{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T18:40:01Z","timestamp":1789065601207,"version":"build-2803163510"},"reference-count":63,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2013,9,1]],"date-time":"2013-09-01T00:00:00Z","timestamp":1377993600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:p> Obesity is a major public health concern affecting an increasing proportion of reproductive-aged women. Avoiding unintended pregnancy is of major importance, given the increased risks associated with pregnancy, but obesity may affect the efficacy of hormonal contraceptives by altering how these drugs are absorbed, distributed, metabolized or eliminated. Limited data suggest that long-acting, reversible contraceptives maintain excellent efficacy in obese women. Some studies demonstrating altered pharmacokinetic parameters and increased failure rates with combined oral contraceptives, the contraceptive patch and emergency contraceptive pills suggest decreased efficacy of these methods. It is unclear whether bariatric surgery affects hormonal contraceptive efficacy. Obese women should be offered the full range of contraceptive options, with counseling that balances the risks and benefits of each method, including the risk of unintended pregnancy. <\/jats:p>","DOI":"10.2217\/whe.13.41","type":"journal-article","created":{"date-parts":[[2013,9,5]],"date-time":"2013-09-05T16:29:30Z","timestamp":1378398570000},"page":"453-466","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":35,"title":["Obesity and Hormonal Contraceptive Efficacy"],"prefix":"10.1177","volume":"9","author":[{"given":"Jennifer A","family":"Robinson","sequence":"first","affiliation":[{"name":"Department of Gynecology & Obstetrics, Johns Hopkins University Bayview Medical Center, 4940 Eastern Avenue, A Building, Room 121, Baltimore, MD 21224, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne E","family":"Burke","sequence":"additional","affiliation":[{"name":"Department of Gynecology & Obstetrics, Johns Hopkins University Bayview Medical Center, 4940 Eastern Avenue, A Building, Room 121, Baltimore, MD 21224, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2013,9,1]]},"reference":[{"key":"bibr1-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181ac0544"},{"key":"bibr2-WHE.13.41","volume-title":"Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: the Evidence Report","year":"1998"},{"key":"bibr3-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1021\/js980173a"},{"key":"bibr4-WHE.13.41","volume-title":"Basic and Clinical Pharmacology","author":"Katzung BG","year":"2012","edition":"12"},{"key":"bibr5-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.01.058"},{"key":"bibr6-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2010.04.016"},{"key":"bibr7-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/0010-7824(81)90045-7"},{"key":"bibr8-WHE.13.41","volume-title":"The Pharmacologic Basis of Therapeutics","author":"Wilkinson GR","year":"2001","edition":"10"},{"key":"bibr9-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2008.02.020"},{"key":"bibr10-WHE.13.41","first-page":"45","volume-title":"Contraceptive Technology","author":"Trussell J","year":"2011","edition":"20"},{"key":"bibr11-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/0010-7824(90)90035-T"},{"key":"bibr12-WHE.13.41","volume-title":"Skyla\u00ae, package insert","year":"2013"},{"key":"bibr13-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318259565a"},{"key":"bibr14-WHE.13.41","volume-title":"Nexplanon\u00ae prescribing information","year":"2011"},{"key":"bibr15-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.05.002"},{"key":"bibr16-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/0010-7824(91)90030-J"},{"key":"bibr17-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1080\/13625180801942754"},{"key":"bibr18-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2011.03.015"},{"key":"bibr19-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/13.12.3371"},{"key":"bibr20-WHE.13.41","volume-title":"Depo-Provera\u00ae prescribing information","year":"2009"},{"key":"bibr21-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2004.01.011"},{"key":"bibr22-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2010.01.021"},{"key":"bibr23-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38706.742731.47"},{"key":"bibr24-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/0010-7824(82)90171-8"},{"key":"bibr25-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2012.05.003"},{"key":"bibr26-WHE.13.41","first-page":"249","volume-title":"Contraceptive Technology","author":"Nelson AL","year":"2011","edition":"20"},{"key":"bibr27-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2009.04.011"},{"key":"bibr28-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2010.01.016"},{"key":"bibr29-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwm221"},{"key":"bibr30-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000149155.11912.52"},{"key":"bibr31-WHE.13.41","first-page":"CD008452","volume":"7","author":"Lopez LM","year":"2010","journal-title":"Cochrane Database Syst. Rev"},{"key":"bibr32-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31820095a2"},{"key":"bibr33-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.03.017"},{"key":"bibr34-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31828317cc"},{"key":"bibr35-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2011.08.001"},{"key":"bibr36-WHE.13.41","volume-title":"Ortho Evra\u00ae Transdermal System, prescribing information","year":"2012"},{"key":"bibr37-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(01)03275-7"},{"key":"bibr38-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.18.2347"},{"key":"bibr39-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2007.01.013"},{"key":"bibr40-WHE.13.41","volume-title":"NuvaRing prescribing information","year":"2012"},{"key":"bibr41-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2010.07.008"},{"key":"bibr42-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.04.022"},{"key":"bibr43-WHE.13.41","volume-title":"Plan B prescribing information","year":"2009"},{"key":"bibr44-WHE.13.41","volume-title":"Ella prescribing information","year":"2012"},{"key":"bibr45-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2012.08.027"},{"key":"bibr46-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2011.02.009"},{"key":"bibr47-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2012.05.012"},{"key":"bibr48-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23408"},{"key":"bibr49-WHE.13.41","first-page":"1","volume":"59","author":"CDC.","year":"2010","journal-title":"MMWR Morb. Mortal. Wkly Rep"},{"key":"bibr50-WHE.13.41","volume-title":"Medical Eligibility Criteria for Contraceptive Use","author":"WHO.","year":"2010","edition":"4"},{"key":"bibr51-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1613379"},{"key":"bibr52-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2006.12.018"},{"key":"bibr53-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2007.11.012"},{"key":"bibr54-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31825194ca"},{"key":"bibr55-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2010.02.008"},{"key":"bibr56-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181ac0544"},{"key":"bibr57-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2009.06.046"},{"key":"bibr58-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-013-0882-6"},{"key":"bibr59-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2009.08.001"},{"key":"bibr60-WHE.13.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2005.04.002"},{"key":"bibr61-WHE.13.41","unstructured":"WHO. Obesity and overweight fact sheet. (2013). www.who.int\/mediacentre\/factsheets\/fs311\/en (Accessed 29 March 2013)."},{"key":"bibr62-WHE.13.41","unstructured":"Washington University, St. Louis, Missouri. The Contraceptive Choice Project. www.choiceproject.wustl.edu (Accessed 1 April 2013)."},{"key":"bibr63-WHE.13.41","unstructured":"Guttmacher Institute. Contraceptive use in the USA (2012). www.guttmacher.org\/pubs\/fb_contr_use.html (Accessed 31 March 2013)."}],"container-title":["Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.2217\/WHE.13.41","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.2217\/WHE.13.41","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.2217\/WHE.13.41","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T12:49:11Z","timestamp":1741610951000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.2217\/WHE.13.41"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,9]]},"references-count":63,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2013,9]]}},"alternative-id":["10.2217\/WHE.13.41"],"URL":"https:\/\/doi.org\/10.2217\/whe.13.41","relation":{},"ISSN":["1745-5057","1745-5065"],"issn-type":[{"value":"1745-5057","type":"print"},{"value":"1745-5065","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,9]]}}}