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Review
. 2014 Jan 29;2014(1):CD003987.
doi: 10.1002/14651858.CD003987.pub5.

Combination contraceptives: effects on weight

Maria F Gallo  1 , Laureen M Lopez, David A Grimes, Florence Carayon, Kenneth F Schulz, Frans M Helmerhorst
Affiliations
Review

Combination contraceptives: effects on weight

Maria F Gallo et al. Cochrane Database Syst Rev. .

Abstract

Background: Weight gain is often considered a side effect of combination hormonal contraceptives, and many women and clinicians believe that an association exists. Concern about weight gain can limit the use of this highly effective method of contraception by deterring the initiation of its use and causing early discontinuation among users. However, a causal relationship between combination contraceptives and weight gain has not been established.

Objectives: The aim of the review was to evaluate the potential association between combination contraceptive use and changes in weight.

Search methods: In November 2013, we searched the computerized databases CENTRAL (The Cochrane Library), MEDLINE, POPLINE, EMBASE, and LILACS for studies of combination contraceptives, as well as ClinicalTrials.gov and International Clinical Trials Registry Platform (ICTRP). For the initial review, we also wrote to known investigators and manufacturers to request information about other published or unpublished trials not discovered in our search.

Selection criteria: All English-language, randomized controlled trials were eligible if they had at least three treatment cycles and compared a combination contraceptive to a placebo or to a combination contraceptive that differed in drug, dosage, regimen, or study length.

Data collection and analysis: All titles and abstracts located in the literature searches were assessed. Data were entered and analyzed with RevMan. A second author verified the data entered. For continuous data, we calculated the mean difference and 95% confidence interval (CI) for the mean change in weight between baseline and post-treatment measurements using a fixed-effect model. For categorical data, such as the proportion of women who gained or lost more than a specified amount of weight, the Peto odds ratio with 95% CI was calculated.

Main results: We found 49 trials that met our inclusion criteria. The trials included 85 weight change comparisons for 52 distinct contraceptive pairs (or placebos). The four trials with a placebo or no intervention group did not find evidence supporting a causal association between combination oral contraceptives or a combination skin patch and weight change. Most comparisons of different combination contraceptives showed no substantial difference in weight. In addition, discontinuation of combination contraceptives because of weight change did not differ between groups where this was studied.

Authors' conclusions: Available evidence was insufficient to determine the effect of combination contraceptives on weight, but no large effect was evident. Trials to evaluate the link between combination contraceptives and weight change require a placebo or non-hormonal group to control for other factors, including changes in weight over time.

PubMed Disclaimer

Conflict of interest statement

DA Grimes has consulted with the pharmaceutical companies Bayer Healthcare Pharmaceuticals and Merck & Co, Inc.

FM Helmerhorst has supervised studies sponsored or assigned by various pharmaceutical companies that manufacture oral contraceptives.

