Determining risk between Depo-Provera use and increased uterine bleeding in obese and overweight women.

BACKGROUND Millions of women worldwide use depot medroxyprogesterone acetate (DMPA) for contraception. Common side effects include bleeding irregularities and weight gain. This study examines whether a relation exists between DMPA use in obese and overweight women and increased uterine bleeding.

METHODS Medical record data were gathered retrospectively from three family medicine clinics, documenting weight and height, DMPA therapy, and increased or excessive bleeding. Body mass index was calculated for each individual and used as the identifier for group assignment. Comorbid conditions, such as concomitant medication use, history of pregnancy while on DMPA, age, socioeconomic status (determined by insurance source), marital status, and number of children (live births only), were also documented.

RESULTS An inverse association was found, indicating that excess weight or obesity was associated with a decreased risk of (risk ratio 0.47) or possible protective factor against increased or excessive bleeding while the patient was on DMPA therapy. There was no significant outcome when consideration was made for age, marital status, socioeconomic status, medical conditions, or number of children.

CONCLUSIONS The finding that excessive weight or obesity was associated with a lower risk of increased or excessive bleeding can be advantageous when counseling this patient population on contraception options, especially with the knowledge that decreased side effects increase the propensity toward compliance and satisfaction.