What birth control is best if I’m plus size?

For people in larger bodies, there are additional factors to consider when choosing a contraceptive method. Studies have shown that plus size women are at an increased risk for a number of side effects from birth control. A leading risk is venous thromboembolism, also known as VTE. This happens when blood clots form in your veins. There are a few birth control methods that increase the risk of VTE, including combination birth control pills (progestin and estrogen), the patch, and the ring. A heavier weight does not rule out these options, but we strongly recommend talking through any concerns you may have with your health care provider. 

The safest and most effective birth control choices for plus size women include: 

• Progestin-only birth control pill

• IUD

• Nexplanon arm implant

• Condoms

Luckily, the progestin-only birth control pill, Opill, was recently approved by the FDA for over-the-counter use. This makes it one of the most accessible options because you don’t need a prescription to get it! For answers to all of your Opill questions, check out this Q&A with a doctor. Estrogen is the component in the combination pill that leads to VTE. By taking a progestin-only pill, you minimize this risk. The only thing to note is that this pill must be taken at the same time every day to be most effective.

Implants like IUDs and the arm implant, also known as Nexplanon, are safe and effective forms of birth control for bigger bodies. No estrogen, no problem! Copper IUDs don’t contain hormones, while hormonal IUDs, like Mirena, are progestin-only. The Implant uses only progestin to prevent pregnancy. 

And, of course, condoms. With proper use, condoms are safe and effective for all bodies. Condoms prevent pregnancy (and STIs!) with their barrier method. BTW, if you’re in college hit us up for free condoms!

Does the morning-after pill have a weight limit?

If you weigh over 165 lbs, over the counter morning-after pills may not be as effective, and you may want to consider the prescription morning-after pill, ella®. If you have concerns about whether the morning-after pill is right for you, always reach out to your health care provider

While everyone — at any weight — should be able to use the morning-after pill and trust that it will work effectively, we know that this isn’t the reality.

No matter your weight, getting certain IUDs as emergency contraception works within 120 hours (5 days) after having unprotected sex. This is the most effective type of emergency contraception. An IUD must be inserted by a health care provider.

Doctors, nurses, and other resources

We always recommend talking with your doctor or nurse about which birth control option might be best for you. This is why it’s essential that you have a trusted health care provider who listens to you. Unfortunately, both medical weight bias, racism, and medical misogyny are common. Medical misogyny is the tendency of medical professionals to believe, consciously or unconsciously, that women, as compared to men, are inaccurate and unreliable reporters of their own symptoms. Medical professionals also may ignore health issues and attribute the problems to weight. 

If your doctor isn’t listening to you, there are steps you can take to find another provider. Ask your friends and family if they have a someone they like and feel comfortable with. Use your insurer’s website or public review websites like Zocdoc to see how other patients feel about providers in your area. Use services like iCareBetter to find vetted specialists, if necessary. You can also search for additional information from reputable sources, such as peer-reviewed medical journals or trusted organizations like the International Society for the Study of Women’s Sexual Health. 

Additionally, speak with your community. We live in a world where information and experiences are available at the touch of a button, or the scroll of a smartphone. Platforms like Reddit can be a good place to learn about others' experiences with birth control in larger bodies. A quick peruse of this thread reveals hundreds of plus size people sharing what contraceptive method worked best for them. 

The National Library of Medicine published a study that concluded, “our findings suggest that women in larger bodies have unmet contraceptive needs.” More research is needed on sexual health and birth control for larger bodies. In the past 10 years, obesity in the US has increased over ten percent. This makes it more important than ever to understand the effects of birth control on all bodies, and develop options that work for everyone.

The fact that birth control and sexual health look different in a larger body should not be some dark hidden secret. In fact, it should be the opposite. Education begets empowerment. When we equip ourselves with the knowledge, we can make the best decisions for our personal health.

Please note: The information provided in this article is strictly for informational purposes and is not intended as a substitute for advice from your physician. You should not use this information for diagnosis or treatment of any health problem or for prescription of any medication. You should consult with a health care professional if you have or suspect you might have a health problem.