title: Prospective study of weight change in new adolescent users of DMPA, NET-EN, COCs, nonusers and discontinuers of hormonal contraception.
abstract: BACKGROUND
  Weight gain is commonly reported as a side effect of hormonal contraception and can lead to method discontinuation or reluctance to initiate the method. The purpose of this study was to investigate weight change in adolescent (aged 15-19 years) users of depot-medroxyprogesterone acetate (DMPA), norethisterone enanthate (NET-EN), combined oral contraceptives (COCs) and discontinuers of these methods as compared to nonusers of hormonal contraception.
  
  
  METHODS
  This longitudinal study recruited initiators of DMPA (n=115), NET-EN (n=115), COCs (n=116) and nonusers of contraception (n=144). Participants were followed up for 4-5 years, and details of current contraceptive method, including switching, discontinuing and/or starting hormonal methods were documented at each 6-monthly visit. Women were classified according to their contraceptive histories on completion of the study, and injectable users were combined into one group for analysis. Height, weight and self-reported dieting were recorded at each visit.
  
  
  RESULTS
  There was no difference in mean age or weight between the groups at baseline. Women using DMPA or NET-EN throughout, or switching between the two, had gained an average of 6.2 kg compared to average increases of 2.3 kg in the COC group, 2.8 kg in nonusers and 2.8 kg among discontinued users of any method (p=.02). There was no evidence of a difference in weight gain between women classified as nonobese or classified as overweight/obese in any of the four study groups at baseline.
  
  
  CONCLUSIONS
  There is fairly strong evidence that adolescent contraceptive hormonal injectable users appear to gain more weight than COC users, discontinuers and nonusers of contraception.
authors.affiliation: Reproductive Health and HIV Research Unit, Department of Obstetrics and Gynaecology, University of the Witwatersrand, Mayville 4091, South Africa. mbeksinska@rhru.co.za
authors.forename: Mags E
authors.initials: ME
authors.lastname: Beksinska
authors.forename: Jenni A
authors.initials: JA
authors.lastname: Smit
authors.forename: Immo
authors.initials: I
authors.lastname: Kleinschmidt
authors.forename: Cecilia
authors.initials: C
authors.lastname: Milford
authors.forename: Timothy M M
authors.initials: TM
authors.lastname: Farley
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D017258:Medroxyprogesterone Acetate / Q000009:adverse effects*; D009640:Norethindrone / Q000009:adverse effects / Q000031:analogs & derivatives*; D011446:Prospective Studies; D015430:Weight Gain / Q000187:drug effects*; D028761:Withholding Treatment / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D003277:Contraceptives, Oral, Combined; D017258:Medroxyprogesterone Acetate; C024319:norethindrone enanthate; D009640:Norethindrone