Little evidence of weight gain with progestin-only contraceptives

Clinical question: 
What is the association between progestin-only contraceptive use and changes in body weight?
Bottom line: 
There was little evidence of weight gain for women when using progestin-only contraceptives. Some differences were noted when a progestin-only contraceptive was compared with no hormonal contraceptive. Actual mean weight gain was low for 6 to 12 months, ie, less than 2kg in most studies. Good counselling about typical weight gain may help reduce discontinuation of contraceptives due to perceptions of weight gain.
Caveat: 
It was not possible to conduct a meta-analysis due to the range of contraceptive methods examined and differences in reporting of weight change. More weight gain was noted at 2 and 3 years, but was generally similar for both comparison groups. People may gain weight over time regardless of contraceptive use.
Context: 
Progestin-only contraceptives are appropriate for many women who cannot or should not take oestrogen. Many progestin-only contraceptives are long-acting, cost-effective methods of preventing pregnancy. However, concern about weight gain can deter the initiation of contraceptives and cause early discontinuation among users.
Review CD#: 
CD008815
PEARLS No: 
329
Date: 
September, 2011
Authored by: 
Brian R McAvoy