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Anticonceptivos combinados: efectos sobre el peso

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References

References to studies included in this review

Aden 1998 {published and unpublished data}

Aden U, Jung‐Hoffmann C, Kuhl H. A randomized cross‐over study on various hormonal parameters of two triphasic oral contraceptives. Contraception 1998;58:75‐81.

Agoestina 1989 {published and unpublished data}

Agoestina T, Sabarudin U, Hoppe G. A study comparing a gestoden triphasic formulation with a fixed combination OC. Advances in Contraception 1989;5:71‐84.

Brill 1991 {published data only}

Brill K, Muller C, Schnitker J, Albring M. The influence of different modern low‐dose oral contraceptives on intermenstrual bleeding. Advances in Contraception 1991;7:51‐61.

Brill 1996 {published and unpublished data}

Brill K, Then A, Beisiegel U, Jene A, Wunsch C, Leidenberger F. Investigation of the influence of two low‐dose monophasic oral contraceptives containing 20 micrograms ethinylestradiol/75 micrograms gestodene and 30 micrograms ethinylestradiol/75 micrograms gestodene, on lipid metabolism in an open randomized trial. Contraception 1996;54:291‐7.

Burkman 2007 {published data only}

Burkman RT, Fisher AC, LaGuardia KD. Effects of low‐dose oral contraceptives on body weight. Journal of Reproductive Medicine 2007;52:1030‐4.
Hampton RM, Short M, Bieber E, Bouchard C, Ayotte N, Shangold G, et al. Comparison of a novel norgestimate/ethinyl estradiol oral contraceptive (Ortho Tri‐Cyclen Lo) with the oral contraceptive Loestrin Fe 1/20. Contraception 2001;63:289‐95.

Cachrimanidou 1993 {published data only}

Cachrimanidou AC, Hellberg D, Nilsson S, Waldenstrom U, Olsson SE, Sikstrom B. Long‐interval treatment regimen with a desogestrel‐containing oral contraceptive. Contraception 1993;48:205‐16.

Coenen 1996 {published data only}

Coenen CM, Thomas CM, Borm GF, Hollanders JM, Rolland R. Changes in androgens during treatment with four low‐dose contraceptives. Contraception 1996;53:171‐6.

Coney 2001 {published data only}

Coney P, Washenik K, Langley RGB, DiGiovanna JJ, Harrison DD. Weight change and adverse event incidence with a low‐dose oral contraceptive: two randomized, placebo‐controlled trials. Contraception 2001;63:297‐302.

Dionne 1974 {published data only}

Dionne P, Vickerson F. A double‐blind comparison of two oral contraceptives containing 50 µg. and 30 µg. ethinyl estradiol. Current Therapeutic Research, Clinical and Experimental 1974;16:281‐8.

Endrikat 1997 {published data only}

Endrikat J, Muller U, Dusterberg B. A twelve‐month comparative clinical investigation of two low‐dose oral contraceptives containing 20 µg ethinylestradiol/75 µg gestodene and 30 µg ethinylestradiol/75 µg gestodene, with respect to efficacy, cycle control, and tolerance. Contraception 1997;55:131‐7.

Endrikat 1999 {published data only}

Endrikat J, Dusterberg B, Ruebig A, Gerlinger C, Strowitzki T. Comparison of efficacy, cycle control, and tolerability of two low‐dose oral contraceptives in a multicenter clinical study. Contraception 1999;60:269‐74.
Endrikat J, Jaques MA, Mayerhofer M, Pelissier C, Muller U, Dusterberg B. A twelve‐month comparative clinical investigation of two low‐dose oral contraceptives containing 20 micrograms ethinylestradiol/75 micrograms gestodene and 20 micrograms ethinylestradiol/150 micrograms desogestrel, with respect to efficacy, cycle control and tolerance. Contraception 1995;52:229‐35.

Endrikat 2001a {published data only}

Endrikat J, Cronin M, Gerlinger C, Ruebig A, Schmidt W, Dusterberg B. Open, multicenter comparison of efficacy, cycle control, and tolerability of a 23‐day oral contraceptive regimen with 20 µg ethinyl estradiol and 75 µg gestodene and a 21‐day regimen with 20 µg ethinyl estradiol and 150 µg desogestrel. Contraception 2001;64:201‐7.

Endrikat 2001b {published and unpublished data}

Endrikat J, Hite R, Bannemerschult R, Gerlinger C, Schmidt W. Multicenter, comparative study of cycle control, efficacy and tolerability of two low‐dose oral contraceptives containing 20 µg ethinylestradiol/100 µg levonorgestrel and 20 µg ethinylestradiol/500 µg norethisterone. Contraception 2001;64:3‐10.

Foulon 2001 {published and unpublished data}

Foulon T, Payen N, Laporte F, Bijaoui S, Dupont G, Roland F, et al. Effects of two low‐dose oral contraceptives containing ethinylestradiol and either desogestrel or levonorgestrel on serum lipids and lipoproteins with particular regard to LDL size. Contraception 2001;64:11‐6.

Franchini 1995 {published and unpublished data}

Franchini M, Caruso C, Nigrelli S, Poggiali C. Evaluation of body composition during low‐dose estrogen oral contraceptives treatment. Acta Europaea Fertilitatis 1995;26:69‐73.

Goldzieher 1971 {published data only}

Goldzieher JW, Moses LE, Averkin E, Scheel C, Taber BZ. A placebo‐controlled double‐blind crossover investigation of the side effects attributed to oral contraceptives. Fertility and Sterility 1971;22:609‐23.

Gruber 2006 {published data only}

Gruber DM, Huber JC, Melis GB, Stagg C, Parke S, Marr J. A comparison of the cycle control, safety, and efficacy profile of a 21‐day regimen of ethinylestradiol 20µg and drospirenone 3mg with a 21‐day regimen of ethinylestradiol 20µg and desogestrel 150µg. Treatments in Endocrinology 2006;5:115‐21.

Halbe 1998 {published data only}

Halbe HW, de Melo NR, Bahamondes L, Petracco A, Lemgruber M, de Andrade RP, et al. Efficacy and acceptability of two monophasic oral contraceptives containing ethinylestradiol and either desogestrel or gestodene. European Journal of Contraception & Reproductive Health Care 1998;3:113‐20.

Kashanian 2010 {published data only}

Kashanian M, Shahpourian F, Zare O. A comparison between monophasic levonorgestrel‐ethinyl estradiol 150/30 and triphasic levonorgestrel‐ethinyl estradiol 50‐75‐125/30‐40‐30 contraceptive pills for side effects and patient satisfaction: a study in Iran. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2010/02/27 2010; Vol. 150, issue 1:47‐51.

Kaunitz 2000 {published and unpublished data}

Kaunitz AM. Efficacy, cycle control, and safety of two triphasic oral contraceptives: Cyclessa (desogestrel/ethinyl estradiol) and Ortho‐Novum 7/7/7 (norethindrone/ethinyl estradiol): a randomized clinical trial. Contraception 2000;61:295‐302.

Kirkman 1994 {published data only}

Kirkman RJ, Pedersen JH, Fioretti P, Roberts HE. Clinical comparison of two low‐dose oral contraceptives, Minulet and Mercilon, in women over 30 years of age. Contraception 1994;49:33‐46.
Kirkman RJE. Clinical comparison of two low‐dose oral contraceptives in women older than 30 years. Advances in Contraception 1991;7:63‐76.

Knopp 2001 {published data only}

Knopp RH, Broyles FE, Cheung M, Moore K, Marcovina S, Chandler WL. Comparison of the lipoprotein, carbohydrate, and hemostatic effects of phasic oral contraceptives containing desogestrel or levonorgestrel. Contraception 2001;63:1‐11.

Koetsawang 1977 {published data only}

Koetsawang S, Srisupandit S, Srivannaboon S, Bhiraleus P. Comparative clinical trial of two oral contraceptives with a low‐‐ estrogen content. Journal of the Medical Association of Thailand 1977;60:368‐73.

Koetsawang 1995 {published data only}

Koetsawang S, Charoenvisal C, Banharnsupawat L, Singhakovin S, Kaewsuk O, Punnahitanont S. Multicenter trial of two monophasic oral contraceptives containing 30 mcg ethinylestradiol and either desogestrel or gestodene in Thai women. Contraception 1995;51:225‐9.

Lachnit‐Fixson 1984 {published data only}

Lachnit‐Fixson U, Aydinlik S, Lehnert J. Clinical comparison between a monophasic preparation and a triphasic preparation. In: Rolland R, Harrison RF, Bonnar J, Thompson W editor(s). Advances in fertility control and the treatment of sterility: the proceedings of a special symposium held at the XIth World Congress on Fertility and Sterility, Dublin, June 1983. Hingham, MA: MTP Press, 1984:71‐9.

Liukko 1987 {published data only}

Liukko P, Erkkola R, Gronroos M, Lammintausta R. Plasma renin activity, blood pressure and body weight during two years' oral contraception with two different low‐estrogen combinations. Annales Chirurgiae et Gynaecologiae Supplementum 1987;202:45‐9.
Liukko P, Erkkola R, Lammintausta R, Gronroos M, Kloosterboer HJ. Blood glucose, serum insulin, serum growth hormone and serum glycosylated proteins during two years' oral contraception with low‐ estrogen combinations. Annales Chirurgiae et Gynaecologiae Supplementum 1987;202:50‐53.

Loudon 1990 {published data only}

Loudon NB, Kirkman RJE, Dewsbury JA. A double‐blind comparison of the efficacy and acceptability of Femodene and Microgynon‐30. European Journal of Obstetrics, Gynecology, and Reproductive Biology 1990;34:257‐66.

Miller 2001 {published data only}

Miller L, Notter KM. Menstrual reduction with extended use of combination oral contraceptive pills: randomized controlled trial. Obstetrics and Gynecology 2001;98:771‐8.

Milsom 2006 {published data only}

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.
Milsom I, Lete I, Bjertnaes A, Rokstad K, Lindh I, Gruber CJ, et al. Effects on cycle control and bodyweight of the combined contraceptive ring, NuvaRing, versus an oral contraceptive containing 30 µg ethinyl estradiol and 3 mg drospirenone. Human Reproduction 2006;21:2304‐11.

Oddsson 2005 {published data only}

Oddsson K, Leifels‐Fischer B, de Melo NR, Wiel‐Masson D, Benedetto C, Verhoeven CHJ, et al. Efficacy and safety of a contraceptive vaginal ring (NuvaRing) compared with a combined oral contraceptive: a 1‐year randomized trial. Contraception 2005;71:176‐82.

Oelkers 1995 {published data only}

Oelkers W, Foidart JM, Dombrovicz N, Welter A, Heithecker R. Effects of a new oral contraceptive containing an antimineralocorticoid progestogen, drospirenone, on the renin‐aldosterone system, body weight, blood pressure, glucose tolerance, and lipid metabolism. Journal of Clinical Endocrinology and Metabolism 1995;80:1816‐21.

Oelkers 2000 {published data only}

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.

Procter‐Gray 2008 {published data only}

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.
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.

Rosenbaum 2000 {published data only}

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.

Sang 1995 {published and unpublished data}

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.

Serfaty 1998 {published data only}

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.

Sibai 2001 {published data only}

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.
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.

Spellacy 1970 {published data only}

Spellacy WN, Birk SA. The development of elevated blood pressure while using oral contraceptives: a preliminary report of a prospective study. Fertility and Sterility 1970;21:301‐6.

Spona 1996 {published and unpublished data}

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.

Stewart 2005 {published data only}

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.

Teichmann 1995 {published and unpublished data}

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.

Van der Does 1995 {published and unpublished data}

Van der Does J, Exalto N, Dieben T, Bennink HC. Ovarian activity suppression by two different low‐dose triphasic oral contraceptives. Contraception 1995;52:357‐61.

Weisberg 1999 {published data only}

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.

Wiegratz 1995 {published and unpublished data}

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.

Wiegratz 2002 {published and unpublished data}

Wiegratz I, Lee JH, Kutschera E, Bauer HH, von Hayn C, Moore C, et al. Effect of dienogest‐containing oral contraceptives on lipid metabolism. Contraception 2002;65:223‐9.

Wiik 1993 {published data only}

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.

Winkler 1996 {published and unpublished data}

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.

Worsley 1980 {published data only}

Worsley A. A prospective study of the effects of the progestagen content of oral contraceptives on measures of affect, automatization, and perceptual restructuring ability. Psychopharmacology (Berl) 1980;67:289‐96.

References to studies excluded from this review

Ahrendt 2009 {published data only}

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.

Bonny 2006 {published data only}

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.

Boonyarangkul 2007 {published data only}

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.

Elkind‐Hirsch 2007 {published data only}

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.

Endrikat 2007 {published data only}

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.

Fan 2010 {published data only}

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.
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.

Gaspard 2003 {published data only}

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.

Grinspoon 2003 {published data only}

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.

Junge 2011 {published data only}

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.

Machado 2006 {published data only}

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.

Miller 2003 {published data only}

Miller L, Hughes JP. Continuous combination oral contraceptive pills to eliminate withdrawal bleeding: a randomized trial. Obstetrics and Gynecology 2003;101:653‐61.

Miller 2005 {published data only}

Miller L, Verhoeven CH, Hout J. Extended regimens of the contraceptive vaginal ring: a randomized trial. Obstetrics and Gynecology 2005;106:473‐82.

Mohamed 2011 {published data only}

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.

O'Connell 2005 {published data only}

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.
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.

O'Connell 2007 {published data only}

O'Connell K, Davis AR, Kerns J. Oral contraceptives: side effects and depression in adolescent girls. Contraception 2007;75:299‐304.

Sabatini 2006 {published data only}

Sabatini R, Cagiano R. Comparison profiles of cycle control, side effects and sexual satisfaction of three hormonal contraceptives. Contraception 2006;74:220‐3.

Sanam 2011 {published data only}

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.

Sangthawan 2005 {published data only}

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.

Skouby 2005 {published data only}

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.

Suthipongse 2004 {published data only}

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.

Taneepanichskul 2002 {published data only}

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.

Tantbirojn 2002 {published data only}

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.

Veres 2004 {published data only}

Veres S, Miller L, Burington B. A comparison between the vaginal ring and oral contraceptives. Obstetrics and Gynecology 2004;104:555‐63.

Westhoff 2007 {published data only}

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.
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.

Westhoff 2010 {published data only}

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.

Westhoff 2012 {published data only}

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.

Winkler 2004 {published data only}

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.

Yildizhan 2009 {published data only}

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.

Mahidol 2013 {published data only}

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

CONSORT 2009

CONSORT group. CONSORT: Transparent reporting of trials. http://www.consort‐statement.org/ (accessed 15 Jul 2009).

Corvol 1983

Corvol P, Elkik F, Feneant M, Oblin ME, Michaud A, Claire M, et al. Effect of progesterone and progestins on water and salt metabolism. In: CW Bardin, E Milgrom, P Mauvais‐Jarvis editor(s). Progesterone and Progestins. New York: Raven Press, 1983.

Emans 1987

Emans SJ, Grace E, Woods ER, Smith DE, Kelin K, Merola J. Adolescents' compliance with the use of oral contraceptives. JAMA 1987;257:3377‐81.

Flegal 2000

Flegal KM, Troiano RP. Changes in the distribution of body mass index of adults and children in the US population. International Journal of Obesity and Related Metabolic Disorders 2000;24:807‐18.

Gaudet 2004

Gaudet LM, Kives S, Hahn, Reid RL. What women believe about oral contraceptives and the effect of counseling. Contraception 2004;69:31‐6.

