Obese women who use IUDs and other birth control methods containing the hormone progestin run a greater risk of developing type 2 diabetes than those using other forms of contraception.
The findings, by researchers at the Keck School of Medicine of the University of Southern California, are the first to flag so-called progestin-releasing LARC devices — short for “long-acting reversible contraception” — such as intrauterine devices (IUDs) and those implanted under the skin.
The six-month Keck study tracked three groups of obese women, one of which used non-hormonal birth control methods (such as condoms, the copper IUD, and female or male sterilization), and two others who used LARC devices implanted in the uterus (IUD) or under the skin.
"All three methods were found to be safe and effective, and they did not create changes in blood pressure, weight, or cholesterol," said Penina Segall-Gutierrez, an assistant professor of clinical obstetrics and gynecology who helped conduct the study. "However, there was a 10 percent increase in fasting blood-glucose levels among the skin implant users, compared to a 5 percent increase among the IUD users and a 2 percent decrease among those using non-hormonal methods. The effects on sensitivity to insulin showed a similar trend.”
The research, published online in the journal Contraception, concludes that progestin-based birth control is largely safe for use by all women, but needs further investigation.
"Contraceptive studies often only look at normal-weight women," said Segall-Gutierrez. "Studies such as this are necessary because, today, one-third of women in the U.S. are overweight and one-third are obese. All women, including overweight and obese women, need to have access to safe and effective contraception."
Obese women are sometimes warned by their doctors not to use contraceptives containing estrogen, such as the pill, patch, and vaginal ring, she added.
"[Those choices] raise the risk for blood clots," Segall-Gutierrez said. "So they need other, viable alternatives. The implanted LARC devices last three to 10 years, are easily reversible, and women don't have to remember to do anything with them, in contrast to the birth-control pill."
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