Do you gain weight from the pill or other hormonal birth control methods?

It was my biggest fear when I started taking the pill at only fourteen years old: would I gain weight from using the Diane-35 pill? I scoured online forums for answers and, of course, came across horror stories about pounds that just came on and never came off. I asked my GP, who explained that the pill contains hormones that cause you to retain fluids and can also increase your appetite. But is that really still the case?

Now, at least 15 years have passed. Currently, the Diane-35 pill is not prescribed anymore due to an increased risk of thrombosis. I also switched to a different kind of birth control soon after starting the Diane-35 pill: First to the Microgynon 30 pill and eventually I got a Mirena IUD. The question of whether or not it would give me curves and a bigger booty was of no concern to me. That I could have safe sex weighed a lot more heavily (no pun intended). However, I still don't really know anything about birth control, hormones and weight gain. And I discovered that I'm not the only one after a quick round of Googling. One article says you don't gain weight, another says a little and yet another says you lose it. So, what is the truth? We tried to find it for you!

Not all birth control methods contain the same hormones

The pill, the contraceptive patch and vaginal ring all contain estrogen as well as progesterone, whilst the Mirena and the Kyleena (hormonal IUDs), Implanon (contraceptive implant), the mini-pill and the contraceptive injection only contain progesterone. 

Want to know exactly which hormone and in what quantity is in hormonal birth control? We made a handy overview with all the hormones listed.

Some studies would show that estrogen inhibits appetite. So, if you do gain weight (for whatever reason) estrogen causes the fat to be stored mainly on the hips and thighs. Progesterone, on the other hand, increases the appetite. For this reason, you may also experience more food cravings before your period. Also, you will often retain a little more fluid the week before your period. This is also due to the hormones estrogen and progesterone, which affect your fluid balance.

Do you have a lot of sugar cravings right before your period? This article tells you why that is and what you can do about it!

The pill, contraceptive patch and the vaginal ring

There have been a lot of scientific studies on the effect of the pill and whether you gain weight from using it. They show that for most women the use of birth control pills does not cause weight gain. Some women do notice that they have gained a very small amount of weight and especially that their figure changed slightly. This weight gain is only temporary, because you retain more fluid during the first few months. Sometimes, especially with the slightly heavier pills, you continue to retain fluid and it is advisable to eat a little less salt. Incidentally, there are also women who report in clinical studies that they have actually lost weight. For this reason, both weight gain and loss are mentioned as possible side effects.

It is not impossible to gain weight from the pill, but it occurs relatively little. In the few cases weight gain was reported, it remained under 2kg. Of course, there are many reasons and circumstances which can cause your weight to change, the pill being just one of them. 

There have been small-scale studies* showing that the birth control pill has an effect on muscle mass production in (young) women. Women on the pill would create less muscle mass than women without the pill. However, it is too early to draw conclusions from this; more research is needed.

Hormonal IUD, the contraceptive injection and the contraceptive implant

Like we mentioned before, it is well known that progesterone can increase the appetite. For that reason, it was said that birth control methods with progesterone, like the Kyleena and the Mirena IUD, cause more weight gain than combination preparations such as the pill. However, recent studies have shown that there is insufficient evidence for this.

A review of 22 studies was conducted in 2016. These showed that contraceptives containing only progestins did not cause more weight gain than other forms of hormonal contraception. However, progestin birth control users did gain more weight than people who did not use contraceptives at all, although the average weight gain remained limited (less than 2 kg).

Final answer: no significant weight gain due to hormonal birth control

So, we can say that hormonal contraceptives are generally not fattening. Of course, no two people are the same and it is not inconceivable for someone to gain weight due to hormonal contraception. Still, it is good to realize that many women experience fluctuations in weight, appetite and hydration even without the use of the pill or other hormonal contraception. Moreover, many women start using contraceptives during their adolescence or college years, a time when many women gain some weight anyway. You may not like that, but it is perfectly normal.

It was once, but not anymore

By the way, it's not surprising that users of hormonal contraceptives are concerned about possible fattening effects. After all, the first generation of birth control pills is known to have caused users to gain quite a bit of weight. The doses of hormones in those pills were up to a factor of one thousand higher than today. In addition to weight gain, this also increased the risk of thrombosis and breast cancer. Fortunately, today's contraceptives are milder. So we can continue to have safe sex with peace of mind without worrying about one kilogram more or less.

Still have questions about your birth control pill? Talk about it with your GP and gynecologist. There are a lot of birth control methods available and not one is the same as the other. The composition differs per brand and there may be another one which suits you better!

Do you want to refresh your knowledge on the different methods of contraception? You can do that with the help of the extensive article we wrote on all methods.

Want to learn more about your body and health? Stay informed and join our community!

* Bron: Pubmed