Figures

1
1
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Dimethisterone 25 mg and ethinyl estradiol (EE) 100 µg versus placebo, Outcome 1 Gained >2.3 kg (cycle 4).
2.1
2.1. Analysis
Comparison 2 Ethynodiol diacetate 1 mg and mestranol 100 µg versus placebo, Outcome 1 Gained >2.3 kg (cycle 4).
3.1
3.1. Analysis
Comparison 3 Levonorgestrel 100 µg and EE 20 µg versus placebo, Outcome 1 Mean weight change in kg (cycle 6).
4.1
4.1. Analysis
Comparison 4 Norgestrel 300 µg and EE 30 µg versus no intervention, Outcome 1 Mean weight change in kg per year.
5.1
5.1. Analysis
Comparison 5 Norethindrone 1 mg and mestranol 50 µg versus placebo, Outcome 1 Gained >2.3 kg (cycle 4).
6.1
6.1. Analysis
Comparison 6 Skin patch norelgestromin 150 µg and EE 20 µg versus placebo, Outcome 1 Gained >5% baseline weight (cycle 9).
6.2
6.2. Analysis
Comparison 6 Skin patch norelgestromin 150 µg and EE 20 µg versus placebo, Outcome 2 Lost >5% baseline weight (cycle 9).
7.1
7.1. Analysis
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).
8.1
8.1. Analysis
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).
9.1
9.1. Analysis
Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 1 Gained >2 kg (cycle 6).
9.2
9.2. Analysis
Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 2 Lost >2 kg (cycle 6).
9.3
9.3. Analysis
Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 3 Gained >2 kg (cycle 12).
9.4
9.4. Analysis
Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 4 Lost >2 kg (cycle 12).
10.1
10.1. Analysis
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).
11.1
11.1. Analysis
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).
12.1
12.1. Analysis
Comparison 12 Standard desogestrel and EE regimen versus prolonged gestodene and EE regimen, Outcome 1 Gained >2 kg (cycle 7).
13.1
13.1. Analysis
Comparison 13 Prolonged desogestrel and EE regimen versus standard desogestrel and EE regimen, Outcome 1 Mean weight change in kg (cycle 12).
14.1
14.1. Analysis
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).
14.2
14.2. Analysis
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).
15.1
15.1. Analysis
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).
15.2
15.2. Analysis
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).
16.1
16.1. Analysis
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).
16.2
16.2. Analysis
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).
17.1
17.1. Analysis
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).
18.1
18.1. Analysis
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).
19.1
19.1. Analysis
Comparison 19 Drospirenone 2 mg and EE 30 µg versus drospirenone 3 mg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 3).
19.2
19.2. Analysis
Comparison 19 Drospirenone 2 mg and EE 30 µg versus drospirenone 3 mg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 3).
20.1
20.1. Analysis
Comparison 20 Drospirenone 3 mg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
20.2
20.2. Analysis
Comparison 20 Drospirenone 3 mg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).
21.1
21.1. Analysis
Comparison 21 Drospirenone 3 mg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
21.2
21.2. Analysis
Comparison 21 Drospirenone 3 mg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).
22.1
22.1. Analysis
Comparison 22 Drospirenone 3 mg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 13).
22.2
22.2. Analysis
Comparison 22 Drospirenone 3 mg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 13).
23.1
23.1. Analysis
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).
24.1
24.1. Analysis
Comparison 24 Drospirenone 3 mg and EE 30 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
24.2
24.2. Analysis
Comparison 24 Drospirenone 3 mg and EE 30 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).
25.1
25.1. Analysis
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).
26.1
26.1. Analysis
Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
26.2
26.2. Analysis
Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).
26.3
26.3. Analysis
Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 3 Gained >2 kg (cycle 12).
26.4
26.4. Analysis
Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 4 Lost >2 kg (cycle 12).
26.5
26.5. Analysis
Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 5 Gained >2 kg (cycle 13).
26.6
26.6. Analysis
Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 6 Lost >2 kg (cycle 13).
27.1
27.1. Analysis
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).
27.2
27.2. Analysis
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).
27.3
27.3. Analysis
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).
28.1
28.1. Analysis
Comparison 28 Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
28.2
28.2. Analysis
Comparison 28 Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg ( cycle 6).
28.3
28.3. Analysis
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).
29.1
29.1. Analysis
Comparison 29 Gestodene 75 µg and EE 30 µg versus norgestimate 250 µg and EE 35 µg, Outcome 1 Gained >2 kg (cycle 6).
29.2
29.2. Analysis
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).
30.1
30.1. Analysis
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).
31.1
31.1. Analysis
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).
32.1
32.1. Analysis
Comparison 32 Prolonged gestodene and EE regimen versus standard gestodene and EE regimen, Outcome 1 Mean weight change in kg (cycle 3).
33.1
33.1. Analysis
Comparison 33 Levonorgestrel 100 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
33.2
33.2. Analysis
Comparison 33 Levonorgestrel 100 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).
34.1
34.1. Analysis
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).
34.2
34.2. Analysis
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).
35.1
35.1. Analysis
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).
36.1
36.1. Analysis
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).
37.1
37.1. Analysis
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).
38.1
38.1. Analysis
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).
38.2
38.2. Analysis
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).
39.1
39.1. Analysis
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).
40.1
40.1. Analysis
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).
41.1
41.1. Analysis
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).
42.1
42.1. Analysis
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).
42.2
42.2. Analysis
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).
43.1
43.1. Analysis
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).
44.1
44.1. Analysis
Comparison 44 Norgestimate 250 µg and EE 35 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
44.2
44.2. Analysis
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).
45.1
45.1. Analysis
Comparison 45 Norethisterone 500 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
45.2
45.2. Analysis
Comparison 45 Norethisterone 500 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).
46.1
46.1. Analysis
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).
47.1
47.1. Analysis
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).
47.2
47.2. Analysis
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).
47.3
47.3. Analysis
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).
47.4
47.4. Analysis
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).
48.1
48.1. Analysis
Comparison 48 Standard norgestrel and EE regimen versus prolonged norgestrel and EE regimen, Outcome 1 Mean weight change in kg (cycle 12).
49.1
49.1. Analysis
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).
50.1
50.1. Analysis
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).
50.2
50.2. Analysis
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).
51.1
51.1. Analysis
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).
51.2
51.2. Analysis
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).
52.1
52.1. Analysis
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).
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References

