Higher Body Weight and Body Mass Index Are Not Associated With Reduced Efficacy in Ortho Tri-Cyclen Lo Users

Obesity and Contraception: Emerging Issues

“…Most other data have not found an increased risk of pill failure in obese women. [21][22][23][24][25] Trussell et al reviewed studies examining contraceptive efficacy in obese women and with the exception of the studies just mentioned, obesity conferred no increased risk of failure. 26 Two of the eight studies were prospective clinical trials, and the others were analyses of existing databases.…”

“…The two clinical trials had measured body weights and were able to confirm that there was no increased risk of failure with OC use in women either overweight or obese. 21,22 A recent study looking at the impact of obesity on the pharmacokinetics of OCs suggests that the ability to reach steady state of hormone levels is decreased in obese women. It may take 3 to 5 days longer for hormone levels in obese women to achieve the steady state levels necessary to allow for hypothalamic pituitary ovarian inhibition.…”

Obesity and oral contraceptive pill failure

“…Duration of OCP use can be correctly handled in life-table analyses; women enter the analysis in the month they start using OCPs and the trial design could exclude women switching directly from use of another OCP. In one trial, Zhang and colleagues found no significantly elevated pregnancy risk for OCP failure among higher weight or obese women using Ortho Tri-Cyclen Lo [27] either in an analysis that counted all failures or in an analysis limited to pregnancies that occurred in a cycle when no active pills were missed. However, this latter analysis included in the denominator cycles with imperfect use that did not result in pregnancy, and thus it is not a true analysis of rates of failure with perfect OCP use.…”

Journal Reviews: Oral Contraceptives Do Not Appear to Be Less Effective Among Obese Women, but Existing Studies Are Imperfect

“…Clinical trials with stronger designs, currently in progress, are expected to offer advantages over previous studies because newer studies follow participants prospectively, measure height and weight instead of relying on self‐report, and have statistical methods, such as life‐table analyses, that can better report duration of OC use. One study in progress has, to date, reported no increased risk of pregnancy among obese women using low‐dose combined OCs, specifically nor‐gestimate/ethinyl estradiol (Ortho TriCyclen Lo) 3 …”