Pcos And Obesity: Contraception Challenges

    May 2025 in “ Open Access Journal of Contraception ”
    Błażej Męczekalski, Melissa Rasi, Christian Battipaglia, Tiziana Fidecicchi, Gregory Bala, Anna Szeliga, Stefano Luisi, Alessandro D. Genazzani
    TLDR Low-dose ethinyl estradiol and LNG-IUD are safer contraception options for obese women with PCOS.
    Polycystic ovary syndrome (PCOS) affects 5-10% of women of reproductive age, with 40-85% being overweight or obese, posing challenges for contraception. While oral contraception is the standard treatment, obesity-related conditions must be considered. Low-dose ethinyl estradiol formulations are safer for obese PCOS patients, and natural estrogens may benefit metabolic parameters. Progestin-only pills are safe for those at high risk of cardiovascular issues. Non-oral methods like patches and rings are alternatives but may lack effectiveness for androgen excess. The LNG-IUD is beneficial for contraception and endometrial protection, especially in obese women with PCOS, due to its ability to regulate abnormal bleeding and reduce the risk of endometrial hyperplasia and cancer.
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