O
RIGINAL
R
ESEARCH
A
RTICLE
Effects of DMPA on Weight and Blood
Pressure in Long Term Acceptors
Surasak Taneepanichskul,* Damrong Reinprayoon,* and Unnop Jaisamrarn*
The study of effects on weight and blood pressure in long
term DMPA acceptors is reported. The objectives were to
study body weight and blood pressure changes in long term
DMPA users compared with intrauterine device (IUD)
acceptors. A total of 50 healthy women who had been
using DMPA for 120 months were compared with 50 IUD
acceptors who had been using an IUD for 120 months. Age,
parity, income, body weight, and blood pressure at the
initiation of contraception were matched. The mean Ϯ SD
body weight at 120 months in the DMPA and IUD groups
were 60.9 Ϯ 7.5 kg and 62.1 Ϯ 9.3 kg. No difference in
mean body weight was demonstrated. The blood pres-
sure change between DMPA and IUD acceptors also was
not different. It is suggested that long term DMPA use
does not have unfavorable effects on weight or blood
pressure. C
ONTRACEPTION
1999;59:301–303 © 1999
Elsevier Science Inc. All rights reserved.
KEY WORDS
:
DMPA, weight, blood pressure
Introduction
Depot-medroxyprogesterone acetate (DMPA), an in-
jectable progestogen, is an effective contraceptive
that is used in many parts of the world.
1
It works by
inhibiting ovulation and creating an unfavorable en-
dometrium and thick cervical mucus.
2
As DMPA
becomes more widely used, clinical questions arise
regarding noncontraceptive risks and benefits. The
effects on weight and blood pressure are controver-
sial. Several studies revealed that DMPA caused
weight gain,
3,4
whereas another study did not demon-
strate this result.
5
Its effect on blood pressure is also
not well demonstrated. The pathological mechanism
responsible for the elevated blood pressure observed
in women using progestogen as a contraceptive is the
sodium metabolism and renin-aldosterone system.
6
However, the studies of DMPA and blood pressure
change are controversial.
7,8
Most of the studies did
not make a comparison with a nonhormonal group.
None of these reports took into account how much
the women may have differed at the time of contra-
ceptive initiation, nor did they consider confounders
such as age, smoking, socioeconomic status, and
duration of use. The objectives of this study were to
evaluate the effects on weight and blood pressure in
long term DMPA acceptors.
Materials and Methods
A total of 50 healthy women, aged between 37 and 50
years, who had been using DMPA for 120 months and
regularly attended the Family Planning Clinic, De-
partment of Obstetrics and Gynaecology, Chula-
longkorn University, Bangkok, Thailand, were re-
cruited. Another 50 healthy women, who had been
using the intrauterine device (IUD) copper T380A for
120 months, who were regularly followed-up, and
who had not used any hormonal contraceptive before,
were selected as controls. Both groups lived in
Bangkok and were matched for age, parity, income,
body weight, and blood pressure at the beginning of
contraceptive use. None had any history of smoking
or alcohol intake. Women who developed chronic
disease or metabolic disorder except hypertension and
weight gain during DMPA and IUD use were ex-
cluded from the study. Weight was measured with
light indoor clothing without shoes. Blood pressure
was measured using a mechanical mercury sphygmo-
manometer (Baumanometer, New York, NY) in a
seated position. The acceptors were routinely allowed
to rest for 15 min before the blood pressure was
measured. WHO/British Hypertension Society guide-
lines were used as a basis for classification of blood
pressure (hypertension: systolic Ͼ160 mm Hg, dia-
stolic Ͼ95 mm Hg; elevated blood pressure: systolic
Ͻ90 mm Hg, diastolic Յ50 mm Hg.
9
The clients who
developed hypertension during DMPA or IUD use
consulted a cardiologist for treatment. It should be
noted that as this study had not been initially de-
signed for measurement of blood pressure, measure-
ments were not made in a supine position Ͼ3 consec-
utive days, as would be required to ensure completely
*Department of Obstetrics and Gynaecology, Faculty of Medicine, Chula-
longkorn University, Bangkok, Thailand
Name and address for correspondence: Dr. Surasak Taneepanichskul,
Department of Obstetrics and Gynaecology, Faculty of Medicine, Chula-
longkorn University, Rama IV Road, Bangkok 10330, Thailand; Tel.: 66 256-
4241; Fax: 66 254-9292
Submitted for publication March 30, 1999
Revised May 25, 1999
Accepted for publication May 25, 1999
© 1999 Elsevier Science Inc. All rights reserved. ISSN 0010-7824/99/$20.00
655 Avenue of the Americas, New York, NY 10010 PII S00010-7824(99)00037-2