Contraception in Obese Women

Journal für Reproduktionsmedizin und Endokrinologie - Journal of Reproductive Medicine and Endocrinology 2015; 12 (4): 241-245

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Today obesity is an epidemic. Within Europe the prevalence of obesity is 20–30% with a tendency to increase further. Obesity is associated with severe complications like diabetes mellitus, cardiovascular disease increased risk for venous thromboembolism (VTE) and metabolic syndrome. Especially availability of efficient methods which do not further enhance the cardiovascular and thromboembolic risk in obese women is an important point. Using contraception to prevent unwanted pregnancies is recommended to all women whatever their weight, as it reduces the risks of unplanned pregnancy, which is higher in women with overweight. Progestin-only contraceptives and IUDs have no or minimal metabolic effects and are first choices options, also it has to be taken in account that oral progestins and the implant might have lower efficacy in very obese women. CHC are associated with a higher risk for VTE in obese women,but should be used if other methods are not acceptable. A long-cycle or use of preparations with 30 mcg EE can contribute to improve efficacy.