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What will the birth control pill do to my weight?

What will the birth control pill do to my weight?

Whilst our weight and size shouldn’t define who we are, for some the potential for weight changes can play a big part in how they choose a contraceptive. The contraceptive pill contains synthetic versions of hormones which, when introduced into the body, can potentially cause a number of side effects. Noticing changes when you take the pill can be quite normal.

A few women report weight gain, or at the very least notice weight fluctuations, when they start taking the pill. This can impact the type of pill they decide to take in the long run.

But is there a genuine link between the pill and weight? Are certain pills more or less likely to affect your weight? And what can you do if you think the pill you’re currently taking is impacting your weight?

We’ll delve into these questions and more, so that you feel confident when it comes to choosing a contraceptive to suit you.

Daniel Atkinson
Medically reviewed by
Daniel Atkinson, GP Clinical lead
Table of contents
Medically reviewed by
Dr Daniel Atkinson
GP Clinical lead
on August 02, 2022.
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Does the pill make you gain weight?

Weight gain is the most commonly reported side effect of the combined birth control pill. This is considerable given that more than 100 million women worldwide use combined oral contraceptives. But can the pill actually make you gain weight?

Well, a lot of studies and medical papers fail to establish a clear link between taking birth control pills and weight gain. This was found to be true for all pills, including those which contained different versions of progesterone.

Yet the anecdotal evidence shouldn’t be ignored. Huge numbers of women report online about the side effects of the pill, from acne to sweating to unwanted hair growth and, of course, weight gain. So what is the truth? Do you gain weight on the birth control pill?

How do hormones in the pill affect weight?

One of the most comprehensive reviews looking at a potential relationship between the pill and weight found no link, but did report that more research was needed. The review considered 49 studies of the combined pill and found “no large effect” was evident.

But these reviews and studies consider weight and not shape or composition, which the pill may impact.

In 2009, a psychological researcher at Texas A&M University studied a group of women over 10 weeks in relation to resistance training. He found, inadvertently, that women on the pill had gained 40% less muscle than those who didn’t take it.

The pill may also impact the way women store fat. Hormones are responsible for the development of women’s bodies when they experience puberty, and affect how fat is distributed. It’s possible that introducing more hormones into the body when you take the pill could affect weight distribution and subcutaneous fat.

Lastly, it’s thought that certain contraceptive pills could cause bloating. Estrogen impacts how the body deals with water and retains it, and all combined pills contain a synthetic version of estrogen. If you’re bloated because of the pill, you might see a higher number on the scale.

So is it right to say the contraceptive pill causes weight gain?

The medical consensus seems to be that the birth control pill does not cause weight gain. But swathes of anecdotal testimonies from those taking the pill seem to suggest the contrary — women believe they are gaining weight while on the pill.

But evidence does demonstrate that the pill can impact muscle growth, fat storage and fluid retention, all of which can contribute to changing numbers on the scale. Ultimately, much more research is needed to establish whether there is a true link between birth control pills and weight gain.

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What combined birth control pills are linked with weight gain?

To understand how combined pills link with weight gain, it can help to understand what is meant by 1st, 2nd, 3rd and 4th generation pills.

The pill has been around since 1960, and it’s undergone a lot of updates since then, which are called generations. Different generations have different types of lab-created progesterone as one of the active ingredients. The type of estrogen, ethinyl estradiol, has stayed the same.

First generation pills — you guessed it — were the first contraceptive pills to be introduced in the 1960s. They contained higher levels of estrogen and progestin than is typically used today. The progestins used in first generation pills include norethynodrel, norethindrone, lynestrenol and ethynodiol diacetate.

Second generation pills contain lower levels of hormones, and were therefore considered a lot safer than first generation pills. If you continue to experience side effects with second generation pills, you may be prescribed third or fourth generation pills which were created much later and with the intention of further lowering the risk of side effects, which they do, but they’re not quite as safe as second generation pills.

If you feel that you are gaining weight while taking a particular pill, you may benefit from switching to one which contains different versions of progesterone or different quantities — or switch to a different generation of the combined pill.

Alesse, Seasonique, Portia and weight gain

Alesse, Seasonique and Portia are all combined pills which contain the same synthetic version of estrogen and progesterone — ethinyl estradiol and levonorgestrel respectively. Because each pill contains levonorgestrel, they are all second generation pills.

