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Combination contraceptives: effects on weight

  1. Maria F Gallo1,
  2. Laureen M Lopez2,*,
  3. David A Grimes3,
  4. Florence Carayon4,
  5. Kenneth F Schulz5,
  6. Frans M Helmerhorst6

Editorial Group: Cochrane Fertility Regulation Group

Published Online: 29 JAN 2014

Assessed as up-to-date: 2 JAN 2014

DOI: 10.1002/14651858.CD003987.pub5


How to Cite

Gallo MF, Lopez LM, Grimes DA, Carayon F, Schulz KF, Helmerhorst FM. Combination contraceptives: effects on weight. Cochrane Database of Systematic Reviews 2014, Issue 1. Art. No.: CD003987. DOI: 10.1002/14651858.CD003987.pub5.

Author Information

  1. 1

    The Ohio State University, Division of Epidemiology, Columbus, Ohio, USA

  2. 2

    FHI 360, Clinical Sciences, Durham, North Carolina, USA

  3. 3

    University of North Carolina, School of Medicine, Obstetrics and Gynecology, Chapel Hill, North Carolina, USA

  4. 4

    FHI360, Clinical Sciences, Durham, North Carolina, USA

  5. 5

    FHI 360 and UNC School of Medicine, Quantitative Sciences, Research Triangle Park, North Carolina, USA

  6. 6

    Leiden University Medical Center, Department of Gynaecology, Division of Reproductive Medicine and Dept. of Clinical Epidemiology, Leiden, Netherlands

*Laureen M Lopez, Clinical Sciences, FHI 360, 359 Blackwell St, Suite 200, Durham, North Carolina, 27701, USA. llopez@fhi360.org.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 29 JAN 2014

