Contraception - Overweight and obesity

With the overweight and obesity “epidemic” in women of reproductive ages, there are three major issues related to contraception: 1. do contraceptive methods increase weight or weight gain; 2. is contraceptive efficacy impaired in obese women; and 3. should hormonal doses be increased to maximize contraceptive efficacy in overweight women. Although a common concern and even complaint of many women, studies are inconsistent on the impact of contraception on weight gain. The prevalence of weight and oversight increases “over time.” Contraceptive studies monitor women longitudinally. So it is difficult to separate the impact of contraception from “time” itself on weight gain. There is limited evidence to support a causal association among hormonal methods. Users and non-users of contraception all tend to experience weight gain with time. Although there have been some reports of diminished efficacy with some hormonal methods with overweight and obese women, most methods are successful “enough” with more than 95% demonstrated efficacy. Because obesity itself increases the risk of venous thromboembolism there is no justification to compound this risk by increasing the contraceptive “dose” for overweight or obese women. Significantly overweight and obese women may experience greater pregnancy-associated risks.

Posted in: Contraception,Health