Human Reproduction Unit, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), and National Institute of Hormones and Women Health, Campinas, SP 13084-971, Brazil.
Contraception. 2010 Feb;81(2):107-11. doi: 10.1016/j.contraception.2009.07.008. Epub 2009 Dec 2.
Weight gain is a frequent reason for discontinuing the contraceptive with depot-medroxyprogesterone acetate (DMPA).
This 3-year retrospective cohort study assessed body mass index (BMI; kg/m(2)) variations in 379 current or past DMPA users compared to TCu380A intrauterine device (IUD) users matched for age and BMI, categorized into G1 (normal weight), G2 (overweight) or G3 (obese) according to baseline BMI. Variations in weight and BMI were evaluated using analysis of variance.
BMI increased progressively in all groups but significantly more in G1 and G2 DMPA users compared to nonusers and according to duration of use. In the G3 subgroup, weight trends were similar in the DMPA and IUD users.
Normal and overweight women increased BMI with DMPA use; however, obese women did not increase weight. Weight increase in DMPA users could be associated with metabolic alterations related to duration of use in normal and overweight women and to alterations already present in obese women. Prospective studies are required to determine triggering factors. DMPA use <or=3 years was not associated with weight increase in women with BMI (kg/m(2)) >or=30.
体重增加是导致停药的常见原因之一，而这种药正是含有醋酸甲羟孕酮的长效避孕针（DMPA）。
这项为期 3 年的回顾性队列研究评估了 379 名当前或过去使用 DMPA 与 TCu380A 宫内节育器（IUD）的患者的体重指数（BMI；kg/m2）变化，这些患者根据年龄和 BMI 与对照组相匹配，并根据基线 BMI 分为 G1（正常体重）、G2（超重）或 G3（肥胖）。体重和 BMI 的变化使用方差分析进行评估。
所有组的 BMI 均逐渐增加，但 G1 和 G2 的 DMPA 用户与非使用者相比以及根据使用时间的长短，增加更为显著。在 G3 亚组中，DMPA 和 IUD 用户的体重趋势相似。
正常体重和超重女性在使用 DMPA 后 BMI 增加；然而，肥胖女性体重没有增加。DMPA 用户的体重增加可能与正常体重和超重女性与使用时间相关的代谢改变有关，也可能与肥胖女性已经存在的改变有关。需要前瞻性研究来确定触发因素。对于 BMI（kg/m2）>or=30 的女性，DMPA 使用<or=3 年与体重增加无关。
