Weight gain may be a side effect of hormonal contraceptives such as birth control pills.
Like birth control pills, hormonal contraceptives offer women a safe and effective method of birth control. 1 But like any drug, hormonal contraceptives can cause side effects, including weight gain.
Women take birth control pills every day. To prevent pregnancy, birth control pills release female sex hormones into your body to stop ovulation (when your ovaries release an egg). 2
While some people experience weight gain while taking birth control pills, the effects are usually temporary, minimal, and manageable. 3
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Do birth control pills cause weight gain?
Although some experts believe weight gain is a side effect of birth control pills, it’s unclear whether birth control pills directly cause weight gain. 3,4
There are two main types of birth control pills. This combination pill contains estrogen and progesterone (a synthetic form of progesterone). Another type is called the “mini pill,” which contains only progestin. 2
Some studies suggest there may be a link between birth control pills and weight gain in some users. For example, a 2020 study found that polypills were associated with an increase in body fat and a decrease in lean body mass (muscle and other lean tissue) in people trying to lose weight. 5 Other studies confirmed that this was not significant. No association was found between hormonal contraception and weight gain regardless of obesity. 6
Even though study results are mixed, weight gain while taking birth control pills is generally minimal. For progestin-only pills, this is typically around 1.6 to 2.5 kilograms, but again, it’s unclear whether it’s the pill or other factors that are responsible for the weight gain. 3 Additionally, weight changes may vary among different brands of pills with different hormone dosages. .
For the combination pill, some studies reported weight gain of more than 4 pounds in some users, while others reported weight loss or no change at all. 4
Experts believe that several factors can lead to weight gain while taking birth control pills:
- Age: Many people start taking hormonal contraceptives during adolescence or early adulthood. Weight usually increases as you age and your body develops. 3
- Stress: Excessive stress can increase your risk of weight gain. 7 For people starting birth control pills as teenagers or young adults, school, college, or a new relationship may lead to stress-related weight gain.
- Hormone effects on appetite: Taking progestins may affect your appetite. Elevated progesterone levels can trigger emotional overeating, and you’re more likely to eat foods high in carbohydrates, salt, and fat. 5
- Increased body water content: Some birth control pills can also cause fluid retention as a side effect during the first few months of taking the pill, which can lead to a few pounds of weight gain. 8
Despite the potential for weight-related hormonal side effects, oral contraceptive pills have evolved over the years. When the pill was first introduced in the 1950s, it contained higher doses of estrogen and progesterone (more than three times as much as modern pills). Today, the pill contains only a fraction of the original dose of the hormone and is therefore less likely to cause serious side effects. 9
Types of contraception associated with weight gain
While birth control pills are not associated with significant long-term weight gain, other types of birth control may have a greater impact.
Contraceptive injection
The birth control shot contains medroxyprogesterone acetate, a progestin that helps prevent pregnancy. Doctors need to inject it into the arm or buttocks every three months. 10
Weight gain is a known side effect of birth control injections. 10 Studies show that a common injectable brand, Depo-Provera (or DMPA), can lead to an average weight gain of nearly 3 pounds per year and about 14 pounds over 10 years. DMPA injections have also been associated with increased body fat. 11
Implantable contraceptive devices and intrauterine devices (IUDs)
Implants and intrauterine devices (IUDs) are long-acting reversible contraceptives (LARC). This means they can prevent pregnancy for years and no longer work once removed. An IUD is a small device that is inserted into the uterus, while an implant is a device that is inserted into the arm. 12
Long-term use of these methods can lead to moderate weight gain: 3,11
- Hormonal IUD. These medications release progesterone, which causes an average weight gain of about 1.5 pounds per year and about 9 pounds over 10 years.
- Non-hormonal IUD. These so-called copper IUDs contain copper to prevent pregnancy and are associated with an average weight gain of about 0.5 pounds per year and about 11 pounds after 10 years.
- Implant contraceptive method. The device releases progesterone. Several studies have shown that implants may cause greater weight gain than non-hormonal birth control methods.
Other risk factors for weight gain
Researchers aren’t entirely sure what causes birth control pills to gain weight. Genetic factors, lifestyle factors and metabolism may all play a role. 13 Other factors that may lead to weight gain while taking hormonal contraceptives include:
- Mental illness: Mental health disorders are often associated with weight gain. Birth control pill users with comorbid psychiatric conditions such as depression or anxiety are more likely to gain weight while taking birth control pills. 14
- Obesity or overweight: A 2020 study compared two groups of women who participated in an 18-month weight loss program. All were overweight or obese and actively trying to lose weight. One group took a combined hormonal contraceptive (CHC) throughout the program and the other group did not. Although both groups lost weight in the first 6 months, women taking CHCs (including birth control pills) were more likely to gain weight in subsequent months. 5
- Other health conditions: People with hormonal imbalances or conditions such as polycystic ovary syndrome (PCOS) may have higher cholesterol and fat levels. Women with PCOS taking polypharmacy may experience a greater increase in fat levels than women without PCOS taking polypharmacy. 11
Tips for managing your weight while taking birth control pills
You may notice weight gain while taking hormonal birth control pills, but birth control pills are not the only possible cause. If you want to control your weight while taking medication, here are some healthy lifestyle changes you can make:
- Reduce stress: Manage stress and emphasize self-care by getting enough sleep, deep breathing or meditation, and taking time to relax. 15
- Eat healthily: Although you may feel hungrier than usual while on birth control pills (especially at the beginning), try to stick to a healthy diet such as: B. Fruits, vegetables, and low-fat and nonfat dairy products. Limit comfort foods that are high in calories, added sugar, or high in carbs and fat. 5,16
- Exercise regularly: Physical activities such as walking, swimming, or yoga can help you manage your weight. The CDC recommends about 150 minutes of moderate aerobic exercise per week. 17
When to see a health care provider
If you are using birth control but don’t want to gain weight, discuss your options with your doctor. They can assess your overall health, give you helpful tips on healthy eating habits, and recommend birth control that won’t cause weight gain.
Birth control methods that are less likely to cause weight gain include:
- Birth control patch: Applies to the skin and releases estrogen and progesterone to prevent ovulation. The patch has side effects such as skin irritation, headache and breakthrough bleeding, but is less associated with weight gain. 4,18 As with birth control pills, any changes in weight while taking the patch are minimal and may be due to external factors. 4
- Vaginal Ring: This is a small, flexible plastic ring that functions like a skin patch. It is inserted into the vagina for 21 days at a time to prevent ovulation each cycle. Common side effects of the ring may include vaginal discharge, vaginal irritation, and nausea. 18
- Barrier methods: Barrier birth control methods, such as spermicides, condoms, diaphragms, cervical caps, and sponges, prevent your partner’s sperm from reaching the egg. These methods are non-hormonal and therefore do not affect your body’s natural hormone levels or metabolism. 19
Review
In most cases, weight gain while taking birth control pills or other birth control pills is not permanent. However, if you’re concerned about weight gain, there are healthy ways to cope with the changes in your body. Talk to your doctor about which birth control method is best for you, your body, and your overall health.