1 Purpose and scope

This new guideline brings together evidence and expert opinion on the provision of contraception to women who are overweight and women with obesity. This guidance is most relevant to women of reproductive age who require contraception and have a body mass index (BMI) of 25 kg/m² or higher. The guidance is intended for use by health professionals who provide contraceptive advice or contraceptive supplies for women in community and hospital settings.

Recommendations are based on available evidence and the consensus opinion of experts and the guideline development group (GDG). They should be used to guide clinical practice but are not intended to serve alone as a standard of medical care or to replace clinical judgement in the management of individual cases. A key to the grading of recommendations, based on levels of evidence, is provided on page iv of this document. Details of the methods used by the Faculty of Sexual & Reproductive Healthcare (FSRH) Clinical Effectiveness Unit (CEU) in developing this guidance are outlined in Appendix 1.

This guideline focuses on contraceptive choices for women who are overweight and women with obesity, reviews the current evidence regarding the interrelationship between contraception and weight (i.e. the effects of weight on contraceptive effectiveness and safety, and the effects of contraceptive use on weight gain) and touches on other potential considerations relating to contraception in women with raised BMI, such as contraception after bariatric surgery and during use of weight-loss medication.

For information on contraceptive choices for women who are overweight or women with obesity who have particular lifestyle risk factors, medical conditions, concomitant medication, or a history of bariatric surgery, health professionals should also refer to the UK Medical Eligibility Criteria for Contraceptive Use (UKMEC),1 British National Formulary,2 Stockley’s Drug Interactions3 and the electronic Medicine Compendium. …