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[Figure 1]
Figure 1. Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
[Figure 2]
Figure 2. Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
[Analysis 1.1]
Analysis 1.1. Comparison 1 Dimethisterone 25 mg and ethinyl estradiol (EE) 100 µg versus placebo, Outcome 1 Gained >2.3 kg (cycle 4).
[Analysis 2.1]
Analysis 2.1. Comparison 2 Ethynodiol diacetate 1 mg and mestranol 100 µg versus placebo, Outcome 1 Gained >2.3 kg (cycle 4).
[Analysis 3.1]
Analysis 3.1. Comparison 3 Levonorgestrel 100 µg and EE 20 µg versus placebo, Outcome 1 Mean weight change in kg (cycle 6).
[Analysis 4.1]
Analysis 4.1. Comparison 4 Norgestrel 300 µg and EE 30 µg versus no intervention, Outcome 1 Mean weight change in kg per year.
[Analysis 5.1]
Analysis 5.1. Comparison 5 Norethindrone 1 mg and mestranol 50 µg versus placebo, Outcome 1 Gained >2.3 kg (cycle 4).
[Analysis 6.1]
Analysis 6.1. Comparison 6 Skin patch norelgestromin 150 µg and EE 20 µg versus placebo, Outcome 1 Gained >5% baseline weight (cycle 9).
[Analysis 6.2]
Analysis 6.2. Comparison 6 Skin patch norelgestromin 150 µg and EE 20 µg versus placebo, Outcome 2 Lost >5% baseline weight (cycle 9).
[Analysis 7.1]
Analysis 7.1. Comparison 7 Skin patch norelgestromin 150 µg and EE 20 µg: extended versus cyclic regimen, Outcome 1 Mean weight change (112 days or cycle 4).
[Analysis 8.1]
Analysis 8.1. Comparison 8 Desogestrel 150 µg and EE 20 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Mean body mass percentage change (cycle 6).
[Analysis 9.1]
Analysis 9.1. Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 1 Gained >2 kg (cycle 6).
[Analysis 9.2]
Analysis 9.2. Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 2 Lost >2 kg (cycle 6).
[Analysis 9.3]
Analysis 9.3. Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 3 Gained >2 kg (cycle 12).
[Analysis 9.4]
Analysis 9.4. Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 4 Lost >2 kg (cycle 12).
[Analysis 10.1]
Analysis 10.1. Comparison 10 Desogestrel 150 µg and EE 20 µg versus norgestimate 250 µg and EE 35 µg, Outcome 1 Mean body mass percentage change (cycle 6).
[Analysis 11.1]
Analysis 11.1. Comparison 11 Desogestrel 150 µg and EE 30 µg versus levonorgestrel 50-75-125 µg and EE 30-40-30 µg, Outcome 1 Gained >2 kg (cycle 6).
[Analysis 12.1]
Analysis 12.1. Comparison 12 Standard desogestrel and EE regimen versus prolonged gestodene and EE regimen, Outcome 1 Gained >2 kg (cycle 7).
[Analysis 13.1]
Analysis 13.1. Comparison 13 Prolonged desogestrel and EE regimen versus standard desogestrel and EE regimen, Outcome 1 Mean weight change in kg (cycle 12).
[Analysis 14.1]
Analysis 14.1. Comparison 14 Dienogest 2 mg, EE 10 µg and estradiol valerate 2 mg versus levonorgestrel 100 µg and EE 20 µg, Outcome 1 Gained >5% baseline weight (cycle 3).
[Analysis 14.2]
Analysis 14.2. Comparison 14 Dienogest 2 mg, EE 10 µg and estradiol valerate 2 mg versus levonorgestrel 100 µg and EE 20 µg, Outcome 2 Lost >5% baseline weight (cycle 3).
[Analysis 15.1]
Analysis 15.1. Comparison 15 Dienogest 2 mg and EE 20 µg versus levonorgestrel 100 µg and EE 20 µg, Outcome 1 Gained >5% baseline weight (cycle 3).
[Analysis 15.2]
Analysis 15.2. Comparison 15 Dienogest 2 mg and EE 20 µg versus levonorgestrel 100 µg and EE 20 µg, Outcome 2 Lost >5% baseline weight (cycle 3).
[Analysis 16.1]
Analysis 16.1. Comparison 16 Dienogest 2 mg and EE 30 µg versus levonorgestrel 100 µg and EE 20 µg, Outcome 1 Gained >5% baseline weight (cycle 3).
[Analysis 16.2]
Analysis 16.2. Comparison 16 Dienogest 2 mg and EE 30 µg versus levonorgestrel 100 µg and EE 20 µg, Outcome 2 Lost >5% baseline weight (cycle 3).
[Analysis 17.1]
Analysis 17.1. Comparison 17 Dl-norgestrel 500 µg and EE 50 µg versus levonorgestrel 250 µg and EE 50 µg, Outcome 1 Mean weight change in kg (cycle 3).
[Analysis 18.1]
Analysis 18.1. Comparison 18 Dl-norgestrel 500 µg and EE 50 µg versus norethisterone acetate 1 mg and EE 50 µg, Outcome 1 Mean weight change in kg (cycle 3).
[Analysis 19.1]
Analysis 19.1. Comparison 19 Drospirenone 2 mg and EE 30 µg versus drospirenone 3 mg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 3).
[Analysis 19.2]
Analysis 19.2. Comparison 19 Drospirenone 2 mg and EE 30 µg versus drospirenone 3 mg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 3).
