Depo-medroxyprogesterone acetate, weight gain and amenorrhea among obese adolescent and adult women

Abstract

Objective: The aim of the study was to evaluate the correlation between obesity and the use of depot medroxyprogesterone (DMPA) with regard to weight gain and changes in bleeding pattern.

Methods: A retrospective chart review was conducted of women receiving 150 mg DMPA via intramuscular injection at inpatient and outpatient clinics at the University of Mississippi Medical Centre between 1 June 2012 and 31 December 2016. Body mass indices (BMI) were assessed at baseline and at the time of final injection. Data on race, medical history, age at first DMPA injection, number and timing of injections, reported side effects, indication for DMPA use and reason for discontinuation, if applicable, were collected.

Results: Of the 240 women included in the study, 3.3% were underweight, 30.8% were normal weight, 23.3% were overweight, 15% were class I obese, 9.6% were class II obese and 17.9% were class III obese; 87.9% of the population were African American. Women gained 2.40 kg (95% confidence interval 1.34–3.45) while they were on DMPA (p < .01), which after adjusting for confounding variables was inversely associated with age at initial injection (β coefficient –0.13; p = .02). Amenorrhoea was the most commonly reported change in bleeding pattern.

Conclusion: Women who started DMPA at an earlier age gained the most weight over time, independently of initial BMI. Similar rates of amenorrhoea were found among all BMI categories.

摘要

目的：本研究的目的是评估肥胖与使用甲羟孕酮(DMPA)的体重增加和出血类型改变的相关性。

方法：对2012年6月1日至2016年12月31日期间在密西西比大学医学中心住院和门诊接受150 mg DMPA肌肉注射的妇女进行回顾性图表分析。在基线和最后一次注射时评估体重指数(BMI)。收集关于种族、病史、首次注射DMPA的年龄、注射次数和时间、报告的副作用、使用DMPA的适应证和停止使用的原因(如果适用)的数据。

结果：240名女性中, 体重不足者占3.3%, 正常体重者占30.8%, 超重者占23.3%, I类肥胖占15%, II类肥胖占9.6%, III类肥胖占17.9%, 87.9%的人口为非裔美国人。用DMPA的女性体重增加了2.40公斤(95%可信区间1.34-3.45)(p<0.01), 在调整混杂变量后, 这与初次注射时的年龄呈负相关(β系数-0.13；p＝.02)。闭经是最常见的出血类型改变。

结论：较早开始用DMPA的女性随着时间的推移体重增加最多, 与最初的BMI无关。在所有BMI类别中发现的闭经率相似。

Keywords:

• Birth control
• depot medroxyprogesterone acetate
• obesity
• weight gain

Disclosure statement

The authors report no conflicts of interest.