Higgins 2011

Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions, Version 5.1.0 [updated March 2011]. The Cochrane Collaboration2011; Vol. available from www.cochrane‐handbook.org.

IOM 1996

Institute of Medicine. Contraceptive research and development: looking to the future. Washington, DC: National Academy Press, 1996.

Juni 2002

Juni P, Holenstein F, Sterne J, Bartlett C, Egger M. Direction and impact of language bias in meta‐analyses of controlled trials: empirical study. International Journal of Epidemiology 2002;31:115‐23.

Le 2003

Le MG, Laveissiere MN, Pelissier C. Factors associated with weight gain in women using oral contraceptives: results of a French 2001 opinion poll survey conducted on 1665 women. Gynecologie, Obstetrique & Fertilite 2003;31:230‐9.

Moher 2000

Moher D, Pham B, Klassen TP, Schulz KF, Berlin JA, Jadad AR, et al. What contributions do languages other than English make on the results of meta‐analyses?. Journal of Clinical Epidemiology 2000;53:964‐72.

Moher 2001

Moher D, Schulz KF, Altman DG. The CONSORT statement: revised recommendations for improving the quality of reports of parallel‐group randomized trials. Lancet 2001;357:1191‐4.

Nelson 2007

Nelson AL. Combined oral contraceptives. In: Hatcher RA, Trussell J, Nelson AL, Cates W, Stewart FH, Kowal D, et al. editor(s). Contraceptive Technology. 19th Edition. New York: Ardent Media, Inc., 2007:193‐270.

Oddens 1999

Oddens BJ. Women's satisfaction with birth control: a population survey of physical and psychological effects of oral contraceptives, intrauterine devices, condoms, natural family planning, and sterilization among 1466 women. Contraception 1999;59:277‐86.

Rosenberg 1995

Rosenberg MJ, Waugh MS, Meehan TE. Use and misuse of oral contraceptives: risk indicators for poor pill taking and discontinuation. Contraception 1995;51:283‐8.

Rosenberg 1998

Rosenberg M. Weight change with oral contraceptive use and during the menstrual cycle. Results of daily measurements. Contraception 1998;58:345‐9.

Rothman 1998

Rothman KJ, Greenland S. Approaches to statistical analysis. In: RJ Rothman, S Greenland editor(s). Modern Epidemiology. 2nd Edition. New York: Lippincott Williams and Wilkins, 1998:183‐99.

Schulz 1995

Schulz KF, Chalmers I, Hayes RJ, Altman DG. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 1995;273:408‐12.

Schulz 2002a

Schulz KF, Grimes DA. Allocation concealment in randomised trials: defending against deciphering. Lancet 2002;359:614‐700.

Schulz 2002b

Schulz KF, Grimes DA. Blinding in randomised trials: hiding who got what. Lancet 2002;359:696‐700.

Turner 1994

Turner R. Most British women use reliable contraceptive methods, but many fear health risks from use. Family Planning Perspectives 1994;26:183‐4.

Weiss 1998

Weiss NS. Clinical epidemiology. In: RJ Rothman, S Greenland editor(s). Modern Epidemiology. 2nd Edition. New York: Lippincott Williams and Wilkins, 1998:519‐28.

Wysocki 2000

Wysocki S. A survey of American women regarding the use of oral contraceptives and weight gain [abstract]. International Journal of Gynecology and Obstetrics2000; Vol. 70:114.

References to other published versions of this review

Gallo 2004

Gallo M, Grimes D, Schulz K, Helmerhorst F. Combination contraceptives: effects on weight. Obstetrics and Gynecology 2004;103:359‐73.

Characteristics of studies

Characteristics of included studies [ordered by study ID]

Aden 1998

Methods

Study location not described.
Cross‐over trial but weight data available from first treatment period only.
Two pre‐treatment 'washout' cycles and three treatment cycles.

Participants

Healthy women age 21 to 32 years with regular menses. Excluded recent hormonal contraceptive use; recent use of certain drugs.

Interventions

Levonorgestrel 50‐75‐150 µg and EE 30‐40‐30 µg versus levonorgestrel 50‐75‐150 µg and EE 30‐40‐30 µg.
29 women randomized; initial number assigned to each study group not reported.

Outcomes

Adverse events, hormonal measurements.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Computer‐generated randomization scheme.

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

No information

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Three women discontinued early. Primary reasons for discontinuation described and did not include weight gain.
Loss to follow up not reported.

Agoestina 1989

Methods

One site in Indonesia.
12 treatment cycles.

Participants

Inclusion and exclusion criteria not described.

Interventions

Gestodene 50‐70‐100 µg and EE 30‐40‐30 µg (N=13) versus desogestrel 150 µg and EE 30 µg (N=17).

Outcomes

Lipoprotein, liver function, blood coagulation, adverse events, body weight, blood pressure.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Computer‐generated randomization scheme.

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Low risk

"Double‐blinded" but did not report who was blinded.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Three women discontinued early or were lost to follow up. Primary reasons for discontinuation not described.

Brill 1991

Methods

Multicenter trial in Germany.
Six treatment cycles.

Participants

Healthy, sexually‐active women age 16 to 45 years with regular menses.
Excluded contraindications to oral contraceptive use; recent oral contraceptive use; certain drug use; abnormal Pap smear.

Interventions

Gestodene 75 µg and EE 30 µg (N=209) versus desogestrel 150 µg and EE 30 µg (N=201) versus norgestimate 250 µg and EE 35 µg (N=195).

Outcomes

Contraceptive efficacy, cycle control, body weight, blood pressure, adverse events.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

No information

Incomplete outcome data (attrition bias)
All outcomes

Low risk

29 women in the gestodene, 29 women in the desogestrel and 18 women in the norgestimate group discontinued early or were lost to follow up. Primary reasons for discontinuation described and did not include weight gain.

Brill 1996

Methods

One site.
Three pill‐free pretreatment cycles and 13 treatment cycles.

Participants

Women age 18 to 35 years with regular menses.
Excluded smokers over age 30 years; pregnancy; liver disease; vascular disease; tumors; certain other diseases; obesity; heavy alcohol use; other hormone preparations or intrauterine device use.

Interventions

Gestodene 75 µg and EE 20 µg (N=32) versus gestodene 75 µg and EE 30 µg (N=32).

Outcomes

Lipid levels, hormone levels, efficacy, cycle control, safety.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

High risk

Unblinded

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

1 woman in EE 20 µg and 5 in EE 30 µg group withdrew before starting treatment. 4 in EE 20 µg and 1 in EE 30 µg group discontinued early due to adverse events. Primary reasons for discontinuation not described.
3 women in EE 20 µg group were excluded for protocol violations.
Lost to follow up not reported.

Burkman 2007

Methods

100 sites in USA and 10 in Canada.
First 1/3 of participants were to have 13 treatment cycles and the remaining 2/3 were to have 6 treatment cycles.

Participants

Sexually active, healthy women aged 18 to 45 years at risk for pregnancy with regular menstrual cycles, blood pressure <140/90.
Excluded recent pregnancy or lactation; contraindications to OCs; certain diseases; smokers aged 35 or more years; certain drugs or devices; recent DMPA use; and recent alcohol or substance abuse.

Interventions

Norethindrone acetate (NETA) 1.0 mg plus EE 20 µg, with 75 mg ferrous fumarate on days 22‐28 (N=853 for 6 cycles, 318 for 13 cycles) versus norgestimate (NGM) 180‐215‐250 µg plus EE 25 µg (N=1236 for 6 cycles, 487 for 13 cycles).

Outcomes

Weight change was primary outcome; contraceptive efficacy, cycle control, and safety were in earlier report (Hampton 2001).
'Breakthrough' bleeding or spotting defined as bleeding or spotting that occurred during the active pill days unless it was contiguous with menses.
'Amenorrhea' defined as two consecutive cycles without any bleeding or spotting.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Allocated with block sizes of 11

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Low risk

Blinded (participants and at least the assessors at cycle 3).

Incomplete outcome data (attrition bias)
All outcomes

High risk

Lost to follow up reportedly 6.5% in NGM/EE group and 5.8% in NETA/EE group. Noncompleters were 21% of 6‐cycle groups; 42% to 40% of 13‐cycle groups, respectively.

Cachrimanidou 1993

Methods

Three sites in Sweden.
12 treatment cycles.

Participants

Healthy women age 18 to 39 years at risk of pregnancy.
Excluded "generally accepted" contraindications of OC use.

Interventions

Prolonged regimen (desogestrel 150 µg and EE 30 µg; nine pill weeks and one pill‐free week; N=198) versus standard regimen (desogestrel 96 µg and EE 30 µg; three pill weeks and one pill‐free week; N=96).

Outcomes

Lipoprotein, liver function, blood coagulation, adverse events, body weight, blood pressure.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

Allocated with sealed envelopes.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

No information

Incomplete outcome data (attrition bias)
All outcomes

High risk

83 women in the prolonged regimen and 32 women in the standard regimen group discontinued early.
Primary reasons for discontinuation described; 10 women in the prolonged and one woman in the standard regimen group cited weight gain.
Loss to follow up not reported.

Coenen 1996

Methods

Unspecified location.
One pre‐treatment cycle and six treatment cycles.

Participants

Healthy women age 18 to 38 years with regular menses.
Excluded obesity; pregnancy; recent pregnancy; lactation; contraindications to oral contraceptives; certain medications; heavy smoking.

Interventions

Norgestimate 250 µg and EE 35 µg (N=25) versus gestodene 75 µg and EE 30 µg (N=25) versus desogestrel 150 µg and EE 30 µg (N=25) versus desogestrel 150 µg and EE 20 µg (N=25).

Outcomes

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

High risk

Unblinded

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

2 women who became pregnant during pretreatment cycle were excluded and replaced.
4 women in the norgestimate, 3 women in the gestodene, 1 woman in the desogestrel/EE 30 µg, and 4 women in the desogestrel/EE 20 µg group discontinued early.

Primary reasons for discontinuation described; 1 women in the norgestimate group cited weight change.
Loss to follow up not reported.

Coney 2001

Methods

32 sites in USA, Canada and Australia.
Article reports pooled data from two randomized controlled trials with similar protocols.
Six treatment cycles.
Placebo tablets identical in appearance to oral contraceptive pills.

Participants

Healthy women age 14 or more years with regular menses and moderate facial acne.
Excluded recent abnormal cervical cytology; pregnancy; willing to use non‐hormonal contraception if at risk of pregnancy; contraindications to oral contraceptive use; recent oral or injectable hormones; recent use of certain drugs.

Interventions

Levonorgestrel 100 µg and EE 20 µg (N=359) versus placebo (N=362).

Outcomes

Lipoprotein, liver function, blood coagulation, adverse events, body weight, blood pressure.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Computer‐generated randomization scheme with block size of four stratified by study site.

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Low risk

"Double‐blinded" but did not report who was blinded.

Incomplete outcome data (attrition bias)
All outcomes

High risk

22 women in the levonorgestrel and 15 women in the placebo group withdrew before starting treatment.
124 in the oral contraceptive and 125 in the placebo group discontinued early or were lost to follow up. Primary reasons for discontinuation described; two women in the levonorgestrel group cited body weight.

Dionne 1974

Methods

Location not described.
6 treatment cycles.

Participants

Inclusion and exclusion criteria not described.
Post‐partum or post‐abortal women were given oral contraceptive (levonorgestrel 250 µg and EE 50 µg) until re‐establishment of regular menses.

Interventions

Levonorgestrel 250 µg and EE 50 µg (N=73) versus levonorgestrel 150 µg and EE 30 µg (N=77).

Outcomes

Cycle control, side effects, discontinuation.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Low risk

"Double‐blinded" but did not report who was blinded.

Incomplete outcome data (attrition bias)
All outcomes

High risk

20 women in the higher dose pill and 21 women in the lower dose pill group discontinued early or were lost to follow up.
Reasons for discontinuation described; two women in the higher dose group cited weight gain and one women in each group cited weight loss.

Endrikat 1997

Methods

10 sites in Germany.
12 treatment cycles.

Participants

Healthy, sexually active women age 18 to 39 years.
Excluded recent depot‐contraceptive use; pregnancy; liver, vascular, and metabolic diseases; tumors; unclassified genital bleeding.

Interventions

Gestodene 75 µg and EE 20 µg (N=428) versus gestodene 75 µg and EE 30 µg (N=221).

Outcomes

Contraceptive reliability, cycle control, tolerance (including body weight).

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Low risk

"Double‐blinded" but did not report who was blinded.

Incomplete outcome data (attrition bias)
All outcomes

High risk

93 women in the EE 20 µg and 40 women in the EE 30 µg group discontinued early. Primary reasons for discontinuation included weight gain but no data reported.
16 women in the EE 20 µg and 12 women in the EE 30 µg group were excluded by the sponsor.
Lost to follow up not reported.

Endrikat 1999

Methods

123 sites in France, Austria, the UK, The Netherlands, Switzerland and Italy.
12 treatment cycles.

Participants

Healthy women age 18 to 35 years with regular menses.
Excluded current use of oral contraceptive containing 150 µg desogestrel and 20 µg EE; contraindications to oral contraceptive use; recent depot‐contraceptives use; unclassified genital bleeding; excessive smoking.

Interventions

Gestodene 75 µg and EE 20 µg (N=786) versus desogestrel 150 µg and EE 20 µg (N=777).

Outcomes

Contraceptive efficacy, cycle control, adverse events.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

High risk

Unblinded

Incomplete outcome data (attrition bias)
All outcomes

High risk

228 women in the gestodene and 221 women in the desogestrel group discontinued early or were lost to follow up. Primary reasons for discontinuation described and did not include weight gain.
87 women were excluded from analysis for protocol violations.

Endrikat 2001a

Methods

67 sites in Austria, Belgium, France, Italy, Switzerland, and the UK.
Seven treatment cycles following at least one pill‐free 'wash‐out' cycle.

Participants

Healthy women age 18 to 35 years.
Excluded "established" oral contraceptive contraindications; recent depot‐contraceptive use; select diseases; menses‐related migraines.

Interventions

Prolonged regimen (gestodene 75 µg and EE 20 µg; 23 pill and 5 placebo days) versus standard regimen (desogestrel 150 µg and EE 20 µg; 21 pill and 7 placebo days).
1101 women randomized; initial number assigned to each study group not reported.

Outcomes

Contraceptive efficacy, cycle control, discontinuation, adverse events, blood pressure, weight.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

High risk

Unblinded

Incomplete outcome data (attrition bias)
All outcomes

High risk

42 women withdrew before starting treatment.
145 women in the gestodene and 127 women in the desogestrel group discontinued early or were lost to follow up. Primary reasons for discontinuation described and did not include weight gain.
81 women in the gestodene and 88 women in the desogestrel group were excluded due to protocol violations.

Endrikat 2001b

Methods

30 sites in Germany.
13 treatment cycles.

Participants

Healthy, normal weight women age 18 to 35 years.
Excluded high blood pressure; heavy smoking; established contraindications to oral contraceptive use; recent depot‐contraceptive use; unexplained vaginal bleeding; migraine headaches during menstruation.

Interventions

Levonorgestrel 100 µg and EE 20 µg (N=380) versus norethisterone 500 µg and EE 20 µg (N=255) versus levonorgestrel 150 µg and EE 30 µg (N=125; study standard).
767 women were randomized; however, the sum of the number of women assigned to each group totaled 760 women. The remaining seven women were not described.

Outcomes

Cycle control, contraceptive efficacy, discontinuations, blood pressure, adverse events, weight.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Computer‐generated randomization scheme.

