Hi all,

I have moved to the UK from Canada and the time has come for me to renew my Nuvaring. I have been on the ring for 3 years now with no problems and it really works for me.

I went into a clinic in London and had a little exam and I was approved for the ring in all areas (including family history, blood pressure, non-smoker etc) except for my weight/BMI… The nurse told me that because my BMI was at 35 (and my weight is 220 lbs, 5’7″, I’m about a 14/16 US in clothing just for further measure), she can’t give me the Nuvaring because it “massively increases” my chance for blood clots.

My question is, how true is this? I’ve read studies that say the ring is BETTER for overweight and obese women and I can’t find anything to back up that it is worse, let alone massively worse, as far as blood clots. Basically, I am just curious if anyone in the UK thinks I’ll have this problem at another clinic? Or if anyone (UK or not), knows anything more about this blood clot issue? I was recommended an IUD/Mirena but I’m not ready to take the plunge just yet but I’m also running low on time to start new BC. Of course, if it is something I shouldn’t ignore, I’ll look into new methods, but otherwise I’d like to stay on the ring!

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13 Responses to Nuvaring & BMI/Weight

  1. 240Nobody says:

    I’ve been using the Nuvaring for close to 9 years now and am obese – 5’3″ and 225 lbs. I’ve had it prescribed by a number of different practitioners who did let me know of the blood clot risk but stated that since I’d been using it for as long as I have with no blood clots it was pretty safe to assume it wasn’t dangerous. I’ve heard they won’t prescribe it if you’re obese with a family history of blood clots, but it seems odd that she wouldn’t prescribe it for you given that you’ve been taking it for 3 years with no complications.

  2. Dekdy says:

    According to the World Health Organization’s Medical Eligibility for Contraceptive Use (links to big PDF), a BMI of 30 or more is a Category 2 condition for combined contraceptives. “Category 2” basically means “the advantages outweigh the theoretical or proven risks.” In this case, while people with a BMI of 30 or more who take combined-hormone contraceptives do have an increased risk of blood clots compared to people with a BMI of 30 or greater who don’t use estrogen-containing BC, the absolute risk is still low.

    Bottom line? If it were me (and actually, your personal stats and BC situation are pretty similar to my own), I’d seek a second opinion if possible. The risk does exist, but the WHO literature suggests it’s much smaller than the way your nurse framed it.

  3. SguTuT says:

    I agree. I’d definitely seek a second opinion on any doctor or nurse that bases something on your BMI alone, especially considering the BMI scale is well known by now to be complete crap! It was never meant to be used for an individual (only as a population estimate of weight), but everyone started using it for individuals because it was convenient. So many factors contribute to your individual BMI that have nothing to do with fat content, including muscle mass, which will totally throw it off.

  4. 008msk says:

    Yeah I actually got ticked that she used BMI as her medical reasoning! Thanks for the advice!

  5. 008msk says:

    Great, thank you very much, this is reassuring for me. I didn’t think it was exponentially worse and I was quite surprised that I had NEVER heard that the risks were that bad when they gave it to me back at home.

  6. 642ova says:

    yup. and also, if the alternative to using estrogen-containing contraception is pregnancy, it should be pointed out that pregnancy carries a significantly greater risk of cardiovascular events like clots.

    (not that one must be pregnant if not using estrogen-containing BC, but still)

  7. 008msk says:

    Yeah if this is the case it seems really ridiculous (and discriminatory, perhaps) that they will not give me the method that works. The nurse made a few choice comments about how maybe this would be “what it takes for me to lose weight” and stuff as well.

  8. Remoma says:

    I get that doctors want to promote us to be healthy, but that’s just rude. Maybe by refusing you birth control and making it much more likely for you to get pregnant will motivate you to lose weight? And what do they know? How do they know you haven’t already lost 50 pounds? That’s just infuriating to me. Reminds me of how my dad brings up my weight EVERY time he sees me and completely ignores the fact that I’ve lost 20 pounds. Because, you know, 20 pounds is nothing if you need to lose 100. Also, while I’m not on NuvaRing, I have used (with no arguments from my doctor) various pills that are considered to have increased blood clot risk, etc. I think you should look for a new doctor.

    Edited to add: For some reason I thought it said you moved to the US. I don’t know anything about the UK, so maybe that’s more common practice over there. 🙁 I’m sorry you’re having to deal with this.

  9. 008msk says:

    Thanks for the comment, yeah, it’s definitely something that pisses me off about over here. The clothing sizes are impossible too, sometimes a US 8 is the smallest size in a PLUS SIZE store.

    And yeah I found out when she weighed me that I’d lost 10lbs in the last six weeks and I was pleased! Your comment totally reassures all of my sentiments and yeah, I’ll be looking somewhere new.

  10. Hybody says:

    This seems to be common practice in the UK. I moved here from South Africa (and switched from Yasmin to Mercilon) and when I went to get it renewed last month the nurse weighed me and said my BMI was over 30 and if I didn’t make an effort to lose weight I’d have to go on the mini-pill. Thankfully she still gave me a refill! Good luck getting a second opinion.

  11. AetFire says:

    i know someone quoted the WHO, but i’m in the US and have been prescribed multiple types of birth control, including nuva ring, while being in various states of obesity. i never had any problems and know a lot of women who haven’t either. i hope you can find someone willing to give it to you.

  12. 008msk says:

    Me too! It seems kind of ridiculous to not be given it when it works for me and the reasoning is over an arbitrary scale… grr

  13. LadZero says:

    I suspect in some areas, NHS staff are currently a bit over-anxious to try and talk people out of combined pills/POP/NuvaRing and talk them into using some sort of long-acting reversible contraceptive. I get the impression that there’s some sort of drive to get as many uterus-owning patients using LARC as possible and therefore if they can provide reasons why said person “shouldn’t” be using another method, they’ll jump on it and use it as a sell for something else. But it sounds as if that nurse was overselling the risks versus benefits, perhaps, and if it’s a method that works for you it’s probably worth the prescribing person taking a more considered approach! I’d agree that it might be worth at least calling up a couple of places and asking their policy on it.

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