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

polycystic ovary syndrome PCOS oral contraception ethinyl estradiol natural estrogens progestin-only pills LNG-IUD endometrial hyperplasia androgen excess low-dose estrogen levonorgestrel intrauterine device

Studysummary This study suggests that lower-dose ethinyl estradiol formulations and progestin-only contraceptives may offer safer options for managing PCOS in obese women due to minimal metabolic effects. Our plain-language summary of this paper — not a Tressless recommendation.

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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