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

High risk

Unblinded

Incomplete outcome data (attrition bias)
All outcomes

High risk

73 women in the levonorgestrel/EE 20 µg, 74 women in the norethisterone, and 13 women in the levonorgestrel/EE 30 µg group discontinued early or were lost to follow up. Primary reasons for discontinuation not described.

Foulon 2001

Methods

One site in France.
Three treatment cycles.

Participants

Healthy, non‐obese women age 19 to 27 years with regular menses and normal lipid values.
Excluded cardiovascular, thyroid, hepatic, renal or pancreatic diseases; certain drugs.

Interventions

Desogestrel 150 µg and EE 20 µg (N=20) versus levonorgestrel 50‐75‐125 µg and EE 30‐40‐30 µg (N=17).

Outcomes

Lipoprotein levels, body mass index, blood pressure.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

No information

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Early discontinuation and loss to follow up not reported.

Franchini 1995

Methods

One site in Italy.
Twelve treatment months.

Participants

Women age 18 to 43 years.
Excluded recent oral contraceptive or certain drug use; current cardiovascular or metabolic disease; agonistic activity.

Interventions

Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg.
80 women randomized; initial number assigned to each study group not reported.

Outcomes

Weight, body composition changes.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

High risk

Unblinded

Incomplete outcome data (attrition bias)
All outcomes

High risk

19 women discontinued early. Adverse events cited as primary reason for discontinuation were not described in detail.
No women were lost to follow up.

Goldzieher 1971

Methods

One site in USA.
Cross‐over design implemented after fourth cycle; however, data after fourth cycle not presented in this review.
Six treatment cycles.
Pre‐packaged, identical capsules. All placebo cases were tagged on their code designations to receive a contraceptive vaginal cream or foam. To preserve the blinding, 10% of the other groups were randomly marked to receive cream or foam as well.

Participants

Women willing to use vaginal contraceptive foam or cream.
Excluded previous oral contraceptive use.

Interventions

EE 100 µg with last five of the 20 pills also containing dimethisterone 25 mg (N=79) versus mestranol 100 µg and ethynodiol diacetate 1 mg (N=78) versus mestranol 50 mg and norethindrone 1 mg (N=81) versus chlormadinone acetate 500 µg daily (N=84) versus placebo (N=76).

Outcomes

Nausea, vomiting, abdominal discomfort, mastalgia, headache, nervousness, depression, body weight, blood pressure.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Low risk

Double‐blinded; participants and investigators blinded.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Early discontinuation and loss to follow up not reported.
18 women were excluded for protocol violations.

Gruber 2006

Methods

25 centers in 4 countries (Italy, UK, Czech Republic, and Belgium).
7 treatment cycles.
No a priori sample size calculation.

Participants

Healthy women aged 18 to 35 years, except for smokers over 30 years.
Exclusion: contraindications for COC use; use of DMPA in past 6 months or OC with desogestrel or drospirenone in last cycle; childbirth, abortion, or lactation in last 3 cycles; suspect cervical smear.

Interventions

Drospirenone 3 mg and EE 20 µg (N=222) versus desogestrel 150 µg and EE 20 µg (N=223).

Outcomes

Mean body weight change (no methods reported), bleeding patterns, and contraceptive efficacy.

Notes

Full analysis defined as having at least one dose of study medication and one study observation rather than intent‐to‐treat.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Randomization via "computer‐generated randomization schedule".

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

High risk

Open‐label

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Lost to follow up: 2.3% drospirenone group and 3.6% desogestrel group.

Halbe 1998

Methods

8 sites in Brazil.
Six treatment cycles.

Participants

Healthy, reproductive‐age women with regular menses and at risk for pregnancy.
Excluded contraindications to oral contraceptive use, lactation, certain drugs, malnutrition.

Interventions

Desogestrel 150 µg and EE 30 µg (N=316) versus gestodene 75 µg and EE 30 µg (N=279).

Outcomes

Contraceptive efficacy, cycle control, skin conditions, blood pressure, body weight, adverse events.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

High risk

Unblinded

Incomplete outcome data (attrition bias)
All outcomes

Low risk

34 women in the desogestrel and 44 women in the gestodene group discontinued early. 19 of these early discontinuations occurred before initiating treatment. Primary reasons for discontinuation described; four women in the gestodene group cited weight gain.
Eight women in each group were lost to follow up.

Kashanian 2010

Methods

Public health centers in Iran.
Six treatment cycles.
Sample size information referred to both 80% and 85% power. Correspondence with researcher indicated 80% power. Sample size of 300 was considered sufficient for power to detect difference in "common side effects". Presuming 10% drop‐out rate, sample of 330 was determined adequate.

Participants

342 women seeking contraception at public health centers. Inclusion criteria: married, age 17 to 40 years, regular menstruation, no signs or symptoms similar to adverse effects of pills before using them, no prior OCP use. Exclusion criteria: contraindication to pills, systemic disorders or drug use, breastfeeding, delivered < 3 weeks previously; use of injectable contraceptive in past 6 months or implant in past 3 months; abnormal Pap smear, abnormal blood cholesterol and triglycerides, and being illiterate.
Further exclusion criteria during the study: omitting one or more pills during the cycles, stopping taking pills, using other contraceptives along with OCPs, acute severe diarrhea and vomiting, and pregnancy.

Interventions

Levonorgestrel 150 µg and EE 30 µg versus levonorgestrel 50‐75‐125 µg and EE 30‐40‐30 µg

Outcomes

Weight change (weight measured monthly by investigator), side effects, satisfaction

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Randomization method not clear in report; blocks of 4 mentioned. Correspondence with researcher indicated use of Random Allocation Software with "simple block randomization."

Allocation concealment (selection bias)

Low risk

"Sealed, sequentially distributed envelopes" with letters A, B, C, D (2 letters assigned to each treatment group). Participant chose an envelope, which investigator opened.

Blinding (performance bias and detection bias)
All outcomes

Low risk

Blinding not mentioned in report, but investigator communicated that the outcome assessors were blinded to group assignment.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Loss to follow up: monophasic 6% (10/171); triphasic 9% (16/171).
In addition, 2 from the monophasic group who discontinued the intervention were excluded from the analysis.

Kaunitz 2000

Methods

131 sites.
Pooled results from two trials with identical study designs.
Six treatment cycles.

Participants

Normal‐weight women age 18 to 50 years at risk of pregnancy with regular menses.
Excluded contraindications to oral contraceptives; breastfeeding; certain medication use; recent injectable contraception or IUD use; heavy alcohol use; heavy smoking among those over age 35 years; drug abuse history; abnormal pap smear.

Interventions

Triphasics: desogestrel 100‐125‐150 µg and EE 25 µg versus norethindrone 500‐750‐1000 µg and EE 35 µg.
5654 women randomized; initial number assigned to each study group not reported.

Outcomes

Contraceptive efficacy, cycle control, adverse events, biochemical changes, weight and body mass index, blood pressure.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Computer‐generated randomization scheme stratified by study site.

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

High risk

Unblinded

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

1040 women discontinued early. Adverse events cited as primary reason for discontinuation were not described in detail.
Loss to follow up not reported.

Kirkman 1994

Methods

66 sites in Denmark, Italy, New Zealand and the United Kingdom.
Six treatment cycles.

Participants

Healthy women over age 30 years.
Excluded irregular menses; smoking among those over age 34 years; lactation; high blood pressure; certain drug use.

Interventions

Gestodene 75 µg and EE 30 µg (N=505) versus desogestrel 150 µg and EE 20 µg (N=501).

Outcomes

Contraceptive efficacy, cycle control, body weight, blood pressure, discontinuation.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Randomization by pre‐distributed schedules.

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

High risk

Unblinded

Incomplete outcome data (attrition bias)
All outcomes

Low risk

52 women in the gestodene and 49 women in the desogestrel group discontinued early.
Weight gain cited as primary reason for discontinuation by four women in the gestodene and two women in the desogestrel group.
7 women in the gestodene and 3 women in the desogestrel group were lost to follow up.
9 women in the gestodene and 12 women in the desogestrel group were excluded for protocol violations.

Knopp 2001

Methods

Study location not described.
Nine treatment cycles.

Participants

Healthy women age 21 to 35 years with normal lipid levels and regular menses.
Excluded diseases affecting lipoprotein metabolism; recent OC, injectable hormones or certain drug use; certain diseases; high blood pressure; recent smoking; recent alcohol or drug abuse; pregnancy; lactation.

Interventions

Desogestrel 50‐100‐150 µg and EE 35‐30‐30 µg (N=33) versus levonorgestrel 50‐75‐125 µg and EE 30‐40‐30 µg (N=34).

Outcomes

Plasma lipids, glucose, insulin, hemostasis, sex hormone binding globulin.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

No information

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Early discontinuation and loss to follow up not reported.
One woman from desogestrel group excluded for protocol violation before starting treatment.

Koetsawang 1977

Methods

One site in India.
12 treatment cycles.

Participants

Healthy women with proven fertility.
Excluded recent hormone use.

Interventions

Lynestrenol 2 mg and EE 40 µg (N=150) versus lynestrenol 1 mg and EE 40 µg (N=150).

Outcomes

Contraceptive efficacy, cycle control, nausea, weight, headache, dysmenorrhea.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

High risk

Unblinded

Incomplete outcome data (attrition bias)
All outcomes

High risk

30 women in the lynestrenol 2 mg and 33 women in the lynestrenol 1 mg group discontinued early. Discontinuations due to side effects not described.
4 women in the lynestrenol 2 mg and 5 women in the lynestrenol 1 mg group were lost to follow up.

Koetsawang 1995

Methods

Six sites in Thailand.
Six treatment cycles.

Participants

Healthy women of fertile age with regular menses.
Excluded contraindications to oral contraceptive use; lactation; certain drug use.

Interventions

Desogestrel 150 µg and EE 30 µg (N=394) versus gestodene 75 µg and EE 30 µg (N=389).

Outcomes

Contraceptive efficacy, cycle control, side effects.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Randomization by random number table.

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Low risk

Unblinded

Incomplete outcome data (attrition bias)
All outcomes

Low risk

23 women in the desogestrel and 31 women in the gestodene group discontinued early. Adverse events cited as primary reason for discontinuation not described in detail.
22 women in the desogestrel and 21 women in the gestodene group were lost to follow up.
Four women in the desogestrel and three women in the gestodene group were excluded for protocol violations.

Lachnit‐Fixson 1984

Methods

Multicenter trial in Austria, Germany, The Netherlands and the UK.
Six treatment cycles.

Participants

Inclusion and exclusion criteria not described.

Interventions

Desogestrel 150 µg and EE 30 µg (N=277) versus triphasic: levonorgestrel 50‐75‐125 µg and EE 30‐40‐30 µg (N=278).

Outcomes

Contraceptive efficacy, cycle control, body weight, blood pressure, side effects.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

No information

Incomplete outcome data (attrition bias)
All outcomes

Low risk

86 women discontinued early or were lost to follow up.
Primary reasons for discontinuation not described.

Liukko 1987

Methods

Study location not described.
24 treatment months.

Participants

Healthy normal‐weight women with regular menses.
Excluded history of hypertension; recent pregnancy; recent hormonal therapy.

Interventions

Levonorgestrel 150 µg and EE 30 µg (N=10) versus desogestrel 150 µg and EE 30 µg (N=10).

Outcomes

Body weight, blood pressure, plasma renin activity.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

No information

Incomplete outcome data (attrition bias)
All outcomes

Low risk

One woman in the levonorgestrel and two women in the desogestrel group discontinued early. Primary reasons for discontinuation described and did not include weight gain.
No women were lost to follow up.

Loudon 1990

Methods

31 sites in the United Kingdom.
Six treatment months.

Participants

Women age 16 to 35 years.
Excluded high blood pressure; amenorrhea; post‐partum women without resumption of menses; thrombotic disorders; history of sickle‐cell anemia, lipid metabolism disorders, or herpes; liver diseases; abnormal vaginal bleeding of unknown origin; certain neoplasias; pregnancy; lactation.

Interventions

Gestodene 75 µg and EE 30 µg (N=229) versus levonorgestrel 150 µg and EE 30 µg (N=227).

Outcomes

Cycle control, body weight, blood pressure, other side effects, withdrawals.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Low risk

"Double‐blinded" but did not report who was blinded.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

24 women in the gestodene and 30 women in the levonorgestrel group discontinued early. Primary reasons for discontinuation not described in detail.
Four women in the gestodene and five women in the levonorgestrel group were lost to follow up.
32 women withdrew before starting intervention.

Miller 2001

Methods

Four sites in USA.
12 treatment cycles.

Participants

Women age 18 to 45 years who could speak and read English and who did not intend to become pregnant within one year.
Excluded "standard" contraindications to OC use.

Interventions

Standard regimen (28‐day cycle with 21 active pills; N=44) versus prolonged regimen (49‐day cycle with 42 active pills; N=46). Both groups used same oral contraceptive (levonorgestrel 300 µg and EE 30 µg).

Outcomes

Cycle control, body weight, blood pressure, other side effects, withdrawals.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Randomized using random number table and permuted blocks of six.

Allocation concealment (selection bias)

Low risk

Allocation concealed with sequentially numbered, opaque envelopes.

Blinding (performance bias and detection bias)
All outcomes

High risk

Unblinded

Incomplete outcome data (attrition bias)
All outcomes

High risk

2 women in each group withdrew before starting treatment.
9 women in the standard regimen and 5 women in the prolonged regimen group discontinued early. Primary reasons for discontinuation described; 1 woman in prolonged regimen group cited weight gain.
9 women in the standard and 11 women in the prolonged regimen group were lost to follow up.

Milsom 2006

Methods

Open‐label, randomized trial in 10 European countries from May 2002 to April 2004.

Participants

1017 women, at least 18 years old, seeking contraception. Exclusion criteria: contraindication for hormonal contraception, abortion or breastfeeding in past 2 months, injectable hormonal contraceptive use in past 6 months, abnormal cervical smear during screening, and use in past 2 months of drugs that interfere with metabolism of hormonal contraceptives.

Interventions

Vaginal ring releasing etonogestrel 120 µg + EE 15 µg daily versus COC containing drospirenone 3 mg + EE 30 µg; 13 treatment cycles.

Outcomes

Body weight (methods reported for standardized measurements) and body composition; contraceptive efficacy, compliance, acceptability, tolerability (adverse events), continuation in earlier report (Ahrendt 2006)

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Randomization conducted via an interactive voice response system.

Allocation concealment (selection bias)

Low risk

Interactive voice response system.

Blinding (performance bias and detection bias)
All outcomes

High risk

Open‐label

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Loss after randomization and before treatment: 1017 ‐ 983 = 34.
Loss after treatment: ring 29% (144/499) and COC 25% (123/484).
Lost to follow up: 2% ring and 3% COC.

Oddsson 2005

Methods

11 countries in Europe and South America. 13 treatment cycles.

Participants

1030 "healthy" women, 18 or more years old.
Excluded if OC contraindicated, DMPA use in previous 6 months, postpartum or postabortion within 2 months of start, breastfeeding within 2 months, abnormal cervical smear, or drugs that could interfere with contraceptive metabolism.

Interventions

Vaginal ring releasing 120 µg etonogestrel and 15 µg ethinylestradiol daily (N=512) versus OC with 150 µg levonorgestrel and 30 µg ethinylestradiol (N=518).

Outcomes

Contraceptive efficacy, compliance, weight change (≥7% or ≤7%).

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Randomized with interactive voice response system, which gave treatment group and medication number.

