Does Depo Provera Cause Weight Gain?

Despite its effectiveness, birth control shot raises concern

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Depo Provera (depot medroxyprogesterone acetate) is a hormonal drug used as a reversible form of birth control. Despite the fact that the drug is 99.7 percent effective in preventing pregnancy for up to 14 weeks, weight gain is frequently cited as a reason why women will stop using Depo Provera.

How Depo Provera Works

Depo Provera contains a synthetic form of progesterone known as progestin. It is an injectable form of the same drug, known as Provera, used to treat menstruation problems caused by hormone imbalances.

The progestin-based therapy prevents ovulation from occurring. It also thickens the cervical mucus which makes it harder for sperm to pass through the cervix. Moreover, the hormonal action causes a thinning of uterine tissue, making it difficult for a fertilized egg to implant since there is not enough tissue on the uterine wall to receive it.

Depo Provera does have a number of side effects, the most common of which include:

  • Acne
  • Drowsiness
  • Missed or irregular periods
  • Thinning hair
  • Increase facial hair
  • Sleeping problems
  • Stomach pain

Several, more serious side effects are known to occur include an increased risk of birth defects if taken when pregnant and the loss of bone mineral density (a condition that is largely reversible once treatment is stopped).

But, interestingly enough, the one side effect that will often cause the greatest stress among users is the potential risk of weight gain.

Depo Provera and Weight Gain

Since 2009, studies have largely confirmed that Depo Provera can cause women to gain weight.

The degree of this effect, however, can vary significantly with some adding a few pounds while others add or two dress sizes.

One of the more comprehensive studies, conducted by researchers at the University of Texas Medical Branch in Galveston, compared weight gain in 703 women who used either the pill, Depo Provera, or nonhormonal contraception (such as a diaphragm, IUD, or sponge).

The participants included 200 African American, 247 white, and 245 Hispanic women.

What the researchers found was that Depo Provera not only caused weight gain over the course of the 36-month trial, it did so by increasing body fat mass. Weight gain among users of the pill, by contrast, was primarily associated with fluid retention. All told, women who used Depo Provera experienced gains in:

  • Weight (9.7 pounds after 24 months and 11.25 pounds after 36 months)
  • Body fat (9.04 pounds)
  • Body fat percentage (3.4 percent)

The degree of weight gain appeared directly associated with the amount of Depo Provera used. Additionally, non-obese women appeared more vulnerable to this effect with 50 percent likely to become obese after three years.

Fortunately, this effect seems partially reversible among women who stopped Depo Provera and changed to a nonhormonal contraceptive. For these women, there was a mean weight loss of 3.75 pounds after 24 months.

On the flip side, those switching to the pill experienced a gain of 3.75 pounds after 24 months (again, more due to fluid retention than the additional accumulation of fat).

A Word From Verywell

This choice of contraception is a highly personal one. For some women, the benefits of convenience may far outweigh any possible side effects.

In the end, there is no right or wrong answer.

If you do opt to use Depo Provera, it is possible to lower your risk with proper nutrition and regular exercise. Ask your doctor for a referral to a special nutritionist who may be able to offer tips on how to maintain your ideal weight by boosting your metabolism through activity and controlling your overall caloric and fat intake.

Source:

Berenson, A. and Rahman, M. "Changes in weight, total fat, percent body fat, and central-to-peripheral fat ratio associated with injectable and oral contraceptive use." American Journal of Obstetrics and Gynecology. 2009; 220(3):329 e1-329 e8.

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