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Evidence summaries

Progestin-Only Contraceptives: Effects on Weight

Progestin-only contraceptives appear not to have a significant effect on weight. Level of evidence: "B"

Summary

A Cochrane review [Abstract] 1 included 22 studies with a total of 11 450 subjects. 17 of the studies were non-randomized and 5 RCTs. Two studies examined progestin-only pills (POPs), 4 the levonorgestrel-releasing intrauterine system (LNG-IUS), 5 trials progestin implants, and 16 trials depot medroxyprogesterone acetate (DMPA). Comparison groups were similar for weight change in 15 studies. 8 studies were rated as high or moderate quality; in only one of them there was a slight difference in weight. Mean gain was less than 2 kg for most studies up to 12 months, and usually similar for the comparison group using another contraceptive.

A multicenter randomized trial 2 with 1:1 allocation ratio of the etonogestrel (ENG)- or the levonorgestrel (LNG) implants with non-randomized, age-matched control group of women choosing TCu380-IUD evaluated weight changes (n=2963). At 36 months of use, ENG and LNG implant users had similar significant mean weight increase of 3.0 kg (95% CI 2.5-3.5; and 2.9 kg 95% CI 2.4-3.4, respectively; p<.0001), while IUD users had an increase of 1.1 kg (95% CI 0.5-1.7; p=.0003).

    References

    • Lopez LM, Ramesh S, Chen M et al. Progestin-only contraceptives: effects on weight. Cochrane Database Syst Rev 2016;(8):CD008815. [PubMed]
    • Bahamondes L, Brache V, Ali M et al. A multicenter randomized clinical trial of etonogestrel and levonorgestrel contraceptive implants with nonrandomized copper intrauterine device controls: effect on weight variations up to 3 years after placement. Contraception 2018;98(3):181-187. [PubMed]

Primary/Secondary Keywords