Allocation concealment (selection bias)

Low risk

Interactive voice response system

Blinding (performance bias and detection bias)
All outcomes

High risk

Open‐label

Incomplete outcome data (attrition bias)
All outcomes

High risk

1090 were randomized, but only 1079 began treatment.
298 discontinued (149 from each group): 33 lost to follow up in each group, 58 adverse events in ring group and 45 in OC group.

Oelkers 1995

Methods

Study location not described.
One pill‐free pretreatment cycle, six treatment cycles, and one pill‐free post‐treatment cycle.

Participants

Women age 18 to 34 years.
Excluded smoking among those age 30 years or older.

Interventions

Drospirenone 3 mg and EE 30 µg (N=20) versus drospirenone 3 mg and EE 20 µg (N=20) versus drospirenone 3 mg and EE 15 µg (N=20) versus levonorgestrel 150 µg and EE 30 µg (N=20; control group).

Outcomes

Renin‐aldosterone system, well‐being, cycle control, body weight, blood pressure, glucose tolerance, lipid metabolism.
Cycle average weights based on self‐measured weighing conducted every second day in unclothed, fasting‐state.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Low risk

Triple‐blinded; participant, investigator and outcome assessor blinded.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Early discontinuation and loss to follow up not reported.

Oelkers 2000

Methods

Study 2:
Three centers in The Netherlands and Belgium. One pill‐free pre‐treatment cycle and three treatment cycles.

Study 3:
One site in The Netherlands.
Two pill‐free pretreatment cycles, 13 treatment cycles and one follow up cycle.

Participants

Study 2 and 3:
Women age 18 to 35 years (18 to 30 years for smokers) with regular menses.
Excluded pregnancy.

Interventions

Study 2:
Drospirenone 2 mg and EE 30 µg (N=35) versus drospirenone 3 mg and EE 30 µg (N=35).

Study 3:
Drospirenone 3 mg and EE 30 µg (N=30) versus desogestrel 150 µg and EE 30 µg (N=30).

Outcomes

Study 2 and 3:
Renin‐angiotensin‐aldosterone system, body weight.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Study 2, no information; study 3, unblinded.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Early discontinuation and loss to follow up not reported.

Procter‐Gray 2008

Methods

Five sites in USA.
Participants recruited Aug 1998 to Sep 2003 and followed at 1 and 2 years.

Participants

150 female runners. Inclusion criteria: 18 to 26 years old, run at least 40 miles per week during peak training times, and compete in running races.
Exclusion criteria: had used OC, other hormone therapy, or other hormonal contraception in past 6 months; unwilling to be randomized to take OC or not to take OC for 2 years; any medical contraindication to OC use.

Interventions

Norgestrel 300 µg and EE 30 µg (N=69) versus no intervention (N=81).

Outcomes

Bone mass, stress fractures, weight and body composition.

Notes

Crossover from assigned protocol > 25% in each group; researchers conducted primary analysis by assigned group and secondary analysis by treatment received.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Randomization done by investigator not involved in study, using random‐number table. Stratified by clinical site.

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

High risk

Unblinded participants and prescribing physicians; assessors not informed of treatment assignment.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Loss to follow up: 17% overall; treatment 22% (15/69); control 14% (11/81).

Rosenbaum 2000

Methods

Six sites in Germany and Belgium.
Pill‐free cycle followed by three treatment cycles and a follow‐up cycle.

Participants

Women age 18 to 35 years (18 to 30 years for smokers) with regular menses.
Excluded "usual" contraindications to oral contraception.

Interventions

Drospirenone 2 mg and EE 30 µg (N=26) versus drospirenone 3 mg and EE 30 µg (N=26).

Outcomes

Hormonal and peripheral measurements, cycle control, safety.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Computer‐generated randomization scheme.

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

High risk

Unblinded

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

No one in the drospirenone 2 mg and one woman in the drospirenone 3 mg group discontinued early. The primary reasons for discontinuation described and did not include weight gain.
Three women in the drospirenone 2 mg and two women in the drospirenone 3 µg group were excluded for protocol violations.
No women were lost to follow up.

Sang 1995

Methods

15 sites in China.
12 treatment months.

Participants

Healthy women age 18 to 35 years with regular menses and proven fertility.
Excluded lactation; pregnancy; diabetes; abnormal Pap smears; unexplained vaginal bleeding; hypertension; liver disease; hypertension; thromboembolism; malignancy; abnormal nipple discharge; selected drug use; recent injectable or oral contraceptive.

Interventions

Norethisterone enanthate 50 mg and estradiol valerate 5 mg (N=1960) versus medroxyprogesterone acetate 25 mg and estradiol cypionate 5 mg (N=1955).
Also included a study arm with Injectable No. 1, which was not included in the present review since the drug regimen was changed during the trial due to unacceptable efficacy rates.

Outcomes

Contraceptive efficacy, discontinuation, weight, blood pressure, side effects.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Randomization using random numbers table.

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

No information

Incomplete outcome data (attrition bias)
All outcomes

High risk

353 women in the norethisterone enanthate and 498 women in the medroxyprogesterone acetate group discontinued early. Primary reasons for discontinuation described; 10 women in the norethisterone enanthate and 14 women in the medroxyprogesterone acetate group cited weight gain.
17 women in the norethisterone enanthate and 18 women in the medroxyprogesterone acetate group were lost to follow up.

Serfaty 1998

Methods

52 sites in Paris, France.
Six treatment cycles.

Participants

Healthy, normal‐weight women age 18 to 45 years (18 to 35 years for smokers) with regular menses and normal plasma lipid and carbohydrate levels.
Excluded contraindications to oral contraception; recent injectable, implant, or intrauterine contraceptive use; recent birth or abortion; use of certain drugs.

Interventions

Desogestrel 150 µg and EE 20 µg (N=515) versus gestodene 75 µg and EE 20 µg (N=511).

Outcomes

Contraceptive efficacy, cycle control, premenstrual syndrome, adverse events, weight, blood pressure.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Randomized in blocks of four.

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Low risk

Unblinded

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Six women in the desogestrel and four women in the gestodene group withdrew before starting treatment.
85 women in the desogestrel (17%) and 97 (19%) women in the gestodene group discontinued early, were lost to follow up or were excluded for protocol violation. Primary reasons for discontinuation were not described.

Sibai 2001

Methods

Study location not described.
Nine treatment cycles.

Participants

Inclusion and exclusion criteria not described.

Interventions

Contraceptive skin patch releasing norelgestromin 150 µg and EE 20 µg daily (N=92) versus placebo (N=44).
Initial number assigned to each study group not reported.

Outcomes

Body weight.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Low risk

"Double‐blinded" but did not report who was blinded.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Early discontinuation and loss to follow up not reported. Unclear if the number of participants with weight outcomes was the number of women randomized.

Spellacy 1970

Methods

One site in the USA.
Six treatment cycles.

Participants

Inclusion and exclusion criteria not described.

Interventions

Ethynodiol diacetate 1.0 mg and mestranol 100 µg (N=24) versus 15 pills of mestranol 100 mg, 8 pills of mestranol 100 mg and chlormadinone acetate 1.5 mg and 5 placebo pills (N=33).

Outcomes

Blood pressure.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

No information

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Early discontinuation and loss to follow up not reported.

Spona 1996

Methods

Two sites in UK and Austria.
One pill‐free cycle, five treatment cycles and one follow‐up cycle.

Participants

Healthy, non‐obese women age 19 to 35 years with demonstrable ovulatory pretreatment cycle.
Excluded heavy smokers; pregnancy; certain diseases; history of migraine with aura; other contraindications for oral contraceptive use.

Interventions

Standard regimen (21 pill days and 7 pill‐free days; N=30) versus prolonged regimen (23 pill days and 5 pill‐free days; N=30). Both groups used the same oral contraceptive (gestodene 75 µg and EE 20 µg).

Outcomes

Follicular development, endogenous hormone levels, cycle control, adverse effects.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Randomization list using blocks of ten and four.

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Low risk

"Double‐blinded" but did not report who was blinded.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

One woman in the standard regimen and no women in the prolonged regimen group discontinued early. Primary reasons for discontinuation described and did not include weight change.
No women were lost to follow up.

Stewart 2005

Methods

9 clinical research sites.
112 days (4 cycles).

Participants

239 healthy, regularly menstruating women, aged 18 to 45 years.

Interventions

Patch delivered daily 150 µg norelgestromin and 20 µg ethinyl E2.
Extended regimen (N=239) of weekly patch for 12 weeks, 1 patch‐free week, then weekly patch for 3 weeks versus cyclic regimen (N=81) of 4 cycles (28 days each) of 1 patch weekly for 3 weeks then 1 patch‐free week.
Exclusion criteria included contraindication for steroid hormones, dermal hypersensitivity, extended OC within prior 3 months.

Outcomes

Total bleeding or spotting days plus headaches and overall assessment; weight change.

Notes

Four subjects had no information after randomization (3 extended and 1 cyclic).

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Computer‐generated randomization done by pharmaceutical sponsor; permuted blocks of 6. Assigned 2:1.

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

No information

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Lost to follow up: 2% in extended group and 4% in cyclic regimen.
Completed study: 123/155 (79%) in extended group and 68/80 (85%) in cyclic regimen.

Teichmann 1995

Methods

One site in Poland.
One pill‐free pretreatment cycle and 12 treatment cycles.

Participants

Healthy, non‐obese, sexually active women age 19 to 40 years with regular menses.
Excluded abnormal lipid levels; certain drug use; smoking; "generally accepted" contraindications for oral contraceptives.

Interventions

Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 20 µg.
500 women randomized; initial number assigned to each study group not reported.

Outcomes

Follicle growth, discontinuation.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

No information

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

84 women withdrew before starting treatment.
45 women in the gestodene and 54 women in the desogestrel group discontinued early. Primary reasons for discontinuation described and weight gain not cited.
Loss to follow up not reported.
Three women were excluded for protocol violations.

Van der Does 1995

Methods

One site in the Netherlands.
Six treatment cycles.

Participants

Healthy women age 20 to 35 years with regular menses.
Excluded recent oral contraceptive use; recent pregnancy; lactation.

Interventions

Triphasics: levonorgestrel 50‐75‐125 µg and EE 30‐40‐30 µg (N=15) versus desogestrel 50‐100‐150 µg and EE 35‐30‐30 µg (N=16).

Outcomes

Follicle growth, hormone levels.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

High risk

Unblinded

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Early discontinuation and loss to follow up not reported.

Weisberg 1999

Methods

Three sites in Australia and USA.
Four treatment cycles.

Participants

Women age 18 to 35 years with regular menses.
Excluded "usual" contraindications to oral contraceptives; recent oral or injectable contraceptives; vaginal or cervical irritation; pregnancy.

Interventions

Contraceptive vaginal ring releasing norethindrone acetate 1 mg and EE 15 µg (N=37) versus norethindrone acetate 1 mg and EE 20 µg (N=24).

Outcomes

Serum hormone levels, side effects, weight.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

No information

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Nine women discontinued early or were excluded for protocol violations. Primary reasons for discontinuation described and weight gain not cited.
Loss to follow up not reported.

Wiegratz 1995

Methods

Study location not described.
12 treatment cycles.

Participants

Healthy women age 18 to 36 years with regular menses.
Excluded recent hormonal contraceptives; certain drug use.

Interventions

Gestodene 50‐70‐100 µg and EE 30‐40‐30 µg versus norgestimate 250 µg and EE 35 µg.
52 women randomized; initial number assigned to each study group not reported.

Outcomes

Serum hormone levels, side effects.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

No information

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Six women discontinued early. Primary reasons for discontinuation described and weight gain not cited.
No women were lost to follow up.

Wiegratz 2002

Methods

Two sites in Germany.
Six treatment cycles.

Participants

Women age 18 to 35 years with regular menses.
Excluded contraindications for oral contraceptive use; recent hormonal drugs.

Interventions

Dienogest 2 mg and EE 30 µg versus dienogest 2 mg and EE 20 µg versus dienogest 2 mg, estradiol valerate 2 mg and EE 10 µg versus levonorgestrel 100 µg and EE 20 µg.
100 women randomized; initial number assigned to each study group not reported.

Outcomes

Lipid metabolism.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Low risk

"Double‐blinded" but did not report who was blinded.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

110 women screened and 100 randomized.
Eight women discontinued early. Primary reasons for discontinuation not described.
One woman lost to follow up.
Intent‐to treat analysis used.

Wiik 1993

Methods

Ten sites in Norway and Finland.
Six treatment cycles.

Participants

Healthy, normal‐weight women age 18 to 30 years.
Excluded recent oral contraceptive use; certain diseases; high cholesterol levels.

Interventions

Norethisterone 500‐1000 µg and EE 35 µg (N=100) versus levonorgestrel 50‐75‐125 µg and EE 30‐40 µg (N=96).

Outcomes

Serum lipids, discontinuation, side effects, weight.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Computer‐generated randomization scheme.

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Low risk

"Single‐blinded" but did not report who was blinded.

Incomplete outcome data (attrition bias)
All outcomes

High risk

17 women in the norethisterone and seven in the levonorgestrel group discontinued early. Primary reasons for discontinuation described; four women in the norethisterone and one woman in the levonorgestrel group cited weight gain.
Nine women in the norethisterone and 14 in the levonorgestrel group were lost to follow up.

Winkler 1996

Methods

One site.
Two pre‐treatment cycles, six treatment cycles and one post‐treatment cycle.

Participants

Healthy women age 18 to 30 years.
Excluded contraindications to oral contraceptive use; heavy smoking.

Interventions

Gestodene 75 µg and EE 30 µg (N=20) versus gestodene 75 µg and EE 20 µg (N=20).

Outcomes

Hemostatic measurements.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

High risk

Unblinded

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Two women in both groups discontinued early. Primary reasons for discontinuation described and weight change not cited.
No women were lost to follow up.

Worsley 1980

Methods

One site.
Three treatment cycles.

Participants

Inclusion and exclusion criteria not described.

Interventions

Norethisterone acetate 1 mg and EE 50 µg versus levonorgestrel 250 µg and EE 50 µg versus dl‐norgestrel 500 µg and EE 50 µg.
Number of women randomized not reported.

Outcomes

Psychological tests, blood pressure, weight.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information

Allocation concealment (selection bias)

Unclear risk

No information

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

No information

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Early discontinuation and loss to follow up not reported.

COC = combination oral contraceptive
DMPA = depot‐medroxyprogesterone acetate
EE = ethinyl estradiol
OC = oral contraceptive

Characteristics of excluded studies [ordered by study ID]

Study

Reason for exclusion

Ahrendt 2009

No weight change data presented. Researchers presented the numbers that reported an increase in weight as adverse events. Weight was reportedly measured at screening and final assessment.

Bonny 2006

Participants chose DMPA or OC, then DMPA group was randomly assigned to estrogen supplement or placebo supplement.

Boonyarangkul 2007

No change data presented. Researchers presented weights at baseline and maximum weight gain.

Elkind‐Hirsch 2007

No change data presented. Researchers compared body mass index within group at pre‐treatment and post‐treatment.

Endrikat 2007

Single‐arm study

Fan 2010

Weight change was shown in figure without actual numbers. Abstract provided means without variance. Researchers reported that BMI was also measured but no data were provided.

Gaspard 2003

No information on sampling variation for mean weight changes.

Grinspoon 2003

Researchers reported no significant change in weight. No weight data provided for calculating.

Junge 2011

No weight change data presented. Investigators reported mean weight (and SD) at baseline and end of study.

Machado 2006

Study duration was only one cycle.

Miller 2003

No weight change data presented. Researchers compared weights for groups at baseline and at exit.

Miller 2005

No weight change data presented. Researchers reported weights for regimens at baseline and at exit.

