Hormonal contraceptives for contraception in overweight or obese women

FSRH Guideline (January 2019, amended October 2023) Combined Hormonal Contraception

“…Differences between different COC formulations could not be distinguished. A 2016 Cochrane Review110 concluded that in general the evidence identified did not indicate an association between increasing body weight or BMI and effectiveness of COC.…”

FSRH Guideline (April 2019) Overweight, Obesity and Contraception

“…There is limited evidence regarding the effect of weight on the contraceptive effectiveness of progestogen-only injectable contraception, and no studies have specifically compared DMPA-IM or NET-EN failure rates in women with obesity versus women of normal weight 58. Overall, the available evidence (summarised below) indicates that the contraceptive effectiveness of DMPA is not affected by weight or BMI.…”

“…In addition, a 2016 Cochrane Review58 concluded that in general, the evidence identified in that review did not indicate an association between increasing body weight or BMI and effectiveness of COC.…”

Not such a different world: providing contraception services in Lesotho

“…Our understanding of the effect of obesity on contraception is limited despite the high prevalence of obesity in the Western world. One trial found that the failure rate while using the combined oral contraceptive (COC) pill is higher in obese women 12. In addition, correctly fitting IUDs and performing sterilisation procedures is more difficult in extremely overweight women 13.…”