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Combination contraceptives: effects on weight.

Maria F Gallo1, Laureen M Lopez, David A Grimes

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Concerns about weight gain with combination contraceptives are common, but current evidence is insufficient to establish a causal link. Most studies show no significant weight changes or differences between contraceptive types.

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Area of Science:

  • Reproductive Health
  • Pharmacology
  • Evidence-Based Medicine

Background:

  • Weight gain is a frequently perceived side effect of combination hormonal contraceptives.
  • This perception can negatively impact contraceptive choice and adherence.
  • However, a definitive causal relationship between combination contraceptives and weight gain remains unproven.

Purpose of the Study:

  • To systematically review and evaluate the potential association between combination contraceptive use and changes in body weight.
  • To synthesize evidence from randomized controlled trials to clarify the impact of these contraceptives on weight.

Main Methods:

  • Comprehensive literature search of multiple databases (e.g., Cochrane Library, MEDLINE, EMBASE) and clinical trial registries up to November 2013.
  • Inclusion of English-language randomized controlled trials (RCTs) with at least three treatment cycles comparing combination contraceptives to placebo or other combinations.
  • Statistical analysis using fixed-effect models for mean weight difference and Peto odds ratios for categorical weight changes.

Main Results:

  • Analysis of 49 trials involving 85 weight change comparisons.
  • Four trials with placebo or no intervention groups found no evidence of a causal link between combination contraceptives and weight change.
  • Most comparisons between different combination contraceptives revealed no substantial weight differences, and discontinuation rates due to weight change were similar across groups.

Conclusions:

  • Current evidence is insufficient to definitively establish the effect of combination contraceptives on weight, though no large effect is apparent.
  • Future trials investigating combination contraceptives and weight change should include placebo or non-hormonal control groups to account for confounding factors.