title: [Contraception and obesity].
abstract: The prevalence of obesity is increasing massively over several decades in industrialized countries. Obese women are sexually active but they use fewer contraceptive methods and are at high risk of unintended pregnancy. In addition, obesity is an important risk factor for venous thromboembolism events and arterial thrombosis (myocardial infarction and ischemic stroke). All of these data are to be considered in choosing a contraceptive method for obese women. Except depot medroxyprogesterone acetate injection, the progestin-only contraceptives (progestin only pills and etonogestrel subdermal implant) and the intra-uterine devices are the preferred contraceptive methods in obese women. The combined estrogen-progestin contraceptives (pill, patch and vaginal ring) may be proposed in very strict conditions (no other associated vascular risk factor). Obesity does not increase the risk of failure of most contraceptive methods. Bariatric surgery is a complex situation. It requires to program a possible pregnancy and contraception is needed for several months. Some bariatric surgical techniques such as by-pass can induce gastrointestinal malabsorption. In this situation, all oral contraceptives are not recommended because of a higher risk of failure.
authors.affiliation: Service de gynécologie médicale, orthogénie et médecine du couple, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugene-Avinée, 59037 Lille cedex, France; Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugene-Avinée, 59037 Lille cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Lobert
authors.affiliation: Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugene-Avinée, 59037 Lille cedex, France; Service de nutrition, hôpital Huriez, CHRU de Lille, avenue Oscar-Lambret, 59037 Lille cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Pigeyre
authors.affiliation: Service de médecine de la reproduction, hôpital Jean-Verdier, avenue du 14-Juillet, 93143 Bondy cedex, France.
authors.forename: H
authors.initials: H
authors.lastname: Gronier
authors.affiliation: Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugene-Avinée, 59037 Lille cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Catteau-Jonard
authors.affiliation: Service de gynécologie médicale, orthogénie et médecine du couple, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugene-Avinée, 59037 Lille cedex, France; Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugene-Avinée, 59037 Lille cedex, France. Electronic address: geoffroy.ROBIN@chru-lille.fr.
authors.forename: G
authors.initials: G
authors.lastname: Robin
mesh_terms: D050110:Bariatric Surgery; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D003267:Contraception / Q000009:adverse effects / Q000379:methods; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D003271:Contraceptive Agents, Female; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects; D005260:Female; D006801:Humans; D007434:Intrauterine Devices; D009765:Obesity / Q000150:complications / Q000601:surgery; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D012307:Risk Factors
chemical_list: D003271:Contraceptive Agents, Female; D003278:Contraceptives, Oral, Hormonal
keywords: Accident thromboembolique veineux; Bariatric surgery; Chirurgie bariatrique; Contraception; Deep venous thrombosis; Infarctus cérébral; Infarctus du myocarde; Ischemic stroke; Myocardial infarction; Obesity; Obésité