Bigger Ladies, Your Reproductive Choices May Be Limited

The condom broke, you skipped a pill, or you just had a little too much to drink. There are dozens of reasons, but whatever yours may be, you need a morning after pill. It’s a decision women all over the world have to make everyday.

But if your BMI is over 26, you may want to really re-evaluate your options. And unfortunately, the bigger your curves, the fewer options you have.

What You Need to Know

In recent years, there has been an emergence of disconcerting findings with emergency contraceptive pills. Research by Ana Glasier, a professor at the University of Edinburgh, shows that obese women are three times as likely than their smaller counterparts to get pregnant after taking emergency contraceptives.

In Europe, some action has been taken. HRA Pharma, a company specializing in pharmaceuticals for women, requested permission from the European Union to update its product information. If you were to buy a box of Novela (the leading brand of emergency contraceptive pills, or ECP, in Europe) right now and were to read the accompanying leaflet, you would find that it is not recommended for women weighing over 75 kg, or roughly 165 pounds.

So what’s the deal here in the States? The FDA is currently reviewing information before making a formal recommendation (and has been since late 2013). In the meantime, that means no company is forced to give consumers a warning, and women could continue to make ill-informed decisions about their bodies and futures.

Considering the average weight of the American woman was 166.2 pounds in 2010, and over 36% of American women are clinically obese, it’s reasonable to expect that Teva Pharmaceuticals, the manufacturer of Plan B, the leading ECP in the U.S., take the same initiative as HRA Pharma. But HRA Pharma is also the company behind Ella, an ECP which is purportedly effective for women with a BMI of up to 35, due to a different chemical make-up than most ECPs.

In simpler terms: HRA Pharma can still serve a product to larger women. But Teva Pharmaceuticals doesn’t have a product that can compete.

It may be conspiratorial, but it’s still fair to assume that Teva won’t be taking any action unless they are forced to. Since the FDA doesn’t allow generic drug manufacturers to make product information changes, that means other ECP manufacturers can’t update their leaflets with warnings about weight and effectiveness unless Teva does.

Your Emergency Contraceptive Options

If you’re a woman with a BMI between 26 and 35, your best bet would be to take Ella. Ella is a prescription medication, so if you can’t get an appointment with your doctor immediately, try an online pharmacy (you can verify these websites on https://www.legitscript.com) or go to your local Planned Parenthood. Remember that Ella is effective within 5 days of contraceptive failure, but most effective within 72 hours (and even more effective within 24).

If your BMI is over 35, the best option is unfortunately not one that’s commonly available to all women. Inserting an IUD is over 99% effective in preventing an unwanted pregnancy, but unfortunately, most gynecologists require that a patient be tested for STDs and pregnancy before scheduling the necessary appointment, which will, of course, pass the limited window of time in which a women has to prevent pregnancy.

Gynocologists should really consider each patient’s individual history and risk before denying them this service. But until they do, or a better option is available for bigger women on the market place, plus-size ladies should be aware that their reproductive options are not the same as their skinnier friends, and should focus on preventative methods.

Call to Action 

We need a discussion about IUDs as emergency contraceptives, and we need to pressure the FDA to complete their review and issue a statement already. The European Medicines Agency has decided that ECPs are effective for women of all weights, but it also acknowledges that emergency contraceptives should continue to include information concerning study results and reduced effectiveness in heavier ladies.

Also, let Teva Pharmaceuticals know your concern; more studies need to be done on the issue, and we should demand transparency with our contraceptive options. And if shouting at Big Pharma on social media isn’t your thing, at least pass the information along — the less women in the dark, the better.

Header image credit: Vix/Flickr