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    1. Ahrendt H‐J, Nisand I, Bastianelli C, Gómez AM, Gemzell‐Danielsson K, Urdl W, et al. Efficacy, acceptability and tolerability of the combined contraceptive ring, NuvaRing, compared with an oral contraceptive containing 3 µg of ethinyl estradiol and 3 mg of drospirenone. Contraception 2006;74:451‐7. - PubMed
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Oddsson 2005 {published data only}
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Oelkers 1995 {published data only}
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Oelkers 2000 {published data only}
    1. Oelkers W, Helmerhorst FM, Wuttke W, Heithecker R. Effect of an oral contraceptive containing drospirenone on the renin‐angiotensin‐aldosterone system in healthy female volunteers. Gynecological Endocrinology 2000;14:204‐13. - PubMed
Procter‐Gray 2008 {published data only}
    1. Cobb KL, Bachrach LK, Sowers M, Nieves J, Greendale GA, Kent KK, et al. The effect of oral contraceptives on bone mass and stress fractures in female runners. Medicine & Science in Sports & Exercise. 2007/09/07 2007; Vol. 39, issue 9:1464‐73. - PubMed
    1. Procter‐Gray E, Cobb KL, Crawford SL, Bachrach LK, Chirra A, Sowers M, et al. Effect of oral contraceptives on weight and body composition in young female runners. Medicine & Science in Sports & Exercise. 2008/06/27 2008; Vol. 40, issue 7:1205‐12. - PubMed
Rosenbaum 2000 {published data only}
    1. Rosenbaum P, Schmidt W, Helmerhorst FM, Wuttke W, Rossmanith W, Freundl F, et al. Inhibition of ovulation by a novel progestogen (drospirenone) alone or in combination with ethinylestradiol. European Journal of Contraception & Reproductive Health Care 2000;5:16‐24. - PubMed
Sang 1995 {published and unpublished data}
    1. Sang GW, Shao QX, Ge RS, Ge JL, Chen JK, Song S, et al. A multicentred phase III comparative clinical trial of Mesigyna, Cyclofem and injectable No. 1 given monthly by intramuscular injection to Chinese women. Contraception 1995;51:167‐83. - PubMed
Serfaty 1998 {published data only}
    1. Serfaty D, Vree ML. A comparison of the cycle control and tolerability of two ultra low‐ dose oral contraceptives containing 20 micrograms ethinylestradiol and either 150 micrograms desogestrel or 75 micrograms gestodene. European Journal of Contraception & Reproductive Health Care 1998;3:179‐89. - PubMed
Sibai 2001 {published data only}
    1. Sibai B, Odlind V, Meador M, Shangold G, Fisher A, Creasy G. A comparative assessment of ORTHO EVRA™/EVRA™ to placebo patch effects on body weight. Fertility and Sterility 2001;76:S188.
    1. Sibai BM, Odlind V, Meador ML, Shangold GA, Fisher AC, Creasy GW. A comparative and pooled analysis of the safety and tolerability of the contraceptive patch (Ortho Evra/Evra). Fertility and Sterility 2002;77 Suppl 2:19‐26. - PubMed
Spellacy 1970 {published data only}
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Spona 1996 {published and unpublished data}
    1. Spona J, Elstein M, Feichtinger W, Sullivan H, Ludicke F, Muller U, et al. Shorter pill‐free interval in combined oral contraceptives decreases follicular development. Contraception 1996;54:71‐7. - PubMed
Stewart 2005 {published data only}
    1. Stewart FH, Kaunitz AM, LaGuardia KD, Karvois DL, Fisher AC, Friedman AJ. Extended use of transdermal norelgestromin/ethinyl estradiol: a randomized trial. Obstetrics and Gynecology 2005;105:1389‐96. - PubMed
Teichmann 1995 {published and unpublished data}
    1. Teichmann AT, Brill K, Albring M, Schnitker J, Wojtynek P, Kustra E. The influence of the dose of ethinylestradiol in oral contraceptives on follicle growth. Gynecology and Endocrinology 1995;9:299‐305. - PubMed
Van der Does 1995 {published and unpublished data}
    1. Does J, Exalto N, Dieben T, Bennink HC. Ovarian activity suppression by two different low‐dose triphasic oral contraceptives. Contraception 1995;52:357‐61. - PubMed
Weisberg 1999 {published data only}
    1. Weisberg E, Fraser IS, Mishell DR, Lacarra M, Darney P, Jackanicz TM. A comparative study of two contraceptive vaginal rings releasing norethindrone acetate and differing doses of ethinyl estradiol. Contraception 1999;59:305‐10. - PubMed
Wiegratz 1995 {published and unpublished data}
    1. Wiegratz I, Jung‐Hoffman C, Kuhl H. Effect of two oral contraceptives containing ethinylestradiol and gestodene or norgestimate upon androgen parameters and serum binding proteins. Contraception 1995;51:341‐6. - PubMed
Wiegratz 2002 {published and unpublished data}
    1. Wiegratz I, Lee JH, Kutschera E, Bauer HH, Hayn C, Moore C, et al. Effect of dienogest‐containing oral contraceptives on lipid metabolism. Contraception 2002;65:223‐9. - PubMed
Wiik 1993 {published data only}
    1. Wiik P, Nordby J, Paulsen JE. Effect of norethisterone and levonorgestrel in low‐dose multiphasic oral contraceptives on serum lipids. Acta Obstetricia et Gynecologica Scandinavica 1993;72:550‐5. - PubMed
Winkler 1996 {published and unpublished data}
    1. Winkler UH, Schindler AE, Endrikat J, Dusterberg B. A comparative study of the effects of the hemostatic system of two monophasic gestodene oral contraceptives containing 20 micrograms and 30 micrograms ethinylestradiol. Contraception 1996;53:75‐84. - PubMed
Worsley 1980 {published data only}
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References to studies excluded from this review

