Zwayne Noor, Lyman Elizabeth, Ebersole Ashley, Morse Jessica
University of Texas at Austin, Dell Medical School, Department of Women's Health, Division of Pediatric and Adolescent Gynecology, Austin, TX, United States.
Nationwide Children's Hospital, Medical Library, Columbus, OH, United States.
Contraception. 2025 Jan;141:110725. doi: 10.1016/j.contraception.2024.110725. Epub 2024 Oct 11.
Understanding the relationship between contraception and body weight is an important clinical consideration. Body weight and size has the potential to affect fertility and the effectiveness of some contraceptive methods, although historically this association has not been applied within a person-centered context that would allow individuals to select their preferred contraceptive method. Further, individuals with higher body weights and larger sizes have unmet contraceptive care and counseling needs. This document aims to provide evidence-based, person-centered, and equity-driven recommendations that destigmatize contraceptive care across all body weights. Clinicians should: provide person-centered, unbiased contraceptive care, including counseling pregnant-capable individuals on their risk of pregnancy based on sexual practices and contraceptive use regardless of body weight or size; utilize evidence-based and person-centered contraceptive counseling to offer the full range of contraceptive methods regardless of body weight or size; counsel patients about any risks and benefits associated with body weight and size to assist in their selection of contraceptive methods, including emergency contraception; counsel individuals about the potential for weight change, particularly weight gain, associated with contraceptive methods as a possible factor in decision-making; and counsel individuals regarding the potential impact of weight management approaches, such as bariatric surgery and glucagon-like peptide 1 (GLP-1) agonists, on contraceptive efficacy.
了解避孕与体重之间的关系是一项重要的临床考量。体重和体型有可能影响生育能力以及某些避孕方法的有效性，尽管从历史上看，这种关联尚未在以个人为中心的背景下应用，以便个人能够选择他们偏爱的避孕方法。此外，体重较高和体型较大的个体有未满足的避孕护理和咨询需求。本文档旨在提供基于证据、以个人为中心且公平驱动的建议，消除所有体重人群避孕护理方面的污名化。临床医生应：提供以个人为中心、无偏见的避孕护理，包括根据性行为和避孕措施使用情况，向有怀孕可能的个体提供基于体重或体型的怀孕风险咨询；利用基于证据且以个人为中心的避孕咨询，提供所有避孕方法，无论体重或体型如何；就与体重和体型相关的任何风险和益处向患者提供咨询，以帮助他们选择避孕方法，包括紧急避孕；向个体咨询与避孕方法相关的体重变化可能性，尤其是体重增加，作为决策的一个可能因素；并就体重管理方法，如减肥手术和胰高血糖素样肽1（GLP - 1）激动剂，对避孕效果的潜在影响向个体提供咨询。
