Obesity and hormonal contraceptive efficacy
Jennifer A Robinson1, Anne E Burke
1Department of Gynecology & Obstetrics, Johns Hopkins University Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD 21224, USA. jrobin87@jhmi.edu
Women'S Health (London, England)
|September 7, 2013
Summary
Obesity in women impacts hormonal contraceptive effectiveness. Long-acting reversible contraceptives appear effective, but other methods may have reduced efficacy, requiring careful counseling for family planning.
Area of Science:
- Reproductive Health
- Endocrinology
- Public Health
Background:
- Obesity is a growing public health issue impacting women of reproductive age.
- Pregnancy in obese women carries increased health risks, making effective contraception crucial.
- Obesity may alter the pharmacokinetics of hormonal contraceptives, potentially affecting their efficacy.
Purpose of the Study:
- To review the efficacy of various hormonal contraceptive methods in obese women.
- To identify contraceptive methods with potentially altered efficacy due to obesity.
- To inform counseling for family planning in reproductive-aged women with obesity.
Main Methods:
- Literature review of studies examining contraceptive efficacy in obese women.
- Analysis of pharmacokinetic data related to hormonal contraceptives and obesity.
- Synthesis of evidence on the effectiveness of different contraceptive types.
Main Results:
- Long-acting reversible contraceptives (LARCs) demonstrate sustained high efficacy in obese women.
- Combined oral contraceptives, contraceptive patches, and emergency contraceptive pills may have reduced efficacy.
- Data on the impact of bariatric surgery on hormonal contraceptive efficacy remain limited.
Conclusions:
- Obese women should have access to all contraceptive options.
- Counseling should address the specific risks and benefits of each method for obese individuals.
- Balancing contraceptive efficacy and unintended pregnancy risk is essential for family planning.
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