open access

Vol 87, No 8 (2016)
REVIEW PAPERS Gynecology
Published online: 2016-08-31
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The use of contraception for patients after bariatric surgery

Lucyna Ostrowska, Medard Lech, Ewa Stefańska, Marta Jastrzębska-Mierzyńska, Joanna Smarkusz
DOI: 10.5603/GP.2016.0050
·
Pubmed: 27629135
·
Ginekol Pol 2016;87(8):591-593.

open access

Vol 87, No 8 (2016)
REVIEW PAPERS Gynecology
Published online: 2016-08-31

Abstract

Obesity in women of reproductive age is a serious concern regarding reproductive health. In many cases of infertility in obese women, reduction of body weight may lead to spontaneous pregnancy, without the need for more specific methods of treatment. Bariatric surgery is safe and is the most effective method for body weight reduction in obese and very obese patients. In practice there are two bariatric techniques; gastric banding, which leads to weight loss through intake restriction, and gastric bypass, leads to weight loss through food malabsorption. Gastric bypass surgery (the more frequently performed procedure), in most cases, leads to changes in eating habits and may result in vomiting, diarrhea and rapid body mass reduction. There are reliable data describing the continuous increase in the number of women who are trying to conceive, or are already pregnant, following bariatric surgery. Most medical specialists advise women to avoid pregnancy within 12–18 months after bariatric surgery. This allows for time to recover sufficiency from the decreased absorption of nutrients caused by the bariatric surgery. During this period there is a need for the use of reliable contraception. As there is a risk for malabsorption of hormones taken orally, the combined and progestogen-only pills are contraindicated, and displaced by non-oral hormonal contraception or non-hormonal methods, including intrauterine devices and condoms.

Abstract

Obesity in women of reproductive age is a serious concern regarding reproductive health. In many cases of infertility in obese women, reduction of body weight may lead to spontaneous pregnancy, without the need for more specific methods of treatment. Bariatric surgery is safe and is the most effective method for body weight reduction in obese and very obese patients. In practice there are two bariatric techniques; gastric banding, which leads to weight loss through intake restriction, and gastric bypass, leads to weight loss through food malabsorption. Gastric bypass surgery (the more frequently performed procedure), in most cases, leads to changes in eating habits and may result in vomiting, diarrhea and rapid body mass reduction. There are reliable data describing the continuous increase in the number of women who are trying to conceive, or are already pregnant, following bariatric surgery. Most medical specialists advise women to avoid pregnancy within 12–18 months after bariatric surgery. This allows for time to recover sufficiency from the decreased absorption of nutrients caused by the bariatric surgery. During this period there is a need for the use of reliable contraception. As there is a risk for malabsorption of hormones taken orally, the combined and progestogen-only pills are contraindicated, and displaced by non-oral hormonal contraception or non-hormonal methods, including intrauterine devices and condoms.

Get Citation

Keywords

obesity, operative techniques, bariatrics, contraceptive methods, hormones

About this article
Title

The use of contraception for patients after bariatric surgery

Journal

Ginekologia Polska

Issue

Vol 87, No 8 (2016)

Pages

591-593

Published online

2016-08-31

DOI

10.5603/GP.2016.0050

Pubmed

27629135

Bibliographic record

Ginekol Pol 2016;87(8):591-593.

Keywords

obesity
operative techniques
bariatrics
contraceptive methods
hormones

Authors

Lucyna Ostrowska
Medard Lech
Ewa Stefańska
Marta Jastrzębska-Mierzyńska
Joanna Smarkusz

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