[Analysis 20.1]
Analysis 20.1. Comparison 20 Drospirenone 3 mg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
[Analysis 20.2]
Analysis 20.2. Comparison 20 Drospirenone 3 mg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).
[Analysis 21.1]
Analysis 21.1. Comparison 21 Drospirenone 3 mg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
[Analysis 21.2]
Analysis 21.2. Comparison 21 Drospirenone 3 mg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).
[Analysis 22.1]
Analysis 22.1. Comparison 22 Drospirenone 3 mg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 13).
[Analysis 22.2]
Analysis 22.2. Comparison 22 Drospirenone 3 mg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 13).
[Analysis 23.1]
Analysis 23.1. Comparison 23 Drospirenone 3 mg and EE 20 μg versus desogestrel 150 μg and EE 20 μg, Outcome 1 Mean weight change in kg (cycle 7).
[Analysis 24.1]
Analysis 24.1. Comparison 24 Drospirenone 3 mg and EE 30 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
[Analysis 24.2]
Analysis 24.2. Comparison 24 Drospirenone 3 mg and EE 30 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).
[Analysis 25.1]
Analysis 25.1. Comparison 25 Ethynodiol diacetate 1 mg and mestranol 100 µg versus chlormadinone acetate 1.5 mg and mestranol 100 µg, Outcome 1 Mean weight change in kg (cycle 6).
[Analysis 26.1]
Analysis 26.1. Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
[Analysis 26.2]
Analysis 26.2. Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).
[Analysis 26.3]
Analysis 26.3. Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 3 Gained >2 kg (cycle 12).
[Analysis 26.4]
Analysis 26.4. Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 4 Lost >2 kg (cycle 12).
[Analysis 26.5]
Analysis 26.5. Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 5 Gained >2 kg (cycle 13).
[Analysis 26.6]
Analysis 26.6. Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 6 Lost >2 kg (cycle 13).
[Analysis 27.1]
Analysis 27.1. Comparison 27 Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 20 µg, Outcome 1 Mean body mass percentage change (cycle 6).
[Analysis 27.2]
Analysis 27.2. Comparison 27 Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 20 µg, Outcome 2 Mean weight change in kg (cycle 6).
[Analysis 27.3]
Analysis 27.3. Comparison 27 Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 20 µg, Outcome 3 Mean weight change in kg (cycle 12).
[Analysis 28.1]
Analysis 28.1. Comparison 28 Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
[Analysis 28.2]
Analysis 28.2. Comparison 28 Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg ( cycle 6).
[Analysis 28.3]
Analysis 28.3. Comparison 28 Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 3 Mean body mass percentage change (cycle 6).
[Analysis 29.1]
Analysis 29.1. Comparison 29 Gestodene 75 µg and EE 30 µg versus norgestimate 250 µg and EE 35 µg, Outcome 1 Gained >2 kg (cycle 6).
[Analysis 29.2]
Analysis 29.2. Comparison 29 Gestodene 75 µg and EE 30 µg versus norgestimate 250 µg and EE 35 µg, Outcome 2 Mean body mass percentage change (cycle 6).
[Analysis 30.1]
Analysis 30.1. Comparison 30 Gestodene 50-70-100 µg and EE 30-40-30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Mean weight change in kg (cycle 12).
[Analysis 31.1]
Analysis 31.1. Comparison 31 Gestodene 50-70-100 µg and EE 30-40-30 µg versus norgestimate 250 µg and EE 35 µg, Outcome 1 Mean weight change in kg (cycle 12).
[Analysis 32.1]
Analysis 32.1. Comparison 32 Prolonged gestodene and EE regimen versus standard gestodene and EE regimen, Outcome 1 Mean weight change in kg (cycle 3).
[Analysis 33.1]
Analysis 33.1. Comparison 33 Levonorgestrel 100 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
[Analysis 33.2]
Analysis 33.2. Comparison 33 Levonorgestrel 100 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).
[Analysis 34.1]
Analysis 34.1. Comparison 34 Levonorgestrel 150 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Gained >2.5 kg (cycle 24).
[Analysis 34.2]
Analysis 34.2. Comparison 34 Levonorgestrel 150 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 2 Lost >2.5 kg (cycle 24).
[Analysis 35.1]
Analysis 35.1. Comparison 35 Levonorgestrel 150 µg and EE 30 µg versus gestodene 75 µg and EE 30 µg, Outcome 1 Mean weight change in kg (cycle 6).
[Analysis 36.1]
