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Body weight and body composition of depot medroxyprogesterone acetate users

  • Natália Dal'Ava
    Correspondence
    Corresponding author. Caixa Postal 6181, 13084–971, Campinas, SP, Brazil. Tel.: +55 19 3289 2856; fax: +55 19 3289 2440.
    Affiliations
    Human Reproduction Unit, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), and the National Institute of Hormones and Women's Health, 13084–971, Campinas, SP, Brazil
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  • Luis Bahamondes
    Affiliations
    Human Reproduction Unit, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), and the National Institute of Hormones and Women's Health, 13084–971, Campinas, SP, Brazil
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  • M. Valeria Bahamondes
    Affiliations
    Human Reproduction Unit, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), and the National Institute of Hormones and Women's Health, 13084–971, Campinas, SP, Brazil
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  • Bruna F. Bottura
    Affiliations
    Human Reproduction Unit, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), and the National Institute of Hormones and Women's Health, 13084–971, Campinas, SP, Brazil
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  • Ilza Monteiro
    Affiliations
    Human Reproduction Unit, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), and the National Institute of Hormones and Women's Health, 13084–971, Campinas, SP, Brazil
    Search for articles by this author

      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.

      Keywords

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