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Womens Health (Lond). 2013 Sep;9(5):453-66. doi: 10.2217/whe.13.41.

Obesity and hormonal contraceptive efficacy.

Author information

1
Department of Gynecology & Obstetrics, Johns Hopkins University Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD 21224, USA. jrobin87@jhmi.edu

Abstract

Obesity is a major public health concern affecting an increasing proportion of reproductive-aged women. Avoiding unintended pregnancy is of major importance, given the increased risks associated with pregnancy, but obesity may affect the efficacy of hormonal contraceptives by altering how these drugs are absorbed, distributed, metabolized or eliminated. Limited data suggest that long-acting, reversible contraceptives maintain excellent efficacy in obese women. Some studies demonstrating altered pharmacokinetic parameters and increased failure rates with combined oral contraceptives, the contraceptive patch and emergency contraceptive pills suggest decreased efficacy of these methods. It is unclear whether bariatric surgery affects hormonal contraceptive efficacy. Obese women should be offered the full range of contraceptive options, with counseling that balances the risks and benefits of each method, including the risk of unintended pregnancy.

PMID:
24007251
PMCID:
PMC4079263
DOI:
10.2217/whe.13.41
[Indexed for MEDLINE]
Free PMC Article

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