Mohamed 2011

No weight change data presented. Investigators reported an increase in weight as adverse event.

O'Connell 2005

Mean change in body mass index was reported, but no variance was provided.

O'Connell 2007

Trial of OCs as treatment for dysmenorrhea.

Sabatini 2006

Insufficient change data presented. Reported maximum weight gain per group rather than mean.

Sanam 2011

No Ns given for analysis. Unable to obtain further information from investigator.
Report is inconsistent regarding weight change: text states 2.5 kg increase in mean weight for one group, while table shows 3.3 kg change for same group.

Sangthawan 2005

Weight data provided for baseline only. Questionnaire asked about perception of weight change (scored 0 to 4).

Skouby 2005

Weight data only provided for baseline.

Suthipongse 2004

No change data presented. Researchers compared weights for groups at baseline and at exit.

Taneepanichskul 2002

No change data presented. Researchers presented weights per group at baseline and at end of study. Sample sizes differed for baseline and end of study data.

Tantbirojn 2002

No change data presented. Researchers presented weights per group at admission and at end of study. No sample sizes provided per group.

Veres 2004

Researchers reported there was no significant change in weight. Data were not provided.

Westhoff 2007

Weight change not quantified, but reported as gained, lost or no change.

Westhoff 2010

Body mass index was used for stratifying; outcomes did not include weight or BMI change.

Westhoff 2012

No weight change data; investigators reported slight differences in weight increase between the groups. Data were not provided. Adverse events included percent reporting weight gain.

Winkler 2004

Researchers reported there was no significant change in weight. Data were not provided.

Yildizhan 2009

Researchers reported there was no significant change in BMI. Means were shown but not change data.

Characteristics of ongoing studies [ordered by study ID]

Mahidol 2013

Trial name or title

Comparison of body weight change during contraception with Belara and Yasmin

Methods

Family Planning Unit, Mahidol University, Bangkok, Thailand

RCT; blinding of subject, caregiver, investigator, outcome assessor

Participants

100 women, 19 to 45 years old

Inclusion criteria: reproductive age; BMI < 28.5 kg/m2; regular menstruation; no pelvic organ disorder; wants contraception with oral contraceptive pills.
Exclusion criteria: abnormal blood pressure; abnormal vaginal bleeding; pregnant; on medication effecting contraceptive pills, i.e., anti‐fungal, anti‐retroviral, anti‐convulsant drug; contraindication for OCP; used steroid in 3 months before enrollment; smoking; eating disorder.

Interventions

2 mg chlormadinone acetate and 30 µg ethinyl estradiol versus 3 mg drospirenone and 30 µg ethinyl estradiol

Duration: 6 cycles

Outcomes

Body weight change at 3 and 6 months of use

Starting date

Study start June 2012; estimated completion July 2014

Contact information

no information

Notes

Data and analyses

Open in table viewer
Comparison 1. Dimethisterone 25 mg and ethinyl estradiol (EE) 100 µg versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2.3 kg (cycle 4) Show forest plot

1

113

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.02 [0.46, 2.26]

Analysis 1.1

Comparison 1 Dimethisterone 25 mg and ethinyl estradiol (EE) 100 µg versus placebo, Outcome 1 Gained >2.3 kg (cycle 4).

Comparison 1 Dimethisterone 25 mg and ethinyl estradiol (EE) 100 µg versus placebo, Outcome 1 Gained >2.3 kg (cycle 4).

Open in table viewer
Comparison 2. Ethynodiol diacetate 1 mg and mestranol 100 µg versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2.3 kg (cycle 4) Show forest plot

1

112

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.57 [0.24, 1.33]

Analysis 2.1

Comparison 2 Ethynodiol diacetate 1 mg and mestranol 100 µg versus placebo, Outcome 1 Gained >2.3 kg (cycle 4).

Comparison 2 Ethynodiol diacetate 1 mg and mestranol 100 µg versus placebo, Outcome 1 Gained >2.3 kg (cycle 4).

Open in table viewer
Comparison 3. Levonorgestrel 100 µg and EE 20 µg versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 6) Show forest plot

1

473

Mean Difference (IV, Fixed, 95% CI)

0.30 [‐0.23, 0.83]

Analysis 3.1

Comparison 3 Levonorgestrel 100 µg and EE 20 µg versus placebo, Outcome 1 Mean weight change in kg (cycle 6).

Comparison 3 Levonorgestrel 100 µg and EE 20 µg versus placebo, Outcome 1 Mean weight change in kg (cycle 6).

Open in table viewer
Comparison 4. Norgestrel 300 µg and EE 30 µg versus no intervention

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg per year Show forest plot

1

150

Mean Difference (IV, Fixed, 95% CI)

‐0.54 [‐1.39, 0.31]

Analysis 4.1

Comparison 4 Norgestrel 300 µg and EE 30 µg versus no intervention, Outcome 1 Mean weight change in kg per year.

Comparison 4 Norgestrel 300 µg and EE 30 µg versus no intervention, Outcome 1 Mean weight change in kg per year.

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Comparison 5. Norethindrone 1 mg and mestranol 50 µg versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2.3 kg (cycle 4) Show forest plot

1

123

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.50 [0.22, 1.17]

Analysis 5.1

Comparison 5 Norethindrone 1 mg and mestranol 50 µg versus placebo, Outcome 1 Gained >2.3 kg (cycle 4).

Comparison 5 Norethindrone 1 mg and mestranol 50 µg versus placebo, Outcome 1 Gained >2.3 kg (cycle 4).

Open in table viewer
Comparison 6. Skin patch norelgestromin 150 µg and EE 20 µg versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >5% baseline weight (cycle 9) Show forest plot

1

136

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.95 [0.30, 2.98]

Analysis 6.1

Comparison 6 Skin patch norelgestromin 150 µg and EE 20 µg versus placebo, Outcome 1 Gained >5% baseline weight (cycle 9).

Comparison 6 Skin patch norelgestromin 150 µg and EE 20 µg versus placebo, Outcome 1 Gained >5% baseline weight (cycle 9).

2 Lost >5% baseline weight (cycle 9) Show forest plot

1

136

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.27 [0.04, 1.82]

Analysis 6.2

Comparison 6 Skin patch norelgestromin 150 µg and EE 20 µg versus placebo, Outcome 2 Lost >5% baseline weight (cycle 9).

Comparison 6 Skin patch norelgestromin 150 µg and EE 20 µg versus placebo, Outcome 2 Lost >5% baseline weight (cycle 9).

Open in table viewer
Comparison 7. Skin patch norelgestromin 150 µg and EE 20 µg: extended versus cyclic regimen

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change (112 days or cycle 4) Show forest plot

1

191

Mean Difference (IV, Fixed, 95% CI)

‐0.12 [‐0.79, 0.55]

Analysis 7.1

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).

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).

Open in table viewer
Comparison 8. Desogestrel 150 µg and EE 20 µg versus desogestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean body mass percentage change (cycle 6) Show forest plot

1

45

Mean Difference (IV, Fixed, 95% CI)

0.10 [‐1.54, 1.74]

Analysis 8.1

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).

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).

Open in table viewer
Comparison 9. Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

801

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.84 [0.58, 1.22]

Analysis 9.1

Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 1 Gained >2 kg (cycle 6).

Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 1 Gained >2 kg (cycle 6).

2 Lost >2 kg (cycle 6) Show forest plot

1

801

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.65 [1.13, 2.41]

Analysis 9.2

Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 2 Lost >2 kg (cycle 6).

Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 2 Lost >2 kg (cycle 6).

3 Gained >2 kg (cycle 12) Show forest plot

1

1476

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.13 [0.85, 1.49]

Analysis 9.3

Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 3 Gained >2 kg (cycle 12).

Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 3 Gained >2 kg (cycle 12).

4 Lost >2 kg (cycle 12) Show forest plot

1

1476

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.95 [0.68, 1.33]

Analysis 9.4

Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 4 Lost >2 kg (cycle 12).

Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 4 Lost >2 kg (cycle 12).

Open in table viewer
Comparison 10. Desogestrel 150 µg and EE 20 µg versus norgestimate 250 µg and EE 35 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean body mass percentage change (cycle 6) Show forest plot

1

42

Mean Difference (IV, Fixed, 95% CI)

0.60 [‐1.45, 2.65]

Analysis 10.1

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).

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).

Open in table viewer
Comparison 11. Desogestrel 150 µg and EE 30 µg versus levonorgestrel 50‐75‐125 µg and EE 30‐40‐30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

469

Peto Odds Ratio (Peto, Fixed, 95% CI)

3.29 [1.84, 5.88]

Analysis 11.1

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).

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).

Open in table viewer
Comparison 12. Standard desogestrel and EE regimen versus prolonged gestodene and EE regimen

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 7) Show forest plot

1

890

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.20 [0.86, 1.68]

Analysis 12.1

Comparison 12 Standard desogestrel and EE regimen versus prolonged gestodene and EE regimen, Outcome 1 Gained >2 kg (cycle 7).

Comparison 12 Standard desogestrel and EE regimen versus prolonged gestodene and EE regimen, Outcome 1 Gained >2 kg (cycle 7).

Open in table viewer
Comparison 13. Prolonged desogestrel and EE regimen versus standard desogestrel and EE regimen

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 12) Show forest plot

1

196

Mean Difference (IV, Fixed, 95% CI)

0.57 [‐0.42, 1.56]

Analysis 13.1

Comparison 13 Prolonged desogestrel and EE regimen versus standard desogestrel and EE regimen, Outcome 1 Mean weight change in kg (cycle 12).

Comparison 13 Prolonged desogestrel and EE regimen versus standard desogestrel and EE regimen, Outcome 1 Mean weight change in kg (cycle 12).

Open in table viewer
Comparison 14. Dienogest 2 mg, EE 10 µg and estradiol valerate 2 mg versus levonorgestrel 100 µg and EE 20 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >5% baseline weight (cycle 3) Show forest plot

1

49

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.20 [0.32, 4.51]

Analysis 14.1

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).

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).

2 Lost >5% baseline weight (cycle 3) Show forest plot

1

49

Peto Odds Ratio (Peto, Fixed, 95% CI)

7.10 [0.14, 358.08]

Analysis 14.2

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).

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).

Open in table viewer
Comparison 15. Dienogest 2 mg and EE 20 µg versus levonorgestrel 100 µg and EE 20 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >5% baseline weight (cycle 3) Show forest plot

1

49

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.95 [0.24, 3.76]

Analysis 15.1

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).

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).

2 Lost >5% baseline weight (cycle 3) Show forest plot

1

49

Peto Odds Ratio (Peto, Fixed, 95% CI)

7.40 [0.45, 121.93]

Analysis 15.2

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).

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).

Open in table viewer
Comparison 16. Dienogest 2 mg and EE 30 µg versus levonorgestrel 100 µg and EE 20 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >5% baseline weight (cycle 3) Show forest plot

1

48

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.77 [0.18, 3.21]

Analysis 16.1

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).

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).

2 Lost >5% baseline weight (cycle 3) Show forest plot

1

48

Peto Odds Ratio (Peto, Fixed, 95% CI)

7.39 [0.15, 372.38]

Analysis 16.2

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).

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).

Open in table viewer
Comparison 17. Dl‐norgestrel 500 µg and EE 50 µg versus levonorgestrel 250 µg and EE 50 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 3) Show forest plot

1

21

Mean Difference (IV, Fixed, 95% CI)

0.22 [‐1.30, 1.74]

Analysis 17.1

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).

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).

Open in table viewer
Comparison 18. Dl‐norgestrel 500 µg and EE 50 µg versus norethisterone acetate 1 mg and EE 50 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 3) Show forest plot

1

16

Mean Difference (IV, Fixed, 95% CI)

1.14 [‐0.54, 2.82]

Analysis 18.1

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).

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).

Open in table viewer
Comparison 19. Drospirenone 2 mg and EE 30 µg versus drospirenone 3 mg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 3) Show forest plot

2

112

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.14 [0.00, 6.82]

Analysis 19.1

Comparison 19 Drospirenone 2 mg and EE 30 µg versus drospirenone 3 mg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 3).

Comparison 19 Drospirenone 2 mg and EE 30 µg versus drospirenone 3 mg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 3).

2 Lost >2 kg (cycle 3) Show forest plot

1

66

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.99 [0.20, 19.82]

Analysis 19.2

Comparison 19 Drospirenone 2 mg and EE 30 µg versus drospirenone 3 mg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 3).

Comparison 19 Drospirenone 2 mg and EE 30 µg versus drospirenone 3 mg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 3).

Open in table viewer
Comparison 20. Drospirenone 3 mg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

40

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.50 [0.05, 5.06]

Analysis 20.1

Comparison 20 Drospirenone 3 mg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

Comparison 20 Drospirenone 3 mg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

2 Lost >2 kg (cycle 6) Show forest plot

1

40

Peto Odds Ratio (Peto, Fixed, 95% CI)

9.92 [1.79, 55.04]

Analysis 20.2

Comparison 20 Drospirenone 3 mg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).

Comparison 20 Drospirenone 3 mg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).

Open in table viewer
Comparison 21. Drospirenone 3 mg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

40

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.13 [0.01, 2.13]

Analysis 21.1

Comparison 21 Drospirenone 3 mg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

Comparison 21 Drospirenone 3 mg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

2 Lost >2 kg (cycle 6) Show forest plot

1

40

Peto Odds Ratio (Peto, Fixed, 95% CI)

7.39 [0.15, 372.38]

Analysis 21.2

Comparison 21 Drospirenone 3 mg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).

Comparison 21 Drospirenone 3 mg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).

Open in table viewer
Comparison 22. Drospirenone 3 mg and EE 30 µg versus desogestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 13) Show forest plot

1

56

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.86 [0.29, 2.56]

Analysis 22.1

Comparison 22 Drospirenone 3 mg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 13).

Comparison 22 Drospirenone 3 mg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 13).

2 Lost >2 kg (cycle 13) Show forest plot

1

56

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.38 [0.29, 6.62]

Analysis 22.2

Comparison 22 Drospirenone 3 mg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 13).

Comparison 22 Drospirenone 3 mg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 13).

Open in table viewer
Comparison 23. Drospirenone 3 mg and EE 20 μg versus desogestrel 150 μg and EE 20 μg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 7) Show forest plot

1

441

Mean Difference (IV, Fixed, 95% CI)

‐0.67 [‐1.16, ‐0.18]

Analysis 23.1

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).

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).

Open in table viewer
Comparison 24. Drospirenone 3 mg and EE 30 µg versus levonorgestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

40

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.13 [0.01, 2.13]

Analysis 24.1

Comparison 24 Drospirenone 3 mg and EE 30 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

Comparison 24 Drospirenone 3 mg and EE 30 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

2 Lost >2 kg (cycle 6) Show forest plot

1

40

Peto Odds Ratio (Peto, Fixed, 95% CI)

7.39 [0.15, 372.38]

Analysis 24.2

Comparison 24 Drospirenone 3 mg and EE 30 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).

Comparison 24 Drospirenone 3 mg and EE 30 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).

Open in table viewer
Comparison 25. Ethynodiol diacetate 1 mg and mestranol 100 µg versus chlormadinone acetate 1.5 mg and mestranol 100 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 6) Show forest plot

1

57

Mean Difference (IV, Fixed, 95% CI)

0.30 [‐1.43, 2.03]

Analysis 25.1

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).

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).

Open in table viewer
Comparison 26. Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

39

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.05 [0.06, 17.51]

Analysis 26.1

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

2 Lost >2 kg (cycle 6) Show forest plot

1

39

Peto Odds Ratio (Peto, Fixed, 95% CI)

7.79 [0.15, 393.02]

Analysis 26.2

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).

