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18-04-2010 | Gynaecology | Article

Lack of evidence for contraception effectiveness after bariatric surgery

Abstract

Free abstract

MedWire News: US researchers report limited evidence for the safety and efficacy of contraception after bariatric surgery, despite concerns regarding the risk for unintended pregnancy during the initial period after surgery.

Weight loss after surgery can improve menstrual regularity and fertility among women, particularly in the first 1-2 years postoperatively.

“Of particular concern are the substantial risks associated with maternal and fetal outcomes due to the nutritional effects of bariatric surgery,” explain Kathryn Curtis, from Centers for Disease Control and Prevention in Atlanta, Georgia, and colleagues.

The team conducted a systematic review of three low-quality observational studies involving women with a history of bariatric surgery and their absorption of oral contraceptives (OCs).

Two pharmacokinetic studies were also included in the review, but involved a surgical procedure which is no longer performed.

The overall results showed no substantial decrease in effectiveness of OCs. One observational study reported no pregnancies among an unspecified number of women using OCs, and another found two of nine OC-users became pregnant within 2 years of surgery. Both of these women experienced long-term diarrhea.

Curtis et al conclude that evidence on effectiveness of OC after bariatric surgery is “quite limited,” and that “evidence on failure rates for other contraceptive methods and evidence on safety for all contraceptive methods was not identified.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Sarah Guy