Body mass index does not affect the efficacy or bleeding profile during use of an ultra-low-dose combined oral contraceptive

Nakajima, Steven T.; Pappadakis, Jennifer A.; Archer, David F.

doi:10.1016/j.contraception.2015.09.013

Cited by 8 publications

(6 citation statements)

References 31 publications

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“…Most studies demonstrating an association between increasing BMI and OCP failure had significant limitations, including failing to differentiate between PK factors and behavioral factors, such as pill compliance, and use of selfreported weight remote from the time of contraceptive failure (35)(36)(37). Multiple population-level and observation studies that better controlled for exposure classification (weight, adherence) and outcome ascertainment (pregnancy) did not show a difference in effectiveness between normal weight and obese women, though many of these did not include women in the highest categories of obesity (>BMI 35 kg/m 2 ) (38)(39)(40)(41).…”

Section: Oral Contraceptive Pillsmentioning

confidence: 99%

Hormonal contraception and obesity

Simmons

Edelman

2016

Fertility and Sterility

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The rising rate of overweight and obesity is a public health crisis in the United States and increasingly around the globe. Rates of contraceptive use are similar among women of all weights, but because contraceptive development studies historically excluded women over 130% of ideal body weight, patients and providers have a gap in understanding of contraceptive efficacy for obese and overweight women. Because of a range of drug metabolism alterations in obesity, there is biologic plausibility for changes in hormonal contraception effectiveness in obese women. However, these pharmacokinetic changes are not linearly related to body mass index or weight, and it is unknown what degree of obesity begins to affect pharmacokinetic or pharmacodynamics processes. Overall, most studies of higher quality do not demonstrate a difference in oral contraceptive pill effectiveness in obese compared with non-obese women. However, data are scant for women in the highest categories of obesity, and differences by progestin type are incompletely understood. Effectiveness of most non-oral contraceptives does not seem to be compromised in obesity. Exceptions to this include the combined hormonal patch and oral levonorgestrel emergency contraception, which may have lower rates of effectiveness in obese women. The purpose of this review is to summarize evidence on contraceptive use in women with obesity, including differences in steroid hormone metabolism, contraceptive effectiveness, and safety, compared with women of normal weight or body mass index using the same methods.

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Section: Oral Contraceptive Pillsmentioning

confidence: 99%

Hormonal contraception and obesity

Simmons

Edelman

2016

Fertility and Sterility

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“…19 Most studies conducted previously have shown that obesity affects the efficacy and effectiveness of combined OCs, [20][21][22][23][24][25] but but other studies showed that obesity had no effect on COC efficacy and effectiveness. [26][27][28] Additionally some researchers have pointed out the effects of OC on ovarian cancer, polycystic ovary syndrome and cardiovascular disease. [29][30][31][32] In the Ethiopian context different researchers have extensively identified the determinant factors of overweight/obesity, [33][34][35][36][37][38][39][40][41][42] but none of them depicted the correlation between combined OC use and overweight/ obesity.…”

Section: Introductionmentioning

confidence: 99%

The association between combined oral contraceptive use and overweight/obesity: a secondary data analysis of the 2016 Ethiopia Demographic and Health Survey

et al. 2020

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ObjectivesIn this study, we aimed to assess the association between combined oral contraceptive (OC) use and overweight/obesity among Ethiopian adult women of reproductive age.Design, setting and participantsThe data were extracted from the 2016 Ethiopia Demographic and Health Survey; these data were collected from nine regions and two city administrations. We analysed the data from a total of 11 018 women aged 18–49 years who met eligibility criteria.Main outcome measuresWe employed WHO criteria to classify the body mass index of women. Specifically we tested the association between combined OC utilisation with overweight/obesity after controlling for confounding variables.ResultThe prevalence of combined OC utilisation was 1.7% and the prevalence of overweight/obesity was 8.6% among adult women of reproductive age. Use of combined OC increases the odds of overweight/obesity by two times among adult women of reproductive age after controlling for potential confounders (adjusted OR=1.902 (1.064–3.399)).ConclusionIn conclusion there is significant association between combined OC use and overweight/obesity. The findings have important implications for policymakers to design evidence based policy approachs to obesity prevention for women and at large for government to recognise the negative consequences of combined OC on women health.

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“…Amenorrhea rates with use of a COC containing EE 10 mcg and norethindrone acetate 1 mg demonstrated minimal difference in obese (50.1%), overweight (54.9%), and normal weight (54.6%) users [23]. With E4/DRSP use, missing one or more pills per cycle increased the frequency of both absence of scheduled bleeding/spotting and of unscheduled bleeding/spotting, and the pattern became less favorable when more pills were missed.…”

Section: Discussionmentioning

confidence: 96%