3 Gained >2 kg (cycle 12) Show forest plot

1

452

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.06 [0.63, 1.81]

Analysis 26.3

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 3 Gained >2 kg (cycle 12).

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 3 Gained >2 kg (cycle 12).

4 Lost >2 kg (cycle 12) Show forest plot

1

452

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.13 [0.63, 2.03]

Analysis 26.4

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 4 Lost >2 kg (cycle 12).

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 4 Lost >2 kg (cycle 12).

5 Gained >2 kg (cycle 13) Show forest plot

1

40

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.71 [0.14, 3.57]

Analysis 26.5

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 5 Gained >2 kg (cycle 13).

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 5 Gained >2 kg (cycle 13).

6 Lost >2 kg (cycle 13) Show forest plot

1

40

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.14 [0.00, 6.82]

Analysis 26.6

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 6 Lost >2 kg (cycle 13).

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 6 Lost >2 kg (cycle 13).

Open in table viewer
Comparison 27. Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 20 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean body mass percentage change (cycle 6) Show forest plot

1

43

Mean Difference (IV, Fixed, 95% CI)

0.7 [‐1.32, 2.72]

Analysis 27.1

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).

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).

2 Mean weight change in kg (cycle 6) Show forest plot

1

805

Mean Difference (IV, Fixed, 95% CI)

0.20 [0.00, 0.40]

Analysis 27.2

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).

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).

3 Mean weight change in kg (cycle 12) Show forest plot

2

462

Mean Difference (IV, Fixed, 95% CI)

0.01 [‐0.50, 0.51]

Analysis 27.3

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).

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).

Open in table viewer
Comparison 28. Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

3

1524

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.18 [0.87, 1.60]

Analysis 28.1

Comparison 28 Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

Comparison 28 Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

2 Lost >2 kg ( cycle 6) Show forest plot

2

1172

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.34 [0.90, 2.00]

Analysis 28.2

Comparison 28 Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg ( cycle 6).

Comparison 28 Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg ( cycle 6).

3 Mean body mass percentage change (cycle 6) Show forest plot

1

46

Mean Difference (IV, Fixed, 95% CI)

0.8 [‐1.18, 2.78]

Analysis 28.3

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).

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).

Open in table viewer
Comparison 29. Gestodene 75 µg and EE 30 µg versus norgestimate 250 µg and EE 35 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

357

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.54 [0.92, 2.60]

Analysis 29.1

Comparison 29 Gestodene 75 µg and EE 30 µg versus norgestimate 250 µg and EE 35 µg, Outcome 1 Gained >2 kg (cycle 6).

Comparison 29 Gestodene 75 µg and EE 30 µg versus norgestimate 250 µg and EE 35 µg, Outcome 1 Gained >2 kg (cycle 6).

2 Mean body mass percentage change (cycle 6) Show forest plot

1

43

Mean Difference (IV, Fixed, 95% CI)

1.3 [‐1.03, 3.63]

Analysis 29.2

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).

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).

Open in table viewer
Comparison 30. Gestodene 50‐70‐100 µg and EE 30‐40‐30 µg versus desogestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 12) Show forest plot

1

30

Mean Difference (IV, Fixed, 95% CI)

1.25 [‐1.22, 3.72]

Analysis 30.1

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).

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).

Open in table viewer
Comparison 31. Gestodene 50‐70‐100 µg and EE 30‐40‐30 µg versus norgestimate 250 µg and EE 35 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 12) Show forest plot

1

47

Mean Difference (IV, Fixed, 95% CI)

‐0.25 [‐1.09, 0.59]

Analysis 31.1

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).

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).

Open in table viewer
Comparison 32. Prolonged gestodene and EE regimen versus standard gestodene and EE regimen

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 3) Show forest plot

1

58

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐1.23, 1.23]

Analysis 32.1

Comparison 32 Prolonged gestodene and EE regimen versus standard gestodene and EE regimen, Outcome 1 Mean weight change in kg (cycle 3).

Comparison 32 Prolonged gestodene and EE regimen versus standard gestodene and EE regimen, Outcome 1 Mean weight change in kg (cycle 3).

Open in table viewer
Comparison 33. Levonorgestrel 100 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

418

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.26 [0.74, 2.15]

Analysis 33.1

Comparison 33 Levonorgestrel 100 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

Comparison 33 Levonorgestrel 100 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

2 Lost >2 kg (cycle 6) Show forest plot

1

418

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.31 [0.70, 2.44]

Analysis 33.2

Comparison 33 Levonorgestrel 100 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).

Comparison 33 Levonorgestrel 100 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).

Open in table viewer
Comparison 34. Levonorgestrel 150 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2.5 kg (cycle 24) Show forest plot

1

17

Peto Odds Ratio (Peto, Fixed, 95% CI)

8.66 [0.77, 97.74]

Analysis 34.1

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).

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).

2 Lost >2.5 kg (cycle 24) Show forest plot

1

17

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.88 [0.17, 21.18]

Analysis 34.2

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).

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).

Open in table viewer
Comparison 35. Levonorgestrel 150 µg and EE 30 µg versus gestodene 75 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 6) Show forest plot

1

369

Mean Difference (IV, Fixed, 95% CI)

0.7 [0.14, 1.26]

Analysis 35.1

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).

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).

Open in table viewer
Comparison 36. Levonorgestrel 250 µg and EE 50 µg versus levonorgestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2.7 kg (cycle 6) Show forest plot

1

109

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.92 [0.74, 4.96]

Analysis 36.1

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).

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).

Open in table viewer
Comparison 37. Levonorgestrel 50‐75‐125 µg and EE 30‐40‐30 µg versus levonorgestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 6) Show forest plot

1

314

Mean Difference (IV, Fixed, 95% CI)

‐0.02 [‐0.06, 0.03]

Analysis 37.1

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).

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).

Open in table viewer
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 or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean BMI change (cycle 6) Show forest plot

1

57

Mean Difference (IV, Fixed, 95% CI)

0.35 [‐0.13, 0.83]

Analysis 38.1

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).

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).

2 Mean weight change in kg (cycle 6) Show forest plot

1

31

Mean Difference (IV, Fixed, 95% CI)

1.30 [‐0.32, 2.92]

Analysis 38.2

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).

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).

Open in table viewer
Comparison 39. Levonorgestrel 50‐75‐125 µg and EE 30‐40‐30 µg versus desogestrel 150 µg and EE 20 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 3) Show forest plot

1

33

Mean Difference (IV, Fixed, 95% CI)

0.78 [‐0.28, 1.84]

Analysis 39.1

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).

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).

Open in table viewer
Comparison 40. Levonorgestrel 250 µg and EE 50 µg versus norethisterone acetate 1 mg and EE 50 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 3) Show forest plot

1

21

Mean Difference (IV, Fixed, 95% CI)

0.92 [‐1.25, 3.09]

Analysis 40.1

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).

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).

Open in table viewer
Comparison 41. Levonorgestrel and EE 6‐6‐9 day regimen versus levonorgestrel 6‐5‐10 day regimen

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 3) Show forest plot

1

28

Mean Difference (IV, Fixed, 95% CI)

0.09 [‐1.15, 1.33]

Analysis 41.1

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).

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).

Open in table viewer
Comparison 42. Lynestrenol 2 mg and EE 40 µg versus lynestrenol 1 mg and EE 40 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2.5 kg (cycle 12) Show forest plot

1

228

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.75 [0.98, 3.11]

Analysis 42.1

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).

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).

2 Lost >2.5 kg (cycle 12) Show forest plot

1

228

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.66 [0.25, 1.77]

Analysis 42.2

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).

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).

Open in table viewer
Comparison 43. Norethisterone 500‐1000 µg and EE 35 µg versus levonorgestrel 50‐75‐125 µg and EE 30‐40 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 6) Show forest plot

1

144

Mean Difference (IV, Fixed, 95% CI)

0.10 [‐0.70, 0.90]

Analysis 43.1

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).

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).

Open in table viewer
Comparison 44. Norgestimate 250 µg and EE 35 µg versus desogestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

349

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.15 [0.65, 2.06]

Analysis 44.1

Comparison 44 Norgestimate 250 µg and EE 35 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

Comparison 44 Norgestimate 250 µg and EE 35 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

2 Mean body mass percentage change (cycle 6) Show forest plot

1

45

Mean Difference (IV, Fixed, 95% CI)

‐0.5 [‐2.51, 1.51]

Analysis 44.2

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).

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).

Open in table viewer
Comparison 45. Norethisterone 500 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

292

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.09 [0.60, 1.99]

Analysis 45.1

Comparison 45 Norethisterone 500 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

Comparison 45 Norethisterone 500 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

2 Lost >2 kg (cycle 6) Show forest plot

1

292

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.69 [0.89, 3.20]

Analysis 45.2

Comparison 45 Norethisterone 500 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).

Comparison 45 Norethisterone 500 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).

Open in table viewer
Comparison 46. Norethindrone 500‐750‐1000 µg and EE 35 µg versus desogestrel 100‐125‐150 µg and EE 25 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 6) Show forest plot

1

5328

Mean Difference (IV, Fixed, 95% CI)

0.26 [0.12, 0.40]

Analysis 46.1

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).

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).

Open in table viewer
Comparison 47. Norgestimate 180‐215‐250 µg and EE 25 µg versus norethindrone acetate 1 mg and EE 20 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Weight gain >=5% (cycle 6) Show forest plot

1

2157

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.15 [0.91, 1.45]

Analysis 47.1

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).

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).

2 Weight gain >=5% (cycle 13) Show forest plot

1

453

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.09 [0.69, 1.74]

Analysis 47.2

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).

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).

3 Weight loss >=5% (cycle 6) Show forest plot

1

2157

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.99 [0.72, 1.37]

Analysis 47.3

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).

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).

4 Weight loss >=5% (cycle 13) Show forest plot

1

453

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.32 [0.74, 2.34]

Analysis 47.4

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).

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).

Open in table viewer
Comparison 48. Standard norgestrel and EE regimen versus prolonged norgestrel and EE regimen

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 12) Show forest plot

1

43

Mean Difference (IV, Fixed, 95% CI)

1.8 [‐0.73, 4.33]

Analysis 48.1

Comparison 48 Standard norgestrel and EE regimen versus prolonged norgestrel and EE regimen, Outcome 1 Mean weight change in kg (cycle 12).

Comparison 48 Standard norgestrel and EE regimen versus prolonged norgestrel and EE regimen, Outcome 1 Mean weight change in kg (cycle 12).

Open in table viewer
Comparison 49. Injectable medroxyprogesterone acetate 25 mg and EC 5 mg versus norethisterone enanthate 50 mg and EV 5 mg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 12) Show forest plot

1

3029

Mean Difference (IV, Fixed, 95% CI)

0.13 [‐0.04, 0.30]

Analysis 49.1

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).

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).

Open in table viewer
Comparison 50. Vaginal ring with norethindrone acetate 1 mg and EE 15 µg versus norethindrone acetate 1 mg and EE 20 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gain >2 kg (cycle 4) Show forest plot

1

51

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.69 [0.13, 3.58]

Analysis 50.1

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).

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).

2 Lost >2 kg (cycle 4) Show forest plot

1

51

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.69 [0.35, 8.07]

Analysis 50.2

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).

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).

Open in table viewer
Comparison 51. Vaginal ring etonogestrel 120 µg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gain >=7% body weight (cycle 13) Show forest plot

1

1030

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.84 [0.55, 1.28]

Analysis 51.1

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).

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).

2 Lost >=7% body weight (cycle 13) Show forest plot

1

1030

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.39 [0.83, 2.32]

Analysis 51.2

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).

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).

Open in table viewer
Comparison 52. Vaginal ring etonogestrel 120 µg and EE 15 µg versus drospirenone 3 mg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 13 or last assessment) Show forest plot

1

937

Mean Difference (IV, Fixed, 95% CI)

0.4 [0.03, 0.77]

Analysis 52.1

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).

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).

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figures and Tables -
Figure 1

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figures and Tables -
Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Comparison 1 Dimethisterone 25 mg and ethinyl estradiol (EE) 100 µg versus placebo, Outcome 1 Gained >2.3 kg (cycle 4).
Figures and Tables -
Analysis 1.1

Comparison 1 Dimethisterone 25 mg and ethinyl estradiol (EE) 100 µg versus placebo, Outcome 1 Gained >2.3 kg (cycle 4).

Comparison 2 Ethynodiol diacetate 1 mg and mestranol 100 µg versus placebo, Outcome 1 Gained >2.3 kg (cycle 4).
Figures and Tables -
Analysis 2.1

Comparison 2 Ethynodiol diacetate 1 mg and mestranol 100 µg versus placebo, Outcome 1 Gained >2.3 kg (cycle 4).

Comparison 3 Levonorgestrel 100 µg and EE 20 µg versus placebo, Outcome 1 Mean weight change in kg (cycle 6).
Figures and Tables -
Analysis 3.1

Comparison 3 Levonorgestrel 100 µg and EE 20 µg versus placebo, Outcome 1 Mean weight change in kg (cycle 6).

Comparison 4 Norgestrel 300 µg and EE 30 µg versus no intervention, Outcome 1 Mean weight change in kg per year.
Figures and Tables -
Analysis 4.1

Comparison 4 Norgestrel 300 µg and EE 30 µg versus no intervention, Outcome 1 Mean weight change in kg per year.

Comparison 5 Norethindrone 1 mg and mestranol 50 µg versus placebo, Outcome 1 Gained >2.3 kg (cycle 4).
Figures and Tables -
Analysis 5.1

Comparison 5 Norethindrone 1 mg and mestranol 50 µg versus placebo, Outcome 1 Gained >2.3 kg (cycle 4).

Comparison 6 Skin patch norelgestromin 150 µg and EE 20 µg versus placebo, Outcome 1 Gained >5% baseline weight (cycle 9).
Figures and Tables -
Analysis 6.1

Comparison 6 Skin patch norelgestromin 150 µg and EE 20 µg versus placebo, Outcome 1 Gained >5% baseline weight (cycle 9).

Comparison 6 Skin patch norelgestromin 150 µg and EE 20 µg versus placebo, Outcome 2 Lost >5% baseline weight (cycle 9).
Figures and Tables -
Analysis 6.2

Comparison 6 Skin patch norelgestromin 150 µg and EE 20 µg versus placebo, Outcome 2 Lost >5% baseline weight (cycle 9).

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).
Figures and Tables -
Analysis 7.1

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).

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).
Figures and Tables -
Analysis 8.1

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).

Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 1 Gained >2 kg (cycle 6).
Figures and Tables -
Analysis 9.1

Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 1 Gained >2 kg (cycle 6).

Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 2 Lost >2 kg (cycle 6).
Figures and Tables -
Analysis 9.2

Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 2 Lost >2 kg (cycle 6).

Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 3 Gained >2 kg (cycle 12).
Figures and Tables -
Analysis 9.3

Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 3 Gained >2 kg (cycle 12).

Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 4 Lost >2 kg (cycle 12).
Figures and Tables -
Analysis 9.4

Comparison 9 Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg, Outcome 4 Lost >2 kg (cycle 12).

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).
Figures and Tables -
Analysis 10.1

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).

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).
Figures and Tables -
Analysis 11.1

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).

Comparison 12 Standard desogestrel and EE regimen versus prolonged gestodene and EE regimen, Outcome 1 Gained >2 kg (cycle 7).
Figures and Tables -
Analysis 12.1

Comparison 12 Standard desogestrel and EE regimen versus prolonged gestodene and EE regimen, Outcome 1 Gained >2 kg (cycle 7).

