Although those increases in serious side effects are real, Dr. Trussell said that they are not as clinically significant as some fear.
According to the World Health Organization Medical Eligibility Criteria, combined hormonal contraceptives are given a rating of 1 (no restrictions on use) for women with BMIs less than 30 kg/m
The version of these Medical Eligibility Criteria adopted in the United Kingdom, on the other hand, give a rating of 3 (risks generally outweigh benefits) for women with BMIs between 35 and 39, and a rating of 4 (unacceptable risk) for women with BMIs of 40 and above, said Dr. Trussell, who also is the John Foster Dulles Professor in International Affairs and Professor of Economics and Public Affairs at Princeton.
A study of OC safety in women with a BMI over 40 has never been done. There's only one study in the literature of women in the BMI category of greater than or equal to 35. The WHO ratings have a firmer evidence base than the U.K. ratings, according to Dr. Trussell.
Dr. Trussell stated that he had no conflicts of interest related to his presentation.
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