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Contraceptive considerations in overweight teens

Kaneshiro, Blissa; Edelman, Alisonb

Current Opinion in Obstetrics & Gynecology: October 2011 - Volume 23 - Issue 5 - p 344–349
doi: 10.1097/GCO.0b013e328348ec82
Adolescent and pediatric gynecology: Edited by Paula J. Adams Hillard

Purpose of review: The purpose of this review is to explore the efficacy and safety of contraceptives in overweight adolescents.

Recent findings: There are few studies exploring hormonal contraceptive efficacy and safety in overweight and obese adults and almost none addressing these issues in adolescents. Luckily for teens, in terms of safety, many of the comorbidities associated with obesity are yet to transpire and their options for contraception remain relatively unrestricted. Studies of the combined oral contraceptive pill and patch in adults suggest that efficacy may be decreased in overweight adolescents. There is no evidence to suggest that the efficacy of the contraceptive implant or intrauterine device (IUD) is decreased in overweight adolescents. Indeed, these long-acting reversible methods will be the best choice for many adolescents because of their high efficacy. Although the literature is not definitive, there is probably a subset of adolescents who are susceptible to weight gain with use of depot medroxyprogesterone acetate.

Summary: Although there is little research regarding contraceptive efficacy in overweight adolescents, IUDs and implants will be the best methods for many adolescents because of their high efficacy, reversibility, and safety.

aDepartment of Obstetrics and Gynecology, University of Hawaii, Honolulu, Hawaii

bDepartment of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon, USA

Correspondence to Bliss Kaneshiro, Department of Obstetrics and Gynecology, University of Hawaii, 1319 Punahou Street #824, Honolulu, HI 96817, USA Tel: +1 808 203 6549; fax: +1 808 955 2174; e-mail: bkaneshiro@ucera.org

© 2011 Lippincott Williams & Wilkins, Inc.