A multicentred phase III comparative clinical trial of depot-medroxyprogesterone acetate given three-monthly at doses of 100mg or 150mg: 1. Contraceptive efficacy and side effects

Said, S.; Omar, K.; Koetsawang, Suporn; Kiriwat, Orawan; Srisatayapan, Yuwadee; Kazi, A.; Ajmal, Fozia; Wynter, H.; Pretnar-Darovec, A.; Benitez, Isidro; Cruz, J. de la; Apelo, R; Kovács, László; Koloszár, S; Busca, B.; Hall, Peter; Machín, David

doi:10.1016/0010-7824(86)90004-1

Cited by 68 publications

(4 citation statements)

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“…This paper reported the results of three trials conducted in the US and Europe, two of which were carried out for a year and the third for three years. The combined trials, which observed more than 2,300 women (aged [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35], reported modest weight gain (<2.3kg at 12 months) with large individual variation 53 .…”

Section: Activitymentioning

confidence: 99%

Determinants of Weight Gain in Young Women: A Review of the Literature

Wane

Uffelen

Brown

2010

Journal of Women's Health

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Abstract:Background: Young adult women (18-36 years) are gaining weight at rates higher than women in other age groups. Given its long term deleterious health effects, it is important to know the determinants of this weight gain. However, other than in relation to pregnancy, little is known about the determinants of weight gain in this population group.Method: Papers examining non-pregnancy weight gain in young women were identified through a literature search in PubMed in August 2008. Subsequently, reference lists of included papers were checked for additional eligible papers. Results: 29 papers were included in this review. They were grouped into five categories on the basis of the main identified determinant of weight gain: contraception (4); dietary behaviours (3); quitting smoking (1); physical activity (1) and university transition (20 papers). Study duration ranged from 13 days to 15 years. Weight was objectively measured in 25 studies and selfreported in 4 studies. 27 papers reported weight gain; the highest rates were observed with initial exposure to contraceptive use and the first semester of university.Conclusions: Even though young adulthood is a vulnerable time for weight gain in women, the number of studies examining specific determinants of weight gain was small.Those located identified five social and behavioural determinants, with most of the research focussing on the transition to and through university, and few studies in nonuniversity populations. More studies are needed to assess the concurrent contributions of multiple determinants of weight gain at this life-stage, so that appropriate interventions to prevent excess weight gain can be developed.

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Section: Activitymentioning

confidence: 99%

Determinants of Weight Gain in Young Women: A Review of the Literature

Wane

Uffelen

Brown

2010

Journal of Women's Health

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“…Because of the pharmacokinetics of the formulations, serum concentrations of MPA and NET in the first weeks following injection of DMPA-IM and NET-EN, respectively, exceed contraceptive efficacy but are necessary to ensure maintenance of contraceptive efficacy throughout the dosing duration. For DMPA-IM, contraceptive efficacy has been shown to be the same with 100 mg and 150 mg of DMPA-IM [1] , [2] , [3] , [23] . At the prescribed doses, DMPA has a longer duration of action than NET-EN.…”

Section: Pharmacologic Biologic and Epidemiologic Studies Of Dmpa Anmentioning

confidence: 99%

Pharmacokinetic, biologic and epidemiologic differences in MPA- and NET-based progestin-only injectable contraceptives relative to the potential impact on HIV acquisition in women

et al. 2019

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Access to safe and effective contraceptive choices is a reproductive right and contributes tremendously to improvements in maternal and child health. Progestin-only injectables, particularly intramuscularly injected depot medroxyprogesterone acetate (DMPA-IM), have received increased attention given findings suggesting a potential association with increased HIV risk. For women at high risk of HIV, the World Health Organization's Medical eligibility criteria for contraceptive use currently aggregate recommendations for all progestin-only injectables, including DMPA-IM, subcutaneously injected DMPA (DMPA-SC) and intramuscularly injected norethindrone/ norethisterone enanthate (NET-EN), except in the case of some drug interactions. We considered whether published data indicate differences or similarities between these injectables relevant to risk of acquiring HIV. In vitro data confirm different biological activities of these distinct progestins, including that MPA, and not NET, binds and activates the glucocorticoid receptor resulting in different biological effects relevant to immune function. Limited clinical data suggest changes in immunologic activity following DMPA-IM and NET-EN initiation, but interstudy variation and study design differences diminish ability to determine clinical relevance and the degree to which DMPA-IM and NET-EN could act differentially. The highest-quality epidemiologic studies suggest a potential 40% increase in HIV incidence in users of DMPA-IM relative to women not using hormonal contraception but no significant increase in risk in users of NET-EN. In our opinion, most of the available biologic activity and epidemiologic data indicate that DMPA and NET-EN are likely to act differently, and data remain too limited to evaluate differences between DMPA-IM and DMPA-SC.

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“…Side effects with DMPA include irregular bleeding (with a 30% incidence in the 1st year), significant weight gain, breast tenderness (5%), and depression (5%) (29). Studies about DMPA‐associated weight gain have been inconsistent (30,31); however the package insert states a possible weight gain of 5 pounds in 1 year.…”

Section: Depo‐medroxyprogesterone Acetate (Dmpa)mentioning

confidence: 99%