Cochrane for Clinicians

Putting Evidence into Practice

Progestin-Only Contraceptives: Effects on Weight

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Am Fam Physician. 2014 May 1;89(9):715-716.

Clinical Question

Do progestin-only contraceptives cause weight gain?

Evidence-Based Answer

There is little evidence that progestin-only contraceptives cause weight gain; in this review, mean weight gain was less than 2 kg (4.4 lb) for most studies up to 12 months. (Strength of Recommendation: B, based on inconsistent or limited-quality patient-oriented evidence.)

Practice Pointers

More than 99% of all U.S. women 15 to 44 years of age who are or have been sexually active have used some form of contraception. Of those who use contraception, nearly one-fourth have tried depot medroxyprogesterone acetate (DMPA; Depo-Provera). The most common reason given for discontinuation of DMPA was weight gain.1 This Cochrane review examined 16 studies on various forms of progestin-only contraceptives and their association with weight gain. The data from these studies were too varied to be combined for meta-analysis. Most of the studies examined DMPA, but others looked at progestin-only implants, oral contraceptives, and intrauterine devices (IUDs). Only one study examined weight change in women taking different types of oral progestin-only contraceptives. The mean weight change in each group was small.

Ten studies examined weight gain in women using DMPA. Three

Author disclosure: No relevant financial affiliations.

The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the U.S. Army, the U.S. Army Medical Department, the Department of Defense, or the U.S. government.

The practice recommendations in this activity are available at


Lopez LM, Edelman A, Chen M, Otterness C, Trussell J, Helmerhorst FM. Progestin-only contraceptives: effects on weight. Cochrane Database Syst Rev. 2013;(7):CD008815.


1. Daniels K, Mosher WD, Jones J. Contraceptive methods women have ever used: United States, 1982–2010. National Health Statistics Reports, no. 62. Hyattsville, Md.: National Center for Health Statistics; 2013.

These are summaries of reviews from the Cochrane Library.

The series coordinator for AFP is Corey D. Fogleman, MD, Lancaster General Hospital Family Medicine Residency, Lancaster, Pa.

A collection of Cochrane for Clinicians published in AFP is available at

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