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

[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.