Depot medroxyprogesterone acetate contraception. Metabolic parameters and mood changes

Area of Science:

• Reproductive Health
• Endocrinology
• Metabolic Medicine

Background:

• Depot medroxyprogesterone acetate (DMPA) is a widely used injectable contraceptive.
• Concerns exist regarding its potential effects on metabolic parameters and mood.

Purpose of the Study:

• To review the literature on metabolic changes and mood alterations in women using DMPA.
• To identify gaps in current research and guide future studies.

Main Methods:

• Comprehensive literature search of MEDLINE and other databases.
• Inclusion of English-language clinical trials and cross-sectional studies from the past 20 years.

Main Results:

• DMPA has minimal effect on glucose tolerance; insulin levels may rise.
• Lipid profiles show increased LDL and decreased HDL cholesterol, without clear clinical adverse events.
• Evidence suggests decreased bone density with long-term DMPA use, requiring further longitudinal data.
• Most studies indicate weight gain in DMPA users, necessitating controlled research on contributing factors.
• Data on depression or mood changes are limited and do not establish a causal link.

Conclusions:

• DMPA demonstrates limited impact on glucose tolerance and mood.
• Observed lipid and bone density changes warrant further investigation for clinical significance.
• Weight gain is a common observation, requiring more research for patient guidance.
• Adverse clinical outcomes are rare despite extensive DMPA use.