Obesity and Contraception

Reported October 28, 2011
By Ivanhoe Health Correspondent Melissa Colon

(Ivanhoe Newswire) -- Birth control is made as a one dose fits all. According to recent statistics, 66 percent of U.S adults are overweight or obese. Women are included in the 66 percent, and aside from being at a higher risk for chronic medical conditions, certain contraceptives may have certain set backs.

“When we think about contraceptive use in women of different BMI’s there are really two issues that we need to address, the first one is contraceptive efficacy is different in women of different BMI’s and the second is whether certain contraceptives are unsafe in obese or overweight women,” stated Bliss E. Kaneshiro, M.D, M.P.H, Oregon Health and Science University.

However, few studies have actually explored contraception in obese women because historically women who are above 130 percent body weight are typically excluded from the studies therefore the effectiveness of contraceptives in obese women is not fully known.

“There is no BMI specific data for contraceptive patch or contraceptive ring in terms of safety,” said Kaneshiro.

In terms of safety, blood clots are a major concern, in which obese women are at a higher risk.

Another choice for contraceptive is an IUD, intrauterine device. There is no published data to suggest risks of insertion or its use is higher in obese women. However, there are reports of technical challenges and a need for additional equipment, such as longer speculums or beds with the ability to carry more weight.

As far as using Depo Provera, a birth control shot, a longer needle may need to be used to inject the medication through the intramuscular layer. Obese teens may also have an increased risk for added weight gain.

In general, when looking at the effectiveness of birth control, one has to look at how well the patient is compliant with the contraceptive, the continuation rate, how fertile they are, and how often they have sex.

“What we know about obese women is that basically their compliance rates appear to be no different from the information we have, although we don’t have great information about compliance rates,” said Alison B. Edelman, M.D, Oregon Health and Science University. The little data that is available shows that obese women have about the same continuation rate as other women.

Edelmen still suggested that the use of contraceptives is better than no use of a contraceptive.

“Traditionally, you know, hormonal methods and anything that is contraception is a one dose fits all, and I don’t know about you guys one size fits all doesn’t often fit me,” said Edelmen.

SOURCE: American Society for Reproductive Medicine Conference, Orlando, Florida