Body weight and body composition of depot medroxyprogesterone acetate users

• Published in: Contraception (Stoneham) 2014-08, Vol.90 (2), p.182-187
• Main Authors: Dal'Ava, Natália, Bahamondes, Luis, Bahamondes, M. Valeria, Bottura, Bruna F, Monteiro, Ilza
• Format: Article
• Language: English
• Subjects: Abdominal Fat - drug effects; Adiposity - drug effects; Adolescent; Adult; Biological and medical sciences; Body mass; Brazil; Cohort Studies; Contraceptive Agents, Female - administration & dosage; Contraceptive Agents, Female - adverse effects; Delayed-Action Preparations - administration & dosage; Delayed-Action Preparations - adverse effects; DMPA; Dual-energy X-ray absorptiometry; Fat mass; Female; Follow-Up Studies; Genital system. Reproduction; Gynecology. Andrology. Obstetrics; Hormonal contraceptives; Humans; Intrauterine Devices, Copper - adverse effects; Lean mass; Matched-Pair Analysis; Medical sciences; Medroxyprogesterone Acetate - administration & dosage; Medroxyprogesterone Acetate - adverse effects; Middle Aged; Motor Activity; Obstetrics and Gynecology; Patient Dropouts; Pharmacology. Drug treatments; Prospective Studies; Weight Gain - drug effects; Young Adult
• ISSN: 0010-7824; 1879-0518
• DOI: 10.1016/j.contraception.2014.03.011

Abstract Objectives Weight gain is a concern with the contraceptive depot-medroxyprogesterone acetate (DMPA); however, this issue remains controversial. The objective of this study was to compare body weight (BW) and body composition (BC) in DMPA and copper intrauterine device (IUD) users at baseline and after one year of use. Study Design We enrolled new DMPA users and age and weight matched new IUD users into this prospective study. Weight and height were measured, BC (fat and lean mass) was evaluated using dual-energy X-ray absorptiometry, and physical activity was assessed at baseline and at 12 months. Student's paired t test and the Wilcoxon paired test for matched samples were used. Results Ninety-seven women were enrolled for the study; 26 matched pairs continued using the initial method for at least one year, and completed the baseline and 12 month assessments. An increase of 1.9 kg occurred in BW (p=.02) in DMPA users at 12 months of use, resulting from an increase in fat mass of 1.6 kg (p=.03). Weight remained stable in IUD users; however, there was an increase in lean mass at 12 months of use (p=.001). The number of women practicing physical activity increased in this group. There was a significant difference between the groups regarding the variation in the percentage of central fat (p=.04). Conclusion Weight gain in the DMPA group after the first year of use resulted from an increase in fat mass. Weight remained stable in the IUD group; however, an increase in lean mass and a reduction in localized abdominal fat mass occurred, possibly because more users were practicing physical activity. Implications statement There was a greater increase in body weight in DMPA users compared to TCu380A IUD users in the first year of use of the contraceptive method. Furthermore, the weight increase in users of DMPA occurred principally as the result of an increase in fat mass. Physical activity probably could increase the lean mass in the users of TCu380A IUD.