Second generation pills like Alesse, Seasonique and Portia are less likely to cause certain side effects including heavy bleeding, breast fullness, headaches, fluid retention, tiredness, irritability, nausea and bloating.

However, it’s worth remembering that all medications have the ability to cause side effects, including changes to weight and size.

Some women who take Portia do notice weight gain or changes to their appetite. There are currently no specific studies on Portia and weight gain.

Apri, Marvelon and weight gain

Apri and Marvelon both contain ethinyl estradiol and desogestrel. Desogestrel is a synthetic progesterone used in third generation pills. This means Apri and Marvelon were created to try and reduce certain side effects associated with second generation pills.

There are no specific studies on Apri and weight gain. Common side effects associated with Apri include tender breasts, discharge, reduced acne, headaches and vaginal dryness.

What about Marvelon and weight gain? Weight gain is listed as a side effect on the Marvelon patient information leaflet, but weight may also naturally fluctuate during the menstrual cycle. If you do experience uncomfortable side effects, discuss switching the pill with your doctor or prescriber.

Yaz, Yasmin and weight gain

Yaz and Yasmin are both combined oral contraceptive pills containing ethinyl estradiol and drospirenone. This makes them fourth generation pills. They’ll often be prescribed if you’ve tried other pills and have experienced side effects.

The Yaz pill and weight gain as a side effect have not been largely studied. Yasmin has the same active ingredients as Yaz and Yasmin has not been associated with weight gain.

How will the mini pill affect my weight?

Mini pills are different from combined contraceptive pills because they only contain one synthetic hormone, always a version of progesterone. They’re sometimes referred to as progestin-only pills (POP).

Mini pills are prescribed for women who have migraine-type headaches or cardiovascular risk factors which make the combined pill unsuitable for them. They also tend to stop menstrual periods so many women prefer them for this reason. They’re ideal for women who suffer more greatly with oestrogenic side effects.

However, most studies show that the mini pill does not cause weight gain. But it is still a commonly reported side effect associated with the mini pill, and if you think the progestin-only pill is making you gain weight, you can talk to your doctor about switching.

Jencycla, Norlutate and weight gain

Jencycla and Norlutate are both progestin-only pills, or mini pills. They both contain norethindrone as their sole active ingredient. (They don’t contain estrogen.)

Is there a link between Jencycla and weight gain? Or does the Jencycla pill affect weight loss? On the Jencycla patient leaflet, increased body weight is listed as one of the most common side effects affecting up to 1 in 10 women.

It’s a similar story in relation to the generic Norethindrone and weight gain. Norethindrone and weight loss are not linked, but weight gain is listed on the Norethindrone patient information leaflet as a side effect.

Daily mini pills may impact your weight, and taking them and experiencing weight gain is reported in some women. If you take either Jencycla or Norlutate and you notice changes to your weight, speak with your doctor.

What about other birth control methods? How will these affect my weight?

If you’re concerned about weight gain and its association with hormonal birth control pills, there are a number of non-hormonal methods of contraception available to you.

Examples include barrier methods like condoms, fertility awareness methods, withdrawal and sterilization — none of which affect your weight.

Evra patch and weight gain

The Evra patch is a combined contraceptive patch that releases hormones to prevent pregnancy. When used correctly, it is up to 99% effective.

While studies have not found a direct link between hormonal contraceptives and weight gain, the Evra patch patient information leaflet does list weight gain as a common side effect affecting up to 1 in 10 women.

DepoProvera and weight gain

Depo-Provera is a contraceptive injection that intravenously releases the female hormone progesterone which works to prevent pregnancy. It has to be administered once every 13 weeks.

Some women gain weight while using Depo-Provera. “Studies show that over the first 1-2 years of use, the average weight gain was 5-8 lbs. Women completing 4-6 years of therapy gained an average of 14-16.5 lbs.”

IUDs and weight gain

The Intrauterine device (IUD) is a small, T-shaped device that is placed in the uterus to prevent pregnancy. It’s made from plastic, and releases copper which stops you getting pregnant. IUDs can protect you for between five and 10 years.

