Use of levonorgestrel as emergency contraception in overweight women

Objective: Levonorgestrel (LNG) emergency contraception (EC) may have decreased efficacy for women with body mass indices (BMI) >= 26 kg/m(2). This study aims to evaluate the prevalence of LNG EC use and EC counseling among overweight women. Methods: The 2013-2015 dataset from the National Survey of Family Growth was analyzed to determine the proportion of women with BMI >= 26 kg/m(2) who report recent use of LNG EC and EC counseling. Results: Overall, 2.4% of respondents reported recent use of LNG EC. Among women using oral LNG for EC, 29.8% of survey participants reported BMI >= 26 kg/m(2). Additionally, 40.2% of women with BMI >= 26 kg/m(2) using oral LNG EC reported having a doctor or medical provider talk to them about emergency contraception within the last 12 months, compared to 18.3% of LNG EC users with BMI < 26 kg/m(2) (p < 0.001). Conclusions: Despite recent counseling from clinicians and concerns for decreased efficacy, a significant number of overweight women continue to use LNG for EC. Clinicians should counsel women with BMI >= 26 kg/m(2) on the potential limitations of oral LNG for EC and offer more effective EC methods, including the copper intrauterine device and oral ulipristal acetate. (C) 2019 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.