Comparison 13 Prolonged desogestrel and EE regimen versus standard desogestrel and EE regimen, Outcome 1 Mean weight change in kg (cycle 12).
Figures and Tables -
Analysis 13.1

Comparison 13 Prolonged desogestrel and EE regimen versus standard desogestrel and EE regimen, Outcome 1 Mean weight change in kg (cycle 12).

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).
Figures and Tables -
Analysis 14.1

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).

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).
Figures and Tables -
Analysis 14.2

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).

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).
Figures and Tables -
Analysis 15.1

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).

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).
Figures and Tables -
Analysis 15.2

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).

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).
Figures and Tables -
Analysis 16.1

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).

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).
Figures and Tables -
Analysis 16.2

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).

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).
Figures and Tables -
Analysis 17.1

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).

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).
Figures and Tables -
Analysis 18.1

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).

Comparison 19 Drospirenone 2 mg and EE 30 µg versus drospirenone 3 mg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 3).
Figures and Tables -
Analysis 19.1

Comparison 19 Drospirenone 2 mg and EE 30 µg versus drospirenone 3 mg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 3).

Comparison 19 Drospirenone 2 mg and EE 30 µg versus drospirenone 3 mg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 3).
Figures and Tables -
Analysis 19.2

Comparison 19 Drospirenone 2 mg and EE 30 µg versus drospirenone 3 mg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 3).

Comparison 20 Drospirenone 3 mg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
Figures and Tables -
Analysis 20.1

Comparison 20 Drospirenone 3 mg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

Comparison 20 Drospirenone 3 mg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).
Figures and Tables -
Analysis 20.2

Comparison 20 Drospirenone 3 mg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).

Comparison 21 Drospirenone 3 mg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
Figures and Tables -
Analysis 21.1

Comparison 21 Drospirenone 3 mg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

Comparison 21 Drospirenone 3 mg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).
Figures and Tables -
Analysis 21.2

Comparison 21 Drospirenone 3 mg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).

Comparison 22 Drospirenone 3 mg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 13).
Figures and Tables -
Analysis 22.1

Comparison 22 Drospirenone 3 mg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 13).

Comparison 22 Drospirenone 3 mg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 13).
Figures and Tables -
Analysis 22.2

Comparison 22 Drospirenone 3 mg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 13).

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).
Figures and Tables -
Analysis 23.1

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).

Comparison 24 Drospirenone 3 mg and EE 30 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
Figures and Tables -
Analysis 24.1

Comparison 24 Drospirenone 3 mg and EE 30 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

Comparison 24 Drospirenone 3 mg and EE 30 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).
Figures and Tables -
Analysis 24.2

Comparison 24 Drospirenone 3 mg and EE 30 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).

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).
Figures and Tables -
Analysis 25.1

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).

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
Figures and Tables -
Analysis 26.1

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).
Figures and Tables -
Analysis 26.2

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 3 Gained >2 kg (cycle 12).
Figures and Tables -
Analysis 26.3

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 3 Gained >2 kg (cycle 12).

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 4 Lost >2 kg (cycle 12).
Figures and Tables -
Analysis 26.4

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 4 Lost >2 kg (cycle 12).

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 5 Gained >2 kg (cycle 13).
Figures and Tables -
Analysis 26.5

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 5 Gained >2 kg (cycle 13).

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 6 Lost >2 kg (cycle 13).
Figures and Tables -
Analysis 26.6

Comparison 26 Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg, Outcome 6 Lost >2 kg (cycle 13).

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).
Figures and Tables -
Analysis 27.1

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).

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).
Figures and Tables -
Analysis 27.2

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).

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).
Figures and Tables -
Analysis 27.3

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).

Comparison 28 Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
Figures and Tables -
Analysis 28.1

Comparison 28 Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

Comparison 28 Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg ( cycle 6).
Figures and Tables -
Analysis 28.2

Comparison 28 Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg ( cycle 6).

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).
Figures and Tables -
Analysis 28.3

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).

Comparison 29 Gestodene 75 µg and EE 30 µg versus norgestimate 250 µg and EE 35 µg, Outcome 1 Gained >2 kg (cycle 6).
Figures and Tables -
Analysis 29.1

Comparison 29 Gestodene 75 µg and EE 30 µg versus norgestimate 250 µg and EE 35 µg, Outcome 1 Gained >2 kg (cycle 6).

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).
Figures and Tables -
Analysis 29.2

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).

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).
Figures and Tables -
Analysis 30.1

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).

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).
Figures and Tables -
Analysis 31.1

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).

Comparison 32 Prolonged gestodene and EE regimen versus standard gestodene and EE regimen, Outcome 1 Mean weight change in kg (cycle 3).
Figures and Tables -
Analysis 32.1

Comparison 32 Prolonged gestodene and EE regimen versus standard gestodene and EE regimen, Outcome 1 Mean weight change in kg (cycle 3).

Comparison 33 Levonorgestrel 100 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
Figures and Tables -
Analysis 33.1

Comparison 33 Levonorgestrel 100 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

Comparison 33 Levonorgestrel 100 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).
Figures and Tables -
Analysis 33.2

Comparison 33 Levonorgestrel 100 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).

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).
Figures and Tables -
Analysis 34.1

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).

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).
Figures and Tables -
Analysis 34.2

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).

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).
Figures and Tables -
Analysis 35.1

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).

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).
Figures and Tables -
Analysis 36.1

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).

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).
Figures and Tables -
Analysis 37.1

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).

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).
Figures and Tables -
Analysis 38.1

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).

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).
Figures and Tables -
Analysis 38.2

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).

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).
Figures and Tables -
Analysis 39.1

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).

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).
Figures and Tables -
Analysis 40.1

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).

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).
Figures and Tables -
Analysis 41.1

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).

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).
Figures and Tables -
Analysis 42.1

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).

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).
Figures and Tables -
Analysis 42.2

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).

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).
Figures and Tables -
Analysis 43.1

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).

Comparison 44 Norgestimate 250 µg and EE 35 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
Figures and Tables -
Analysis 44.1

Comparison 44 Norgestimate 250 µg and EE 35 µg versus desogestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

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).
Figures and Tables -
Analysis 44.2

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).

Comparison 45 Norethisterone 500 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).
Figures and Tables -
Analysis 45.1

Comparison 45 Norethisterone 500 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 1 Gained >2 kg (cycle 6).

Comparison 45 Norethisterone 500 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).
Figures and Tables -
Analysis 45.2

Comparison 45 Norethisterone 500 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg, Outcome 2 Lost >2 kg (cycle 6).

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).
Figures and Tables -
Analysis 46.1

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).

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).
Figures and Tables -
Analysis 47.1

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).

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).
Figures and Tables -
Analysis 47.2

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).

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).
Figures and Tables -
Analysis 47.3

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).

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).
Figures and Tables -
Analysis 47.4

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).

Comparison 48 Standard norgestrel and EE regimen versus prolonged norgestrel and EE regimen, Outcome 1 Mean weight change in kg (cycle 12).
Figures and Tables -
Analysis 48.1

Comparison 48 Standard norgestrel and EE regimen versus prolonged norgestrel and EE regimen, Outcome 1 Mean weight change in kg (cycle 12).

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).
Figures and Tables -
Analysis 49.1

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).

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).
Figures and Tables -
Analysis 50.1

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).

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).
Figures and Tables -
Analysis 50.2

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).

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).
Figures and Tables -
Analysis 51.1

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).

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).
Figures and Tables -
Analysis 51.2

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).

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).
Figures and Tables -
Analysis 52.1

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).

Table 1. Discontinuation due to weight change

Study ID

Intervention group

n

N (randomized women)

Cachrimanidou 1993

Prolonged desogestrel / ethinyl estradiol (EE) regimen

10

200

Standard desogestrel / EE regimen

1

100

Coenen 1996

Norgestimate 250 μg / EE 35 μg

1

25

Gestodene 75 μg / EE 30 μg

0

25

Desogestrel 150 μg / EE 30 μg

0

25

Desogestrel 150 μg / EE 20 μg

0

25

Coney 2001

Levonorgestrel 100 μg / EE 20 μg

2

359

Placebo

0

362

Dionne 1974

Levonorgestrel 250 μg / EE 50 μg

3

73

Levonorgestrel 150 μg / EE 30 μg

1

77

Halbe 1998

Gestodene 75 μg / EE 30 μg

4

279

Desogestrel 150 μg / EE 30 μg

0

316

Kirkman 1994

Gestodene 75 μg / EE 30 μg

4

505

Desogestrel 150 μg / EE 20 μg

2

501

Miller 2001

Standard norgestrel / EE regimen

0

44

Prolonged norgestrel / EE regimen

1

46

Oddsson 2005

Vaginal ring etonogestrel 120 µg / EE 15 µg

2

512

Levonorgestrel 150 µg / EE 30 µg

6

518

Sang 1995

Injectable medroxyprogesterone acetate 25 mg / estradiol cypionatge (EC) 5 mg

14

1955

Injectable norethisterone enanthate 50 mg / estradiol valerate (EV) 5 mg

10

1960

Wiik 1993

Norethisterone 500‐1000 μg / EE 35 μg

3

100

Levonorgestrel 50‐75‐125 μg / EE 30‐40 μg

1

96

Figures and Tables -
Table 1. Discontinuation due to weight change
Comparison 1. Dimethisterone 25 mg and ethinyl estradiol (EE) 100 µg versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2.3 kg (cycle 4) Show forest plot

1

113

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.02 [0.46, 2.26]

Figures and Tables -
Comparison 1. Dimethisterone 25 mg and ethinyl estradiol (EE) 100 µg versus placebo
Comparison 2. Ethynodiol diacetate 1 mg and mestranol 100 µg versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2.3 kg (cycle 4) Show forest plot

1

112

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.57 [0.24, 1.33]

Figures and Tables -
Comparison 2. Ethynodiol diacetate 1 mg and mestranol 100 µg versus placebo
Comparison 3. Levonorgestrel 100 µg and EE 20 µg versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 6) Show forest plot

1

473

Mean Difference (IV, Fixed, 95% CI)

0.30 [‐0.23, 0.83]

Figures and Tables -
Comparison 3. Levonorgestrel 100 µg and EE 20 µg versus placebo
Comparison 4. Norgestrel 300 µg and EE 30 µg versus no intervention

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg per year Show forest plot

1

150

Mean Difference (IV, Fixed, 95% CI)

‐0.54 [‐1.39, 0.31]

Figures and Tables -
Comparison 4. Norgestrel 300 µg and EE 30 µg versus no intervention
Comparison 5. Norethindrone 1 mg and mestranol 50 µg versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2.3 kg (cycle 4) Show forest plot

1

123

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.50 [0.22, 1.17]

Figures and Tables -
Comparison 5. Norethindrone 1 mg and mestranol 50 µg versus placebo
Comparison 6. Skin patch norelgestromin 150 µg and EE 20 µg versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >5% baseline weight (cycle 9) Show forest plot

1

136

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.95 [0.30, 2.98]

2 Lost >5% baseline weight (cycle 9) Show forest plot

1

136

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.27 [0.04, 1.82]

Figures and Tables -
Comparison 6. Skin patch norelgestromin 150 µg and EE 20 µg versus placebo
Comparison 7. Skin patch norelgestromin 150 µg and EE 20 µg: extended versus cyclic regimen

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change (112 days or cycle 4) Show forest plot

1

191

Mean Difference (IV, Fixed, 95% CI)

‐0.12 [‐0.79, 0.55]

Figures and Tables -
Comparison 7. Skin patch norelgestromin 150 µg and EE 20 µg: extended versus cyclic regimen
Comparison 8. Desogestrel 150 µg and EE 20 µg versus desogestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean body mass percentage change (cycle 6) Show forest plot

1

45

Mean Difference (IV, Fixed, 95% CI)

0.10 [‐1.54, 1.74]

Figures and Tables -
Comparison 8. Desogestrel 150 µg and EE 20 µg versus desogestrel 150 µg and EE 30 µg
Comparison 9. Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

801

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.84 [0.58, 1.22]

2 Lost >2 kg (cycle 6) Show forest plot

1

801

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.65 [1.13, 2.41]

3 Gained >2 kg (cycle 12) Show forest plot

1

1476

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.13 [0.85, 1.49]

4 Lost >2 kg (cycle 12) Show forest plot

1

1476

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.95 [0.68, 1.33]

Figures and Tables -
Comparison 9. Desogestrel 150 µg and EE 20 µg versus gestodene 75 µg and EE 20 µg
Comparison 10. Desogestrel 150 µg and EE 20 µg versus norgestimate 250 µg and EE 35 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean body mass percentage change (cycle 6) Show forest plot

1

42

Mean Difference (IV, Fixed, 95% CI)

0.60 [‐1.45, 2.65]

Figures and Tables -
Comparison 10. Desogestrel 150 µg and EE 20 µg versus norgestimate 250 µg and EE 35 µg
Comparison 11. Desogestrel 150 µg and EE 30 µg versus levonorgestrel 50‐75‐125 µg and EE 30‐40‐30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

469

Peto Odds Ratio (Peto, Fixed, 95% CI)

3.29 [1.84, 5.88]

Figures and Tables -
Comparison 11. Desogestrel 150 µg and EE 30 µg versus levonorgestrel 50‐75‐125 µg and EE 30‐40‐30 µg
Comparison 12. Standard desogestrel and EE regimen versus prolonged gestodene and EE regimen

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 7) Show forest plot

1

890

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.20 [0.86, 1.68]

Figures and Tables -
Comparison 12. Standard desogestrel and EE regimen versus prolonged gestodene and EE regimen
Comparison 13. Prolonged desogestrel and EE regimen versus standard desogestrel and EE regimen

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 12) Show forest plot

1

196

Mean Difference (IV, Fixed, 95% CI)

0.57 [‐0.42, 1.56]

Figures and Tables -
Comparison 13. Prolonged desogestrel and EE regimen versus standard desogestrel and EE regimen
Comparison 14. Dienogest 2 mg, EE 10 µg and estradiol valerate 2 mg versus levonorgestrel 100 µg and EE 20 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >5% baseline weight (cycle 3) Show forest plot

1

49

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.20 [0.32, 4.51]

2 Lost >5% baseline weight (cycle 3) Show forest plot

1

49

Peto Odds Ratio (Peto, Fixed, 95% CI)

7.10 [0.14, 358.08]

Figures and Tables -
Comparison 14. Dienogest 2 mg, EE 10 µg and estradiol valerate 2 mg versus levonorgestrel 100 µg and EE 20 µg
Comparison 15. Dienogest 2 mg and EE 20 µg versus levonorgestrel 100 µg and EE 20 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >5% baseline weight (cycle 3) Show forest plot

1

49

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.95 [0.24, 3.76]

2 Lost >5% baseline weight (cycle 3) Show forest plot

1

49

Peto Odds Ratio (Peto, Fixed, 95% CI)

7.40 [0.45, 121.93]

Figures and Tables -
Comparison 15. Dienogest 2 mg and EE 20 µg versus levonorgestrel 100 µg and EE 20 µg
Comparison 16. Dienogest 2 mg and EE 30 µg versus levonorgestrel 100 µg and EE 20 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >5% baseline weight (cycle 3) Show forest plot

1

48

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.77 [0.18, 3.21]

2 Lost >5% baseline weight (cycle 3) Show forest plot

1

48

Peto Odds Ratio (Peto, Fixed, 95% CI)

7.39 [0.15, 372.38]

