The Faculty of Sexual and Reproductive Healthcare (FSRH) has issued new guidelines to clarify safe and effective contraceptive options for women who are overweight or obese.
The new guidance reviews the impact of weight on contraceptive effectiveness and safety as well as the effect of contraceptive use on weight. It also considers contraceptive use in relation to medical and surgical interventions for weight loss.
Currently it is estimated that over half of the women in the UK are overweight or obese, and obesity rates continue to rise among women of reproductive age.
Key recommendations include:
- For women with a body mass index (BMI) 35kg/m2 or greater, the potential risks associated with use of combined hormonal contraception (CHC) generally outweigh the benefits
- Past concerns that women with raised weight or BMI would require a double dose of progestogen-only pills, early DMPA injections or early replacement of the contraceptive implant are refuted; the evidence indicates that the effectiveness of these methods is not affected by body weight or BMI
- Oral emergency contraception (EC), particular levonorgestrel 1.5mg, could be less effective for women who are overweight or obese. The effectiveness of the copper intrauterine device is not affected by body weight or BMI: this is the most effective method of emergency contraception
- Women should be advised that the effectiveness of oral contraception, including oral EC, could be reduced during use of weight loss medications or after bariatric surgery. Where possible, these should be avoided in favour of non-oral methods.
Read our Guidelines in a Nutshell summary here
FSRH Clinical Guideline: Overweight, Obesity and Contraception
https://www.fsrh.org/standards-and-guidance/documents/fsrh-clinical-guideline-overweight-obesity-and-contraception/
