Differential Effects of Depot Medroxyprogesterone Acetate and Norethisterone Enanthate on Some Metabolic and Cardiovascular Parameters in Hausa Women of Kano Metropolis

Abstract

Introduction and aim: Injectable contraceptives such as depot medroxyprogesterone acetate (DMPA-SC) and norethisterone enanthate (NET-EN) are widely used in Sub-Saharan Africa. While reported to have effects on weight and altered glucose metabolism, their metabolic and cardiovascular effects remain underexplored in African populations. This study assessed these outcomes among women in Kano, Nigeria.

Methods: A six-month longitudinal study was conducted among 85 Hausa women aged 15–49 years attending family planning clinics. Participants were new or continuing users of DMPA-SC or NET-EN, without chronic illnesses. Anthropometric indices, blood pressure, fasting blood glucose (FBG), and total cholesterol (TC) were measured at baseline and six months. Paired Student’s t-tests were used, with p < 0.05 considered significant.

Results: Both DMPA-SC and NET-EN were associated with significant increases in FBG (p = 0.008 and p = 0.012, respectively) and TC (p = 0.004 and p = 0.027, respectively). NET-EN users had higher post-treatment FBG, whereas DMPA-SC users showed a more pronounced rise in TC, suggesting a greater potential atherogenic burden. Changes in BMI, systolic blood pressure, and diastolic blood pressure were modest and not statistically significant. No significant alterations occurred in the control group.

Conclusion: Six-month use of DMPA-SC and NET-EN was linked to significant increases in FBG and TC among Hausa women in Kano, Nigeria. NET-EN exerted a greater effect on glucose, while DMPA-SC had a stronger impact on cholesterol, highlighting formulation-specific metabolic differences. BMI and blood pressure remained largely unchanged, indicating that early metabolic alterations may precede overt changes in adiposity or cardiovascular measures.

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