E. Brătilă, A. Nastas, C. Mehedințu, C. Berceanu, R. Bohîlțea, M. Cîrstoiu, D.E. Comandașu, M. Mitran
Rezumat: Obesity represents a public health problem, both its
incidence and prevalence continously growing. In case
of failure of the diet and drug therapy, bariatric surgery
(restrictive, malabsorptive and mixed) becomes an option
for the treatment of severe obesity. The weight loss that
accompanies bariatric surgery can enhance fertility in
women who were subfertile because of anovulation.
Due to the rapid drop in weight during this period,
which could have negative side effects on pregnancy,
contraceptive protection is recommended at least 12-18
months postoperatively. This paper is an analysis of
post bariatric surgery contraception options, based on a
review of the literature indexed in PubMed and Cochrane
databases. The main method of contraception in patients
who have recoursed to bariatric surgery is the copper IUD
(the first option in case of emergency) or levonorgestrelreleasing
IUD. The association between the postoperative
gastrointestinal disorders (vomiting, diarrhea,
malabsorption) and microdosed oral contraceptives carries
an increased risk of unwanted pregnancy, so that oral
contraceptives are not recommended. Obesity limitates the
use of other non-hormonal methods (vaginal ring, female
condoms, diaphragms, cervical cap), due to the difficulty
of their application. The objective of this paper is to show
that there is a safe and effective contraceptive method,
customized for each individual case, while taking care not
to alter the purpose of the bariatric surgery - weight loss. Cuvinte cheie: contraception, bariatric surgery, fertility, obesity.