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Progestin-only contraceptives: effects on weight.

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The Cochrane Database of Systematic Reviews
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Summary
This summary is machine-generated.

Progestin-only contraceptives (POCs) show limited evidence of significant weight change, with most users gaining less than 2 kg in the first year. Counseling on typical weight gain may reduce discontinuation.

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Area of Science:

  • Reproductive Health
  • Pharmacology
  • Clinical Research

Background:

  • Progestin-only contraceptives (POCs) are suitable alternatives for individuals unable to use estrogen-containing methods.
  • Available POCs include injectables, intrauterine devices, implants, and oral pills, offering long-acting and cost-effective pregnancy prevention.
  • Concerns regarding weight gain are a significant barrier to POC initiation and a cause for early discontinuation.

Purpose of the Study:

  • To evaluate the association between the use of progestin-only contraceptives (POCs) and changes in body weight.
  • To analyze body composition changes in relation to POC usage.

Main Methods:

  • A systematic review of comparative studies examining POCs against other contraceptive methods or no contraception.
  • Inclusion of 22 studies (17 non-randomized, 5 RCTs) involving 11,450 women, assessing mean weight change and body composition.
  • Data extraction and analysis using adjusted measures for non-randomized studies and mean differences/odds ratios for randomized controlled trials.

Main Results:

  • Fifteen studies found no significant differences in weight or body composition between comparison groups.
  • Five studies indicated differences, with depot medroxyprogesterone acetate (DMPA) users showing greater weight gain compared to copper IUC or no hormonal method.
  • Some studies reported increased body fat and decreased lean body mass with DMPA, LNG-IUC, or desogestrel-containing pills compared to non-hormonal methods.

Conclusions:

  • The overall quality of evidence is low, primarily due to a lack of randomization and high loss to follow-up.
  • Limited evidence suggests minimal weight or body composition changes with most POCs, with mean weight gain typically under 2 kg in the first year.
  • Counseling on expected weight changes can potentially mitigate contraceptive discontinuation due to user perceptions.