Figures and Tables -
Comparison 16. Dienogest 2 mg and EE 30 µg versus levonorgestrel 100 µg and EE 20 µg
Comparison 17. Dl‐norgestrel 500 µg and EE 50 µg versus levonorgestrel 250 µg and EE 50 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 3) Show forest plot

1

21

Mean Difference (IV, Fixed, 95% CI)

0.22 [‐1.30, 1.74]

Figures and Tables -
Comparison 17. Dl‐norgestrel 500 µg and EE 50 µg versus levonorgestrel 250 µg and EE 50 µg
Comparison 18. Dl‐norgestrel 500 µg and EE 50 µg versus norethisterone acetate 1 mg and EE 50 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 3) Show forest plot

1

16

Mean Difference (IV, Fixed, 95% CI)

1.14 [‐0.54, 2.82]

Figures and Tables -
Comparison 18. Dl‐norgestrel 500 µg and EE 50 µg versus norethisterone acetate 1 mg and EE 50 µg
Comparison 19. Drospirenone 2 mg and EE 30 µg versus drospirenone 3 mg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 3) Show forest plot

2

112

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.14 [0.00, 6.82]

2 Lost >2 kg (cycle 3) Show forest plot

1

66

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.99 [0.20, 19.82]

Figures and Tables -
Comparison 19. Drospirenone 2 mg and EE 30 µg versus drospirenone 3 mg and EE 30 µg
Comparison 20. Drospirenone 3 mg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

40

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.50 [0.05, 5.06]

2 Lost >2 kg (cycle 6) Show forest plot

1

40

Peto Odds Ratio (Peto, Fixed, 95% CI)

9.92 [1.79, 55.04]

Figures and Tables -
Comparison 20. Drospirenone 3 mg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg
Comparison 21. Drospirenone 3 mg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

40

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.13 [0.01, 2.13]

2 Lost >2 kg (cycle 6) Show forest plot

1

40

Peto Odds Ratio (Peto, Fixed, 95% CI)

7.39 [0.15, 372.38]

Figures and Tables -
Comparison 21. Drospirenone 3 mg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg
Comparison 22. Drospirenone 3 mg and EE 30 µg versus desogestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 13) Show forest plot

1

56

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.86 [0.29, 2.56]

2 Lost >2 kg (cycle 13) Show forest plot

1

56

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.38 [0.29, 6.62]

Figures and Tables -
Comparison 22. Drospirenone 3 mg and EE 30 µg versus desogestrel 150 µg and EE 30 µg
Comparison 23. Drospirenone 3 mg and EE 20 μg versus desogestrel 150 μg and EE 20 μg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 7) Show forest plot

1

441

Mean Difference (IV, Fixed, 95% CI)

‐0.67 [‐1.16, ‐0.18]

Figures and Tables -
Comparison 23. Drospirenone 3 mg and EE 20 μg versus desogestrel 150 μg and EE 20 μg
Comparison 24. Drospirenone 3 mg and EE 30 µg versus levonorgestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

40

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.13 [0.01, 2.13]

2 Lost >2 kg (cycle 6) Show forest plot

1

40

Peto Odds Ratio (Peto, Fixed, 95% CI)

7.39 [0.15, 372.38]

Figures and Tables -
Comparison 24. Drospirenone 3 mg and EE 30 µg versus levonorgestrel 150 µg and EE 30 µg
Comparison 25. Ethynodiol diacetate 1 mg and mestranol 100 µg versus chlormadinone acetate 1.5 mg and mestranol 100 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 6) Show forest plot

1

57

Mean Difference (IV, Fixed, 95% CI)

0.30 [‐1.43, 2.03]

Figures and Tables -
Comparison 25. Ethynodiol diacetate 1 mg and mestranol 100 µg versus chlormadinone acetate 1.5 mg and mestranol 100 µg
Comparison 26. Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

39

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.05 [0.06, 17.51]

2 Lost >2 kg (cycle 6) Show forest plot

1

39

Peto Odds Ratio (Peto, Fixed, 95% CI)

7.79 [0.15, 393.02]

3 Gained >2 kg (cycle 12) Show forest plot

1

452

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.06 [0.63, 1.81]

4 Lost >2 kg (cycle 12) Show forest plot

1

452

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.13 [0.63, 2.03]

5 Gained >2 kg (cycle 13) Show forest plot

1

40

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.71 [0.14, 3.57]

6 Lost >2 kg (cycle 13) Show forest plot

1

40

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.14 [0.00, 6.82]

Figures and Tables -
Comparison 26. Gestodene 75 µg and EE 20 µg versus gestodene 75 µg and EE 30 µg
Comparison 27. Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 20 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean body mass percentage change (cycle 6) Show forest plot

1

43

Mean Difference (IV, Fixed, 95% CI)

0.7 [‐1.32, 2.72]

2 Mean weight change in kg (cycle 6) Show forest plot

1

805

Mean Difference (IV, Fixed, 95% CI)

0.20 [0.00, 0.40]

3 Mean weight change in kg (cycle 12) Show forest plot

2

462

Mean Difference (IV, Fixed, 95% CI)

0.01 [‐0.50, 0.51]

Figures and Tables -
Comparison 27. Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 20 µg
Comparison 28. Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

3

1524

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.18 [0.87, 1.60]

2 Lost >2 kg ( cycle 6) Show forest plot

2

1172

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.34 [0.90, 2.00]

3 Mean body mass percentage change (cycle 6) Show forest plot

1

46

Mean Difference (IV, Fixed, 95% CI)

0.8 [‐1.18, 2.78]

Figures and Tables -
Comparison 28. Gestodene 75 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg
Comparison 29. Gestodene 75 µg and EE 30 µg versus norgestimate 250 µg and EE 35 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

357

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.54 [0.92, 2.60]

2 Mean body mass percentage change (cycle 6) Show forest plot

1

43

Mean Difference (IV, Fixed, 95% CI)

1.3 [‐1.03, 3.63]

Figures and Tables -
Comparison 29. Gestodene 75 µg and EE 30 µg versus norgestimate 250 µg and EE 35 µg
Comparison 30. Gestodene 50‐70‐100 µg and EE 30‐40‐30 µg versus desogestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 12) Show forest plot

1

30

Mean Difference (IV, Fixed, 95% CI)

1.25 [‐1.22, 3.72]

Figures and Tables -
Comparison 30. Gestodene 50‐70‐100 µg and EE 30‐40‐30 µg versus desogestrel 150 µg and EE 30 µg
Comparison 31. Gestodene 50‐70‐100 µg and EE 30‐40‐30 µg versus norgestimate 250 µg and EE 35 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 12) Show forest plot

1

47

Mean Difference (IV, Fixed, 95% CI)

‐0.25 [‐1.09, 0.59]

Figures and Tables -
Comparison 31. Gestodene 50‐70‐100 µg and EE 30‐40‐30 µg versus norgestimate 250 µg and EE 35 µg
Comparison 32. Prolonged gestodene and EE regimen versus standard gestodene and EE regimen

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 3) Show forest plot

1

58

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐1.23, 1.23]

Figures and Tables -
Comparison 32. Prolonged gestodene and EE regimen versus standard gestodene and EE regimen
Comparison 33. Levonorgestrel 100 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

418

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.26 [0.74, 2.15]

2 Lost >2 kg (cycle 6) Show forest plot

1

418

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.31 [0.70, 2.44]

Figures and Tables -
Comparison 33. Levonorgestrel 100 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg
Comparison 34. Levonorgestrel 150 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2.5 kg (cycle 24) Show forest plot

1

17

Peto Odds Ratio (Peto, Fixed, 95% CI)

8.66 [0.77, 97.74]

2 Lost >2.5 kg (cycle 24) Show forest plot

1

17

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.88 [0.17, 21.18]

Figures and Tables -
Comparison 34. Levonorgestrel 150 µg and EE 30 µg versus desogestrel 150 µg and EE 30 µg
Comparison 35. Levonorgestrel 150 µg and EE 30 µg versus gestodene 75 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 6) Show forest plot

1

369

Mean Difference (IV, Fixed, 95% CI)

0.7 [0.14, 1.26]

Figures and Tables -
Comparison 35. Levonorgestrel 150 µg and EE 30 µg versus gestodene 75 µg and EE 30 µg
Comparison 36. Levonorgestrel 250 µg and EE 50 µg versus levonorgestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2.7 kg (cycle 6) Show forest plot

1

109

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.92 [0.74, 4.96]

Figures and Tables -
Comparison 36. Levonorgestrel 250 µg and EE 50 µg versus levonorgestrel 150 µg and EE 30 µg
Comparison 37. Levonorgestrel 50‐75‐125 µg and EE 30‐40‐30 µg versus levonorgestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 6) Show forest plot

1

314

Mean Difference (IV, Fixed, 95% CI)

‐0.02 [‐0.06, 0.03]

Figures and Tables -
Comparison 37. Levonorgestrel 50‐75‐125 µg and EE 30‐40‐30 µg versus levonorgestrel 150 µg and EE 30 µg
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 or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean BMI change (cycle 6) Show forest plot

1

57

Mean Difference (IV, Fixed, 95% CI)

0.35 [‐0.13, 0.83]

2 Mean weight change in kg (cycle 6) Show forest plot

1

31

Mean Difference (IV, Fixed, 95% CI)

1.30 [‐0.32, 2.92]

Figures and Tables -
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
Comparison 39. Levonorgestrel 50‐75‐125 µg and EE 30‐40‐30 µg versus desogestrel 150 µg and EE 20 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 3) Show forest plot

1

33

Mean Difference (IV, Fixed, 95% CI)

0.78 [‐0.28, 1.84]

Figures and Tables -
Comparison 39. Levonorgestrel 50‐75‐125 µg and EE 30‐40‐30 µg versus desogestrel 150 µg and EE 20 µg
Comparison 40. Levonorgestrel 250 µg and EE 50 µg versus norethisterone acetate 1 mg and EE 50 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 3) Show forest plot

1

21

Mean Difference (IV, Fixed, 95% CI)

0.92 [‐1.25, 3.09]

Figures and Tables -
Comparison 40. Levonorgestrel 250 µg and EE 50 µg versus norethisterone acetate 1 mg and EE 50 µg
Comparison 41. Levonorgestrel and EE 6‐6‐9 day regimen versus levonorgestrel 6‐5‐10 day regimen

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 3) Show forest plot

1

28

Mean Difference (IV, Fixed, 95% CI)

0.09 [‐1.15, 1.33]

Figures and Tables -
Comparison 41. Levonorgestrel and EE 6‐6‐9 day regimen versus levonorgestrel 6‐5‐10 day regimen
Comparison 42. Lynestrenol 2 mg and EE 40 µg versus lynestrenol 1 mg and EE 40 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2.5 kg (cycle 12) Show forest plot

1

228

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.75 [0.98, 3.11]

2 Lost >2.5 kg (cycle 12) Show forest plot

1

228

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.66 [0.25, 1.77]

Figures and Tables -
Comparison 42. Lynestrenol 2 mg and EE 40 µg versus lynestrenol 1 mg and EE 40 µg
Comparison 43. Norethisterone 500‐1000 µg and EE 35 µg versus levonorgestrel 50‐75‐125 µg and EE 30‐40 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 6) Show forest plot

1

144

Mean Difference (IV, Fixed, 95% CI)

0.10 [‐0.70, 0.90]

Figures and Tables -
Comparison 43. Norethisterone 500‐1000 µg and EE 35 µg versus levonorgestrel 50‐75‐125 µg and EE 30‐40 µg
Comparison 44. Norgestimate 250 µg and EE 35 µg versus desogestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

349

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.15 [0.65, 2.06]

2 Mean body mass percentage change (cycle 6) Show forest plot

1

45

Mean Difference (IV, Fixed, 95% CI)

‐0.5 [‐2.51, 1.51]

Figures and Tables -
Comparison 44. Norgestimate 250 µg and EE 35 µg versus desogestrel 150 µg and EE 30 µg
Comparison 45. Norethisterone 500 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gained >2 kg (cycle 6) Show forest plot

1

292

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.09 [0.60, 1.99]

2 Lost >2 kg (cycle 6) Show forest plot

1

292

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.69 [0.89, 3.20]

Figures and Tables -
Comparison 45. Norethisterone 500 µg and EE 20 µg versus levonorgestrel 150 µg and EE 30 µg
Comparison 46. Norethindrone 500‐750‐1000 µg and EE 35 µg versus desogestrel 100‐125‐150 µg and EE 25 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 6) Show forest plot

1

5328

Mean Difference (IV, Fixed, 95% CI)

0.26 [0.12, 0.40]

Figures and Tables -
Comparison 46. Norethindrone 500‐750‐1000 µg and EE 35 µg versus desogestrel 100‐125‐150 µg and EE 25 µg
Comparison 47. Norgestimate 180‐215‐250 µg and EE 25 µg versus norethindrone acetate 1 mg and EE 20 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Weight gain >=5% (cycle 6) Show forest plot

1

2157

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.15 [0.91, 1.45]

2 Weight gain >=5% (cycle 13) Show forest plot

1

453

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.09 [0.69, 1.74]

3 Weight loss >=5% (cycle 6) Show forest plot

1

2157

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.99 [0.72, 1.37]

4 Weight loss >=5% (cycle 13) Show forest plot

1

453

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.32 [0.74, 2.34]

Figures and Tables -
Comparison 47. Norgestimate 180‐215‐250 µg and EE 25 µg versus norethindrone acetate 1 mg and EE 20 µg
Comparison 48. Standard norgestrel and EE regimen versus prolonged norgestrel and EE regimen

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 12) Show forest plot

1

43

Mean Difference (IV, Fixed, 95% CI)

1.8 [‐0.73, 4.33]

Figures and Tables -
Comparison 48. Standard norgestrel and EE regimen versus prolonged norgestrel and EE regimen
Comparison 49. Injectable medroxyprogesterone acetate 25 mg and EC 5 mg versus norethisterone enanthate 50 mg and EV 5 mg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 12) Show forest plot

1

3029

Mean Difference (IV, Fixed, 95% CI)

0.13 [‐0.04, 0.30]

Figures and Tables -
Comparison 49. Injectable medroxyprogesterone acetate 25 mg and EC 5 mg versus norethisterone enanthate 50 mg and EV 5 mg
Comparison 50. Vaginal ring with norethindrone acetate 1 mg and EE 15 µg versus norethindrone acetate 1 mg and EE 20 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gain >2 kg (cycle 4) Show forest plot

1

51

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.69 [0.13, 3.58]

2 Lost >2 kg (cycle 4) Show forest plot

1

51

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.69 [0.35, 8.07]

Figures and Tables -
Comparison 50. Vaginal ring with norethindrone acetate 1 mg and EE 15 µg versus norethindrone acetate 1 mg and EE 20 µg
Comparison 51. Vaginal ring etonogestrel 120 µg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gain >=7% body weight (cycle 13) Show forest plot

1

1030

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.84 [0.55, 1.28]

2 Lost >=7% body weight (cycle 13) Show forest plot

1

1030

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.39 [0.83, 2.32]

Figures and Tables -
Comparison 51. Vaginal ring etonogestrel 120 µg and EE 15 µg versus levonorgestrel 150 µg and EE 30 µg
Comparison 52. Vaginal ring etonogestrel 120 µg and EE 15 µg versus drospirenone 3 mg and EE 30 µg

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean weight change in kg (cycle 13 or last assessment) Show forest plot

1

937

Mean Difference (IV, Fixed, 95% CI)

0.4 [0.03, 0.77]

Figures and Tables -
Comparison 52. Vaginal ring etonogestrel 120 µg and EE 15 µg versus drospirenone 3 mg and EE 30 µg