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Contraception - Management
How does obesity influence choice?

  • Body mass index >= 30–34 kg/m2
    • Methods that can be used without restriction: progestogen-only pill, progestogen-only injectables and implants, copper intrauterine devices (IUDs), the levonorgestrel-releasing intrauterine system (IUS), barrier methods, and natural family planning.
    • Methods that can generally be used (advantages generally outweigh the risks): combined oral contraceptives (COCs), combined contraceptive patch, combined contraceptive vaginal ring.
    • Sterilization can be used with caution (i.e. extra preparation, precautions, and counselling).
    • There are no methods that should not be used (because of unacceptable risk).
  • Body mass index >= 35 kg/m2
    • Methods that can be used without restriction: progestogen-only pill, progestogen-only injectables and implants, copper IUDs, the levonorgestrel-releasing IUS, barrier methods, and natural family planning.
    • Sterilization can be used with caution (i.e. extra preparation, precautions, and counselling).
    • Methods that are not usually recommended (risks usually outweigh the advantages): COCs, combined contraceptive patch, combined contraceptive vaginal ring.
  • In addition, note that:
    • Weight greater than 70 kg — the desogestrel-only pill, Cerazette®, should be considered in preference to other progesterone only pills.
    • Weight greater than 90 kg — the combined contraceptive patch should not be used.
    • 'Heavier women' — the progestogen-only contraceptive implant may need to be removed earlier than the licensed 3 years.

In depth

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