors, that correlation alone is fairly striking, and certainly suggests that reduced efficacy, and not just higher blood pressure, is a concern here.

[paper-machete.livejournal.com]

Then is the same concern established for the NuvaRing as well?

[queensugar.livejournal.com]

As we mention in this part (http://www.vaginapagina.com/index.php?title=Hormonal_Birth_Control#Weight.3F) of the Vulvapedia, there seems to be conflicting evidence about non-patch forms of HBC. However, this release (http://www.organon-usa.com/news/investigators_present_new_studies_demonstrating.asp) from the makers of NuvaRing says that the Ring appears to be "similarly" effective in women over 198 lbs, noting that this finding is meaningful because women over that weight are at the highest risk of contraceptive failure.

[paper-machete.livejournal.com]

Are women of that weight at risk for contraceptive failure because of their weight? As in, there are not enough hormones in whatever they've chosen as a contraceptive to cover a higher body weight?

[frolicnaked.livejournal.com]

Check out the Vulvapedia link (http://www.vaginapagina.com/index.php?title=Hormonal_Birth_Control#Weight.3F) queensugar mentioned above. It explains -- and links to sources -- that there's some evidence that HBC may be somewhat less effective in women with a higher body mass index (over 27.3). However, the exact cause for this is unknown, and with the exception of Ortho Evra, the evidence isn't enough to recommend different methods or prescribing information for women with that higher BMI. :)

[loonylupinlover.livejournal.com]

I think the difficulty with the Patch is that the medication is transdermal, so in women over 198 pounds the medication generally has to literally go through a thicker, heavier layer of skin/fat before it can make it to the bloodstream, and not enough may make it through the thicker barrier. No other HBC is delivered this way, though, hence why it probably isn't an issue for 198lb+ women to use other forms of HBC.

[paper-machete.livejournal.com]

I think it's interesting that we're not told where the other pregnances came from? Or maybe I'm missing that part.

[bmclights.livejournal.com]

i'm going to go with the rest of them came from the women weighing less than 198 pounds, which was around 97% of the testing population, if I read that right.

[queensugar.livejournal.com]

Well, the thing is that sometimes there is no direct "cause" of pregnancy on hormonal birth control. Pregnancies can happen even despite perfect use.

[jennifer0246.livejournal.com]

Yes, the patch has been scientifically found to be less effective for women over that weight threshold. We don't have actual data as to how much the effectiveness decreases however, so it makes it hard to judge whether you feel the increased risk is comfortable for you or not.

I would encourage you to discuss with your healthcare provider the risks of being on the patch while weighing over 198, and to consider using a backup method of contraception with it, if you choose to try the patch. I also think it's worth pointing out here that the patch does have higher cardiovascular risks than other forms of contraception, and that may be a concern for you. Have you considered nuvaring as a non-pill contraceptive alternative?

[sonofawhore.livejournal.com]

I always thought that it was true because the patch has to go through the skin to get to the blood, and if there is more fat in the way, then not as many hormones get to the blood.

And about Nuvaring, I am pretty sure that it is okay for women of all sizes because it delivers the hormones directly to the body parts that need it most.

Am I completely wrong? Someone help me.

[cuteapple.livejournal.com]

I too was under the impression that the patch had a weight limit because of the thicker layer of skin and fat for the hormones to be absorbed through.

[gettogethers.livejournal.com]

I'm not sure on the patch, but I used the ring for awhile and it was easy/great.

[imnotyourstarx.livejournal.com]

ive been on the patch for almost 3 years. i love it. im about 5'5", maybe 5'6", and i weigh about 130. so far, no babies.

my friend's sister, who is about 200 lbs, got pregnant in high school while on the patch. used correctly. she now has a three year old.

so... i dont know.