New Section publication discusses reproductive counseling and weight-loss surgery

Women of reproductive age often pursue weight-loss surgery; in fact, they account for nearly half of all bariatric surgery patients. The relationship between reproduction and rapid weight loss has been well documented and includes an increased risk of infertility, menstrual irregularities, and changing sexual function. Women who receive bariatric surgery are also more likely to have an unplanned pregnancy. Because of these reproductive risks, the American Society for Metabolic and Bariatric Surgery recommends using effective birth control methods when experiencing rapid weight loss and the American College of Obstetricians and Gynecologists recommends delaying pregnancy one to two years after bariatric surgery.

Yet, according to one survey, 31 percent of female bariatric surgery patients planned to become pregnant after obtaining surgery, and nearly one-third planned to do so within two years. These intentions, as well as contraceptive efficacy following weight loss, warrant close collaboration between bariatric surgeons and women’s health providers.

Section faculty Dr. Julie Chor conducted a national survey of bariatric surgeons to assess perioperative reproductive counseling and contraceptive provision. Her findings were published in Surgery for Obesity and Related Diseases.

http://www.soard.org/

Image courtesy of http://www.soard.org

The study found that 74% of bariatric surgeons preoperatively screen patients regarding contraceptive use more than 50% of the time. The most common method prescribed, however, were oral contraceptive pills, which may have decreased efficacy in the obese and in the postoperative state, depending on the type of surgery.

Most respondents (90 percent) recommended delaying pregnancy 12 to 24 months, yet 84% did not require a gynecologic consultation for female patients of reproductive age and 35% further stated that they did not know how their patients obtained contraception.

One-fifth of respondents did not assess their patients’ pregnancy intentions. This disparity suggests that practitioners should counsel patients preoperatively about reproductive changes that can occur after weight loss from bariatric surgery as well as discuss contraception with all women of reproductive age, whether or not they desire a future pregnancy.

Dr. Chor’s findings suggest implementing a routine gynecology consultation for female bariatric surgery patients prior to an operation. These women would greatly benefit from increased education on fertility changes associated with weight loss and on highly effective methods of contraception, such as intrauterine devices and contraceptive implants.

Read the full article here.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: