Contraceptive options for overweight women

Unplanned pregnancies carry extra health risks for obese women. In a 2005 study, researchers found that overweight women (BMI 25-29.9) had increased risks of diabetes, hypertension, pre-eclampsia, and cesarean delivery, with even higher risks for obese women (BMI 30 and above).1

What are some birth control options for these women outside of oral contraceptives? Look at methods with high levels of effectiveness, such as the contraceptive injection depot medroxyprogesterone acetate (DMPA, Depo-Provera, Pfizer, New York City) and the intrauterine device.2 DMPA use reduces uterine bleeding in obese women and offers protection against endometrial hyperplasia.3 In the case of intrauterine devices, research indicates that the Copper T 380A (ParaGard IUD, Barr Pharmaceuticals, Pomona, NY) and nonmedicated intrauterine devices are associated with a reduced risk for endometrial cancer.4

The levonorgestrel intrauterine system (Mirena IUS, Berlex Laboratories, Montville, NJ) may represent an especially appropriate contraceptive choice for heavy women.2 It provides a high level of contraception and also protects the endometrium from the harmful effects of long-term estrogen excess related to obesity.5

References

  1. Rode L, Nilas L, Wojdemann K, et al. Obesity-related complications in Danish single cephalic term pregnancies. Obstet Gynecol 2005; 105:537-542.
  2. Grimes DA, Shields WC. Family planning for obese women: Challenges and opportunities. Contraception 2005; 72:1-4.
  3. Connor PD, Tavernier LA, Thomas SM, et al. Determining risk between Depo-Provera use and increased uterine bleeding in obese and overweight women. J Am Board Fam Pract 2002; 15:7-10.
  4. Hubacher D, Grimes DA. Noncontraceptive health benefits of intrauterine devices: A systematic review. Obstet Gynecol Surv 2002; 57:120-128.
  5. Bahamondes L, Ribeiro-Huguet P, de Andrade KC, et al. Levonorgestrel-releasing intrauterine system (Mirena) as a therapy for endometrial hyperplasia and carcinoma. Acta Obstet Gynecol Scand 2003; 82:580-582.