Ahrendt 2009 {published data only}
    1. Ahrendt HJ, Makalova D, Parke S, Mellinger U, Mansour D. Bleeding pattern and cycle control with an estradiol‐based oral contraceptive: a seven‐cycle, randomized comparative trial of estradiol valerate/dienogest and ethinyl estradiol/levonorgestrel. Contraception. 2009/10/20 2009; Vol. 80, issue 5:436‐44. - PubMed
Bonny 2006 {published data only}
    1. Bonny AE, Ziegler J, Harvey R, Debanne SM, Secic M, Cromer BA. Weight gain in obese and nonobese adolescent girls initiating depot medroxyprogesterone, oral contraceptive pills, or no hormonal contraceptive method. Archives of Pediatrics & Adolescent Medicine 2006;160:40‐5. - PubMed
Boonyarangkul 2007 {published data only}
    1. Boonyarangkul A, Taneepanischskul S. Comparison of cycle contral and side effects between transdermal contraceptive patch and an oral contraceptive in women older than 35 years. Journal of the Medical Association of Thailand 2007;90:1715‐9. - PubMed
Elkind‐Hirsch 2007 {published data only}
    1. Elkind‐Hirsch KE, Darensbourg C, Ogden B, Ogden LF, Hindelang P. Contraceptive vaginal ring use for women has less adverse metabolic effects than an oral contraceptive. Contraception 2007;76:348‐56. - PubMed
Endrikat 2007 {published data only}
    1. Endrikat J, Sandri M, Gerlinger C, Rubig A, Schmidt W, Fortier M. A Canadian multicentre prospective study on the effects of an oral contraceptive containing 3 mg drospirenone and 30 μg ethinyl oestradiol on somatic and psychological symptoms related to water retention and on body weight. European Journal of Contraception & Reproductive Health Care 2007;12:220‐8. - PubMed
Fan 2010 {published data only}
    1. Fan GS, Bian ML, Cheng LN, Cao XM, Huang ZR, Han ZY, et al. Efficacy and safety of drospirenone‐ethinylestradiol on contraception in healthy Chinese women: a multicenter randomized controlled trial [article in Chinese]. Zhonghua Fu Chan Ke Za Zhi 2009;44(1):38‐44. - PubMed
    1. Fan GS, Bian ML, Cheng LN, Cao XM, Huang ZR, Han ZY, et al. Efficacy and safety of the combined oral contraceptive ethinylestradiol/drospirenone (Yasmin) in healthy Chinese women: a randomized, open‐label, controlled, multicentre trial. Clinical Drug Investigation. 2010/03/06 2010; Vol. 30, issue 6:387‐96. - PubMed
Gaspard 2003 {published data only}
    1. Gaspard U, Scheen A, Endrikat J, Buicu C, Lefebvre P, Gerlinger C, et al. A randomized study over 13 cycles to assess the influence of oral contraceptives containing ethinylestradiol combined with drospirenone or desogestrel on carbohydrate metabolism. Contraception 2003;67:423‐9. - PubMed
Grinspoon 2003 {published data only}
    1. Grinspoon SK, Friedman AJ, Miller KK, Lippman J, Olson WH, Warren MP. Effects of a triphasic combination oral contraceptive containing norgestimate/ethinyl estradiol on biochemical markers of bone metabolism in young women with osteopenia secondary to hypothalamic amenorrhea. Journal of Clinical Endocrinology and Metabolism 2003;88:3651‐6. - PubMed
Junge 2011 {published data only}
    1. Junge W, Mellinger U, Parke S, Serrani M. Metabolic and haemostatic effects of estradiol valerate/dienogest, a novel oral contraceptive: a randomized, open‐label, single‐centre study. Clin Drug Investig. 2011/07/05 2011; Vol. 31, issue 8:573‐84. - PubMed
Machado 2006 {published data only}
    1. Machado RB, Tachotti F, Cavenague G, Maia E. Effects of two different oral contraceptives on total body water: a randomized study. Contraception 2006;73:344‐7. - PubMed
Miller 2003 {published data only}
    1. Miller L, Hughes JP. Continuous combination oral contraceptive pills to eliminate withdrawal bleeding: a randomized trial. Obstetrics and Gynecology 2003;101:653‐61. - PubMed
Miller 2005 {published data only}
    1. Miller L, Verhoeven CH, Hout J. Extended regimens of the contraceptive vaginal ring: a randomized trial. Obstetrics and Gynecology 2005;106:473‐82. - PubMed
Mohamed 2011 {published data only}
    1. Mohamed A M, El‐Sherbiny W S, Mostafa W A. Combined contraceptive ring versus combined oral contraceptive (30‐mug ethinylestradiol and 3‐mg drospirenone). International Journal of Gynaecology and Obstetrics 2011;114(2):145‐8. - PubMed
O'Connell 2005 {published data only}
    1. O'Connell KJ, Osborne LM, Westhoff C. Measured and reported weight change for women using a vaginal contraceptive ring vs. a low‐dose oral contraceptive. Contraception 2005;72:323‐7. - PubMed
    1. Westhoff C, Osborne LM, Schafer JE, Morroni C. Bleeding patterns after immediate initiation of an oral compared with a vaginal hormonal contraceptive. Obstetrics and Gynecology 2005;106:89‐96. - PubMed