Current scientific knowledge doesn't give any evidence that the IUD will affect your weight or increase the risk of cervical, uterus or ovarian cancers.

Should I be taking the pill if I’m overweight?

There is some information you may need to be aware of in relation to the pill and being overweight. If you’re overweight, the contraceptive pill is usually safe to take.

However, some women who have a body mass index (BMI) of 25 or over appear to have an equivalent or higher risk of unintended pregnancy compared with women of a normal weight. But some studies refute this, and claim the pill works equally well in women no matter their weight.

In some combined contraceptive pills, certain risk factors can increase if you are seriously overweight or obese. Your risk of breast cancer and blood clots does rise slightly if you’re overweight and take certain pills, but still remains considerably small.

For the most part, combined contraceptives that contain synthetic versions of estrogen and progesterone are generally safe for women who are overweight to use. If you’re worried or concerned about the pill and your weight, you can speak more with your doctor or pharmacist.

Can the birth control pill also help you lose weight?

The answer isn’t completely straightforward, and can vary from person to person. Most studies show hormonal contraceptives do not cause weight gain, but it’s still a widely reported side effect among women.

Some evidence does show that the pill can affect body size and composition. But is there any contraception that doesn’t cause weight gain? Certain fourth generation pills, such as Yasmin, have been found to reduce the risk of certain side effects and even cause weight loss.

However, both weight gain and weight loss are reported side effects in the majority of contraceptive pills. Patient information leaflets often list both as potential side effects. The introduction of additional hormones into the body will affect different people in different ways, so finding a pill that could potentially help you lose weight, or at the very least not gain weight, may come down to switching pills a few times before you find the one for you.

Is there a “best” birth control pill for weight loss?

Birth control pills are not licensed treatments for weight loss, but some women do find that certain pills aren’t as likely to cause weight gain, or they lose weight while they’re on certain other pills.

So establishing the “best” contraceptive pill for weight loss is mostly preferential and down to what works best for you. Studies analyzing each of the main contraceptive pills used in Canada and how they impact weight have yet to be conducted.

However, there may be certain pills which are more likely to cause weight loss than others. Fourth generation pills were introduced to combat a lot of side effects associated with older birth control pills, or at the very least reduce their severity. For some women, fourth generation pills are the best option of birth control for weight loss.

While some women respond better to fourth generation pills, weight gain is still a reported side effect associated with them. Some women notice they lose weight on certain pills, some gain weight, and some see no changes at all. Fourth generation pills are also associated with a slightly higher risk of blood clots. The increase is very small, as is the overall risk of developing a blood clot associated with the pill, but it’s worth keeping in mind.

Is there a best birth control pill for acne, or a best birth control for both acne and weight loss? Some women who suffer adversely with acne may be prescribed hormonal contraceptives to help get their symptoms under control. As it stands, there are currently no contraceptives approved in Canada for treating both acne and weight loss.

Is there a pill that definitely doesn’t cause weight gain?

Unfortunately, it’s almost impossible to say decisively whether there is one single best birth control to avoid weight gain. Finding a birth control pill that doesn’t cause weight gain in Canada is difficult because they all affect women in different ways. Everyone responds differently to hormonal contraceptives, and it’s often a case of trying different pills before you find a birth control that doesn’t personally cause you weight gain.

It’s important to maintain regular communication with the medical professional that prescribes your contraception, especially if you’re seeking a pill without weight gain as a noticeable side effect. You may have other side effects you’re keen to avoid, like acne, for example. Talk to your doctor about what you’d most like to avoid, and they can work with you to find the best pill.

Can coming off the pill help me lose weight?

If you’re thinking about coming off the pill, you may have wondered whether coming off the pill makes you lose weight. This is a common concern for many women. Just as introducing additional hormones into the body can result in a number of changes and side effects, no longer taking the pill and reducing the hormones in your body can also affect you in certain ways as you adjust.

For example, coming off the pill will see your periods return to normal relatively quickly - within a month or two. (That is, if the pill affects your periods to begin with.)

What can I do if I’m worried about my weight on the pill?

If you have questions or concerns about taking the pill and your weight, we have answers. If you think switching pills might help with your weight, or any other issue you’re concerned about with contraception, we have the information you need. 

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