Short-term effects of a progestational contraceptive drug on food intake, resting energy expenditure, and body weight in young women

Does menarche mark a period of elevated resting metabolic rate?

Resting metabolic rate (RMR) and body composition were measured in 44 initially nonoverweight girls at three time points relative to menarche: premenarche (Tanner stage 1 or 2), menarche (+/-6 mo), and 4 yr after menarche. Mean absolute RMR was 1,167, 1,418, and 1,347 kcal/day, respectively. Absolute RMR was statistically significantly higher at menarche than at 4 yr after menarche despite statistically significantly less fat-free mass (FFM) and fat mass (FM), suggesting an elevation in RMR around the time of menarche. The pattern of change in RMR, adjusted for FFM, log transformed FM, age, race, parental overweight, and two interactions (visit by parental overweight, parental overweight by FFM), was also considered. Adjusted RMR did not differ statistically between the visits for girls with two normal-weight parents. For girls with at least one overweight parent, adjusted RMR was statistically significantly lower 4 yr after menarche than at premenarche or menarche. Thus parental overweight may influence changes that occur in RMR during adolescence in girls.

Depot-medroxyprogesterone acetate injection (Depo-Provera): a highly effective contraceptive option with proven long-term safety

Depot-medroxyprogesterone acetate (Depo-Provera(R)) is a highly effective, nondaily hormonal contraceptive option that has been available in the United States for a decade, and worldwide for 40 years. Benefits and risks of hormonal therapy are often under scrutiny; however, long-term clinical experience has established the safety of this long-acting contraceptive. This article reviews the contraceptive efficacy, potential noncontraceptive health benefits and long-term safety of with regard to risk of cardiovascular events, breast and gynecologic malignancy and osteopenia. Comparisons with other hormonal contraceptives are made as clinically appropriate. Common patient management issues, including effects on menstrual cycle, body weight and mood, are also addressed. Finally, this review provides recommendations for appropriate patient selection.

No time to eat: an adaptationist account of periovulatory behavioral changes

A comprehensive review of women's dietary behavior across the menstrual cycle suggests a drop in caloric intake around the time of ovulation; similar patterns occur in many other mammals. The periovulatory nadir is puzzling, as it is not explicable in terms of changes in the energy budget. Existing explanations in the animal literature operate wholly at the proximate level of analysis and hence do not address this puzzle. In this paper, I offer an ultimate explanation for the periovulatory feeding nadir, arguing that the decrease in the set point for satiation during the fertile period of the female cycle is an adaptation produced by natural selection in order to reduce the motivational salience of goals that compete with those directly or indirectly pertaining to mating. In support of this explanation, I adduce evidence of: a) periovulatory reductions in other ingestive behaviors, and b) periovulatory increases in motor activity and the psychological concomitants thereof.

Associations between reproduction and maternal body weight: examining the component parts of a full reproductive cycle

OBJECTIVE

Many transitional societies currently face both extremes of nutritional status, undernutrition and overnutrition. Women of reproductive age are at high risk of these conditions. The purpose of this review is to consider evidence for relationships between reproduction and nutritional status in women from societies of varying economic development, using body weight or weight-for-height as indicators of maternal nutritional status.

DESIGN

The conceptual framework guiding this review is that the duration of the reproductive cycle varies as a function of its component parts, which include (i) pregnancy, (ii) lactation, (iii) the non-pregnant/non-lactating (NP/NL) interval or, possibly, (iv) an overlap between lactation and next pregnancy. All component parts of the complete cycle vary in length and are associated with changes in nutritional status. A variety of factors ('proximal and distal determinants') influence the duration of the component parts of the reproductive cycle. This framework is used to examine current knowledge of changes in maternal nutritional status during each of these parts.

RESULTS

Women in affluent societies retain some weight with each pregnancy, beyond that of non-pregnant women. Women in less affluent societies retain less weight with each pregnancy. During lactation, women in both affluent and less affluent societies experience only modest weight loss. During the NP/NL interval, women in affluent societies tend to gain weight, whereas weight of women in less affluent societies is likely to fluctuate.

CONCLUSIONS

We conclude that there is a dearth of information on certain parts of the cycle, particularly the periods of overlap of lactation with pregnancy and the NP/NL interval.

Effects of low-dose OCs on weight in women with Central European nutritional habits and lifestyle

The aim of the study was to evaluate the acceptance and tolerance of combined low-dose oral contraceptives (OCs) (containing 20 micro g ethinylestradiol and 75 micro g gestodene) in a cohort of Polish women, and to present a relationship between the use of combined OCs and changes in body weight. Changes in body weight with combined low-dose OC have not been demonstrated in placebo-controlled trials, nor were such trials performed in a population whose nutritional/dietary habits and lifestyle resemble that of the population of Poland. We performed the clinical study on a group of 800 patients living in several regions of Poland. Patients used the low-dose OC for a period of 6 months. They were assessed every third cycle of OC use (initial examination and examinations after three and six cycles of OC use). On the basis of this investigation, a relationship between OC use and weight gain was not found.

Comparison of weight increase in users of depot medroxyprogesterone acetate and copper IUD up to 5 years

The objective of this study was to evaluate retrospectively the weight variation in long-term users of depot medroxyprogesterone acetate (DMPA) compared to users of the TCu380A intrauterine device (IUD). A cohort of 206 healthy women allocated in two groups of 103 women according to the contraceptive method used was evaluated through 5 years. Each user of DMPA was paired with an IUD user by age (+/- 1 year) and weight (+/- 1 kg) at the beginning of the study. Weight was evaluated yearly during 5 years. The mean age at the beginning of the study was 33.1 years in both groups, and the mean weight was 59.4 kg in the IUD users and 60.4 kg in the DMPA group. Both cohorts of women presented significant weight increase at the end of the 5 years of observation (p < 0.001). However, DMPA users presented higher weight increase when compared to IUD users from the second through the fifth year of observation. The DMPA users increased weight by 4.3 kg during the 5 years, and IUD users increased 1.8 kg. In conclusion, DMPA users had a significantly higher weight increase when compared to IUD users. In addition, this cohort of women increased weight throughout the 5 years with the use of DMPA or IUD.