SAT-115 Oral Contraceptive Discontinuation Due To Perceived Weight Gain In Women With And Without Polycystic Ovary Syndrome: Insights From The National Survey For Family Growth

Abstract Disclosure: A. Zaman: None. K. Voss: None. M. Strawderman: None. K.M. Hoeger: None. S. Alur-Gupta: None. W.S. Vitek: None. OBJECTIVE: Polycystic ovary syndrome (PCOS) is associated with metabolic dysfunction and obesity, and oral contraceptive pills (OCPs) are commonly used both for medical management of PCOS and for contraception. In 2017, the National Survey for Family Growth (NSFG) added questions regarding PCOS diagnosis, but prevalence estimates using validated diagnostic criteria have not been reported. We aimed to validate self-reported PCOS using International Guideline criteria and assess whether discontinuation of OCPs due to perceived weight gain differs between women with and without PCOS. METHODS: We analyzed data from the 2017-2019 NSFG, including females aged 20-49 years who were not pregnant at the time of the survey. PCOS status was validated based on the 2023 International Evidence-Based PCOS Guidelines (meeting ≥2 of 3 Rotterdam criteria: oligo/anovulation, hyperandrogenism, polycystic ovaries). Discontinuation of OCPs due to perceived weight gain was assessed using survey responses. Multivariable logistic regression models were adjusted for body mass index (BMI), race/ethnicity, age, parity, marital status, education, household income, and smoking status. All reported estimates and 95% confidence intervals (95% CI) are weighted to reflect national estimates. Analyses were performed using SAS survey procedures RESULTS: Among 3,615 eligible respondents, 5.8% report PCOS and met validated diagnostic criteria. Discontinuation of OCPs for any reason occurred in 37.6% of women with PCOS (95% CI: 29.5-46.6%) and 35.1% without PCOS (95% CI: 32.2-38.1%). Weight gain was cited as a reason for OCP discontinuation by 11.4% of women with PCOS (95% CI: 5.4-17.4%) compared to 6.9% of women without PCOS (95% CI: 5.3-8.4%). After adjustment, PCOS was not significantly associated with discontinuation of OCPs for any reason (adjusted odds ratio [aOR] 1.17, 95% CI: 0.80-1.71, p=0.40) or due to weight gain concerns (aOR 1.49, 95% CI: 0.75-2.95, p=0.24). CONCLUSIONS: This is the first study to validate PCOS prevalence in a nationally-representative dataset of over 70 million U.S. women using International Guideline criteria. PCOS was not significantly associated with OCP discontinuation related to perceived weight gain, in line with findings from short-term randomized controlled trials (i.e., Ongoing Weight Loss in PCOS, Comparison of Medications for the Treatment of PCOS) showing minimal weight changes with OCP use. However, the high overall OCP discontinuation rate in the NSFG dataset highlights that perceived side effects may influence contraceptive decisions and underscores the need for contraceptive counseling that addresses these concerns. While weight-related discontinuation may be more frequently reported among women with PCOS, other factors likely contribute to discontinuation and warrant further investigation. Presentation: Saturday, July 12, 2025