Weight variation in users of depot-medroxyprogesterone acetate, the levonorgestrel-releasing intrauterine system and a copper intrauterine device for up to ten years of use

Abstract

Background and objective Data on record regarding weight variation in depot-medroxyprogesterone acetate (DMPA) and levonorgestrel-releasing intrauterine system (LNG-IUS) users are controversial. To date, no studies have yet evaluated weight variation in DMPA and LNG-IUS users in up to ten years of use compared to non-hormonal contraceptive users.Materials and methods A retrospective study analysed weight variations in 2138 women using uninterruptedly DMPA (150 mg intramuscularly, three-monthly; n = 714), the LNG-IUS (n = 701) or a copper-intrauterine device (Cu-IUD; n = 723).Results At the end of the first year of use, there was a mean weight increase of 1.3 kg, 0.7 kg and 0.2 kg among the DMPA-, LNG-IUS- and Cu-IUD users, respectively, compared to weight at baseline (p < 0.0001). After ten years of use, the mean weight had risen by 6.6 kg, 4.0 and 4.9 kg among the DMPA-, LNG-IUS- and Cu-IUD users, respectively. DMPA-users had gained more weight than LNG-IUS- (p = 0.0197) and than Cu-IUD users (p = 0.0294), with the latter two groups not differing significantly from each other in this respect (p = 0.5532).Conclusion Users of hormonal and non-hormonal contraceptive methods gained a significant amount of weight over the years. DMPA users gained more weight over the treatment period of up to ten years than women fitted with either a LNG-IUS or a Cu-IUD.Chinese 摘要背景和目的 目前大多关于使用醋酸甲羟孕酮、左炔诺孕酮——宫内释放系统以及含铜宫内节育器避孕的妇女体重改变的资料数据是有争议的。到目前为止，还没有关于使用醋酸甲羟孕酮、左炔诺孕酮——宫内释放系统避孕与非激素避孕方法十年妇女体重变化的研究。材料和方法 回顾性地研究了2138名妇女，包括持续使用醋酸甲羟孕酮（每3个月肌肉注射150mg； n= 714），使用左炔诺孕酮—宫内释放系统(n= 701)或者使用含铜宫内节育器避孕(Cu-IUD; n= 723).结果 在所有的研究对象中，在使用的第一年末，相比较于她们的基础体重，使用醋酸甲羟孕酮、左炔诺孕酮—宫内释放系统以及含铜宫内节育器避孕的妇女分别有1.3 kg, 0.7 kg 和0.2 kg体重的增加(p ＜0.0001)。在使用十年以后，使用醋酸甲羟孕酮、左炔诺孕酮—宫内释放系统以及含铜宫内节育器避孕的妇女分别有6.6 kg, 4.0 和 4.9 kg体重的增加。与使用左炔诺孕酮—宫内释放系统和含铜宫内节育器避孕的妇女相比，使用醋酸甲羟孕酮避孕的妇女体重增加更多，p值分别为 0.0197和0.0294；而使用前二者避孕方法的妇女体重的改变相互没有显著性差异 (p= 0.5532).结论 长期使用不论是激素避孕还是非激素避孕方法的妇女体重都有显著增加。使用醋酸甲羟孕酮避孕十年的妇女比使用左炔诺孕酮—宫内释放系统以及含铜宫内节育器避孕的妇女的体重增加更多。