A Cochrane review [Abstract] 1 included 49 trials. The trials included 85 weight change comparisons for 52 distinct contraceptive pairs (or placebos). The four studies did not find evidence supporting a causal association between combination oral contraceptives or a combination skin patch and weight gain. Most comparisons of different combination contraceptives showed no substantial difference in weight. In addition, discontinuation of combination contraceptives because of weight gain did not differ between groups where this was studied.
A prospective cohort study 2 evaluated weight and body composition of healthy women using hormonal long-acting reversible contraception (the levonorgestrel intrauterine system [LNG-IUS, n =85], copper intrauterine device [IUD, n=31] or etonogestrel implant [implant, n=33]). The mean age was 25.9 years, 82.5% had some college education and 67.6% were nulliparous. Although lean body mass increased over 12 months in LNG-IUS and copper IUD users but not in implant users, changes in body weight and body composition did not differ between the groups.
Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison) and by limitations in study quality.
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