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Depot medroxyprogesterone acetate (DMPA) is used commonly for contraception in adolescent populations. This 3-month injectable agent affords efficacy, convenience, and privacy but has been associated with concerns about weight gain. Clinicians have attempted to identify reliable predictors of weight gain to better inform patients who seek guidance about DMPA. In a subset of a larger study aimed at investigating bone-density changes in users of hormonal contraception, researchers addressed the issue of weight gain in 97 adolescent DMPA users (age range, 12 to 18). Body-mass index was assessed at baseline, 6, 12, and 18 months.
At 6 months, 20% of participants had experienced >5% weight gain (early gainers). Compared with nonearly gainers (those who gained ≤5% of body weight during the first 6 months), early gainers were much more likely to continue to gain weight during the next 12 months of DMPA use (P<0.01).
Bonny AE et al. Early weight gain related to later weight gain in adolescents on depot medroxyprogesterone acetate. Obstet Gynecol 2011 Apr; 117:793.
Comment
These results, which suggest that identifying early weight gain is a strategy for predicting subsequent excessive weight gain in young DMPA users, echo similar findings in older women (mean age, 24; JW Womens Health Sep 3 2009). Notably, however, most participants (4 out of 5) did not experience substantial weight gain within 6 months of initiating DMPA. Counseling women about the advantages, disadvantages, and potential adverse effects associated with DMPA (as well as other forms of contraception) is important in promoting informed decision making about available options.