Analysis 36.1. Comparison 36 Levonorgestrel 250 µg and EE 50 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2.7 kg (cycle 6).
[Analysis 37.1]
Analysis 37.1. Comparison 37 Levonorgestrel 50-75-125 µg and EE 30-40-30 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Mean weight change in kg (cycle 6).
[Analysis 38.1]
Analysis 38.1. Comparison 38 Levonorgestrel 50-75-125 µg and EE 30-40-30 µg versus desogestrel 50-100-150 µg and EE 35-30-30 µg, Outcome 1 Mean BMI change (cycle 6).
[Analysis 38.2]
Analysis 38.2. Comparison 38 Levonorgestrel 50-75-125 µg and EE 30-40-30 µg versus desogestrel 50-100-150 µg and EE 35-30-30 µg, Outcome 2 Mean weight change in kg (cycle 6).
[Analysis 39.1]
Analysis 39.1. Comparison 39 Levonorgestrel 50-75-125 µg and EE 30-40-30 µg versus desogestrel 150 µg and EE 20 µg, Outcome 1 Mean weight change in kg (cycle 3).
[Analysis 40.1]
Analysis 40.1. Comparison 40 Levonorgestrel 250 µg and EE 50 µg versus norethisterone acetate 1 mg and EE 50 µg, Outcome 1 Mean weight change in kg (cycle 3).
[Analysis 41.1]
Analysis 41.1. Comparison 41 Levonorgestrel and EE 6-6-9 day regimen versus levonorgestrel 6-5-10 day regimen, Outcome 1 Mean weight change in kg (cycle 3).
[Analysis 42.1]
Analysis 42.1. Comparison 42 Lynestrenol 2 mg and EE 40 µg versus lynestrenol 1 mg and EE 40 µg, Outcome 1 Gained >2.5 kg (cycle 12).
[Analysis 42.2]
Analysis 42.2. Comparison 42 Lynestrenol 2 mg and EE 40 µg versus lynestrenol 1 mg and EE 40 µg, Outcome 2 Lost >2.5 kg (cycle 12).
[Analysis 43.1]
Analysis 43.1. Comparison 43 Norethisterone 500-1000 µg and EE 35 µg versus levonorgestrel 50-75-125 µg and EE 30-40 µg, Outcome 1 Mean weight change in kg (cycle 6).
[Analysis 44.1]
Analysis 44.1. Comparison 44 Norgestimate 250 µg and EE 35 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
[Analysis 44.2]
Analysis 44.2. Comparison 44 Norgestimate 250 µg and EE 35 µg versus desogestrel 150 µg and EE 30 µg, Outcome 2 Mean body mass percentage change (cycle 6).
[Analysis 45.1]
Analysis 45.1. Comparison 45 Norethisterone 500 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
[Analysis 45.2]
Analysis 45.2. Comparison 45 Norethisterone 500 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).
[Analysis 46.1]
Analysis 46.1. Comparison 46 Norethindrone 500-750-1000 µg and EE 35 µg versus desogestrel 100-125-150 µg and EE 25 µg, Outcome 1 Mean weight change in kg (cycle 6).
[Analysis 47.1]
Analysis 47.1. Comparison 47 Norgestimate 180-215-250 µg and EE 25 µg versus norethindrone acetate 1 mg and EE 20 µg, Outcome 1 Weight gain >=5% (cycle 6).
[Analysis 47.2]
Analysis 47.2. Comparison 47 Norgestimate 180-215-250 µg and EE 25 µg versus norethindrone acetate 1 mg and EE 20 µg, Outcome 2 Weight gain >=5% (cycle 13).
[Analysis 47.3]
Analysis 47.3. Comparison 47 Norgestimate 180-215-250 µg and EE 25 µg versus norethindrone acetate 1 mg and EE 20 µg, Outcome 3 Weight loss >=5% (cycle 6).
[Analysis 47.4]
Analysis 47.4. Comparison 47 Norgestimate 180-215-250 µg and EE 25 µg versus norethindrone acetate 1 mg and EE 20 µg, Outcome 4 Weight loss >=5% (cycle 13).
[Analysis 48.1]
Analysis 48.1. Comparison 48 Standard norgestrel and EE regimen versus prolonged norgestrel and EE regimen, Outcome 1 Mean weight change in kg (cycle 12).
[Analysis 49.1]
Analysis 49.1. Comparison 49 Injectable medroxyprogesterone acetate 25 mg and EC 5 mg versus norethisterone enanthate 50 mg and EV 5 mg, Outcome 1 Mean weight change in kg (cycle 12).
[Analysis 50.1]
Analysis 50.1. Comparison 50 Vaginal ring with norethindrone acetate 1 mg and EE 15 µg versus norethindrone acetate 1 mg and EE 20 µg, Outcome 1 Gain >2 kg (cycle 4).
[Analysis 50.2]
Analysis 50.2. Comparison 50 Vaginal ring with norethindrone acetate 1 mg and EE 15 µg versus norethindrone acetate 1 mg and EE 20 µg, Outcome 2 Lost >2 kg (cycle 4).
[Analysis 51.1]
Analysis 51.1. Comparison 51 Vaginal ring etonogestrel 120 µg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gain >=7% body weight (cycle 13).
[Analysis 51.2]
Analysis 51.2. Comparison 51 Vaginal ring etonogestrel 120 µg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >=7% body weight (cycle 13).
[Analysis 52.1]
Analysis 52.1. Comparison 52 Vaginal ring etonogestrel 120 µg and EE 15 µg versus drospirenone 3 mg and EE 30 µg, Outcome 1 Mean weight change in kg (cycle 13 or last assessment).