Clark MK et al. (2005) Weight, fat mass, and central distribution of fat increase when women use depot-medroxyprogesterone acetate for contraception. Int J Obes 29: 1252–1258

In a large, prospective, longitudinal study, Clark et al. investigated the changes in weight and fat gain of women receiving the hormonal contraceptive, depot medroxyprogesterone acetate (DMPA), for the first time.

In total, 323 women aged between 18 and 35 years were enrolled in this 30-month study, of whom 178 women had recently started on 150 mg DMPA injections and 145 women used no hormonal contraception. Participants' weight, body fat and the central distribution of fat were measured by electronic scale and dual-energy X-ray absorptiometry at 3-month intervals.

The weight of women receiving DMPA injections increased from a mean of 69.4 kg at baseline to 75.5 kg at the end of the study. Furthermore, fat mass in this group also increased by 6.1kg at the study endpoint, and the ratio of central to peripheral fat mass changed from 0.95 at baseline to 1.01 at 30 months. Noticeably, lean mass of women receiving DMPA did not significantly alter. Women in the control group experienced no significant weight changes throughout the study period.

The authors conclude that these findings should be taken into consideration when women are counseled on contraceptive methods. The authors call for further studies to evaluate the mechanisms that lead to this weight and fat gain and to investigate the metabolic consequences involved. In addition, the issue of whether this weight gain is reversed following discontinuation of DMPA needs to be explored.