O'Connell 2007 {published data only}
    1. O'Connell K, Davis AR, Kerns J. Oral contraceptives: side effects and depression in adolescent girls. Contraception 2007;75:299‐304. - PubMed
Sabatini 2006 {published data only}
    1. Sabatini R, Cagiano R. Comparison profiles of cycle control, side effects and sexual satisfaction of three hormonal contraceptives. Contraception 2006;74:220‐3. - PubMed
Sanam 2011 {published data only}
    1. Sanam M, Ziba O. Desogestrel+ethinylestradiol versus levonorgestrel+ethinylestradiol. Which one has better affect on acne, hirsutism, and weight change. Saudi Medical Journal 2011;32(1):23‐6. - PubMed
Sangthawan 2005 {published data only}
    1. Sangthawan M, Taneepanichskul S. A comparative study of monophasic oral contraceptives containing either drospirenone 3 mg or levonorgestrel 150 µg on premenstrual symptoms. Contraception 2005;71:1‐7. - PubMed
Skouby 2005 {published data only}
    1. Skouby SO, Endrikat J, Dusterberg B, Schmidt W, Gerlinger C, Wessel J, et al. A 1‐year randomized study to evaluate the effects of a dose reduction in oral contraceptives on lipids and carbohydrate metabolism: 20 µg ethniyl estradiol combined with 100 µg levonorgestrel. Contraception 2005;71:111‐7. - PubMed
Suthipongse 2004 {published data only}
    1. Suthipongse W, Taneepanichskul S. An open‐label randomized comparative study of oral contraceptives between medications containing 3 µg drospirenone/30 µg ethinylestradiol and 150 µg levonogestrel/30 µg ethinylestradiol in Thai women. Contraception 2004;69:23‐6. - PubMed
Taneepanichskul 2002 {published data only}
    1. Taneepanichskul S, Kriengsinyot R, Jaisamrarn U. A comparison of cycle control, efficacy, and side effects among healthy Thai women between two low‐dose oral contraceptives containing 20 µg ethinylestradiol/75 µg gestodene (Meliane) and 30 µg ethinylestradiol/75 µg gestodene (Gynera). Contraception 2002;66:407‐9. - PubMed
Tantbirojn 2002 {published data only}
    1. Tantbirojn P, Taneepanichskul S. Clinical comparative study of oral contraceptives containing 30 µg ethinylestradiol/150 µg levonorgestrel, and 35 µg ethinylestradiol/250 µg norgestimate in Thai women. Contraception 2002;66:401‐5. - PubMed
Veres 2004 {published data only}
    1. Veres S, Miller L, Burington B. A comparison between the vaginal ring and oral contraceptives. Obstetrics and Gynecology 2004;104:555‐63. - PubMed
Westhoff 2007 {published data only}
    1. Westhoff C, Heartwell S, Edwards S, Zieman M, Cushman L, Robilotto C, et al. Initiation of oral contraceptives using a quick start compared with a conventional start. Obstetrics and Gynecology 2007;109:1270‐6. - PubMed
    1. Westhoff CL, Heartwell S, Edwards S, Zieman M, Stuart G, Cwiak C, et al. Oral contraceptive discontinuation: do side effects matter?. American Journal of Obstetrics and Gynecology 2007;196:412.e1‐6; discussion 412.e6‐7. - PMC - PubMed
Westhoff 2010 {published data only}
    1. Westhoff CL, Torgal AH, Mayeda ER, Stanczyk FZ, Lerner JP, Benn EK, et al. Ovarian suppression in normal‐weight and obese women during oral contraceptive use: a randomized controlled trial. Obstetrics and Gynecology 2010;116(2 Pt 1):275‐83. - PubMed
Westhoff 2012 {published data only}
    1. Westhoff C, Kaunitz AM, Korver T, Sommer W, Bahamondes L, Darney P, et al. Efficacy, safety, and tolerability of a monophasic oral contraceptive containing nomegestrol acetate and 17β‐estradiol: a randomized controlled trial. Obstetrics and Gynecology 2012;119(5):989‐99. - PubMed
Winkler 2004 {published data only}
    1. Winkler UH, Ferguson H, Mulders JAPA. Cycle control, quality of life and acne with two low‐dose oral contraceptives containing 20 µg ethinylestradiol. Contraception 2004;79:469‐76. - PubMed
Yildizhan 2009 {published data only}
    1. Yildizhan R, Yildizhan B, Adali E, Yoruk P, Birol F, Suer N. Effects of two combined oral contraceptives containing ethinyl estradiol 30 microg combined with either gestodene or drospirenone on hemostatic parameters, lipid profiles and blood pressure. Archives of Gynecology and Obstetrics. 2009/01/07 2009; Vol. 280, issue 2:255‐61. - PubMed

References to ongoing studies

Mahidol 2013 {published data only}
    1. Mahidol University. Comparison of body weight change during contraception with Belara and Yasmin. http://clinicaltrials.gov/show/NCT01608698 (accessed 05 Dec 2013).

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References to other published versions of this review

Gallo 2004
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