Does Birth Control Make You Gain Weight?
When we talk about birth control, we refer to the use of medication, devices, or surgery to prevent pregnancy. Also known as contraception, some of them (barrier ones) can also prevent sexually transmitted diseases (STDs).
Some contraceptives can have other benefits, like the treatment or prevention of diseases or other pathologies, such as Polycystic Ovarian Syndrome.
Contraceptives have been a topic of discussion and debate due to the concern about their association with weight gain. Many women have a fear of using birth control methods, like hormonal contraceptives, because of the unwanted weight gain. However, it’s important to separate fact from fiction and explore the scientific evidence regarding this topic.
Effects of Birth Control on Body Weight
All hormonal birth control, like all medications, can have side effects. Many women that stop using birth control usually do so because they think it causes them to gain weight.
Many studies have suggested that there is little to no evidence supporting the claim that hormonal contraceptives directly cause major weight gain.
However, injectables and implants have been found to cause some body weight gain in some people due to fluid retention, although this can be easily managed with some lifestyle changes. Some other methods like oral contraceptives, hormonal long-acting reversible contraceptives (LARCs), patches, and vaginal rings have been found not to cause weight gain or loss.
Other birth control methods that are not hormonal, like condoms, copper LARCs, etc., do not cause a change in weight in people using them. Progestin-only contraceptives had little evidence of weight gain.
Clinical studies in this area are contradictory because some report women gain weight with the use of contraceptives, while others report losing weight as a side effect.
A study published in the Cochrane Library showed that three placebo-controlled, randomized trials did not find evidence supporting a causal association between combination oral contraceptives or a combination skin patch and weight gain. Also, most comparisons showed no substantial difference in weight. (1)
A comprehensive review published in the Cochrane Database of Systematic Reviews analyzed 49 studies involving more than 85.000 women and found no substantial evidence of weight gain. (2)
However, a prospective study involving 450 adolescent girls (aged 12 to 18) published in Arch Pediatric Adolescent Med found that girls with obesity that initiated injectable birth control gained more weight than obese girls starting oral contraceptives or controls. Weight gain in these girls was also greater than in all the control groups without obesity. (3)
As well as a study published in Elsevier and performed on 380 women who had the same contraceptive method for at least twelve months, in a statistical analysis of the weight gain with hormonal and non-hormonal contraceptive users, the percentage of weight gained by the hormonal contraceptive group was higher. (4)
Factors Influencing Weight Changes
Women on hormonal contraceptives may gain weight due to the following reasons:
- Fluid retention
- An increase in muscle tissue
- An increase in body fat.
Hormonal contraceptives, theoretically, can contribute to weight gain because of fluid retention and increased body fat. Also, combined contraceptives are sometimes believed to increase appetite, but women who don’t use hormonal contraceptives also gain weight as they age; therefore, it is difficult to say whether it is true or not.
As we said before, there are a lot of factors that influence the loss or gain of weight, like exercise, healthy foods, stress, genetics, age, gender, healthy habits (no smoking), and a good sleeping schedule.
This is why reports of weight gain may be related to individual experiences and personal habits, and a healthy lifestyle and good eating can mitigate the slight body weight gain that some contraceptives may produce. On the contrary, if we follow an unhealthy routine, we are more likely to gain weight with or without the use of any birth control.
Other Side Effects
Other side effects are heavy or irregular bleeding (in the first 6 months of introducing the method above all). This bleeding is usually not dangerous. You can also experience temporary nausea.
If you are taking birth control with estrogen in it and you have a history of migraine, high blood pressure, or blood clots, you may experience an increase in these symptoms. You should talk to your physician because it may increase your risk of stroke or thromboembolism. Other side effects could be depression and difficulty in having an orgasm.
What are the Different Types of Birth Control?
- Male condom
- Female condom
- Diaphragm and cervical cap
- Oral contraceptive
- Contraceptive patch
- Vaginal ring
- Injectable birth control
Long-acting reversible contraceptives (LARCs)
- Intrauterine device (IUD)
- Tubal ligation
Other forms of pregnancy prevention
- Fertility awareness-based methods
- Lactational amenorrhea method
Benefits of Using Hormonal Contraceptives
- Treatment of acne and hirsutism
- Treatment of hipermenorrea/dismenorrea
- Treatment of endometriosis
- Treatment of anemia
- Reduces ovarian cancer probability
- Reduces endometrial cancer probability
- Reduces colon cancer probability
Some common indications are:
- Teenagers: Condoms, implants or LARCs
- Lactants: Progestin LARCs or progestin oral contraceptives
- Perimenopause: Hormonal LARCs
- Endometriosis: Oral contraceptives with dienogest
- Dismenorrea: Oral contraceptives
- Obesity: LARCs hormonal or copper
- Hirsutism-acne: Oral contraceptive with cyproterone
- Anemia: Hormonal LARCs or oral contraceptives
When Can You Start Using Birth Control?
Most people can begin using hormonal contraception at the beginning of their menstrual cycle. There is no need for a Papanicolaou test before prescribing hormonal birth control.
After childbirth, most patients can begin using progestin-only contraceptives immediately after birth. This applies to patients that want to begin any appropriate contraceptive immediately after either birth or early pregnancy loss, except for an intrauterine device following septic (infected) abortion.
The handling of birth control should also be accompanied by guidance from the physician, giving comprehensive information about all the available choices, honoring the patient’s preferences, and eliminating delaying giving contraception because of office-related barriers.
In conclusion, birth control is useful for preventing pregnancy, and some can also reduce the risk of STDs. Other additional benefits are the reduction of certain cancers and the treatment of different medical conditions. When choosing a contraceptive method, it’s always important to consider different factors, such as comfort level, ease of use, and desired outcomes.
There are many types of birth control, like barrier methods, hormonal methods, long-acting reversible contraceptives, and others, such as withdrawal and fertility awareness.
The notion that birth control directly causes weight gain is not supported by scientific evidence. While many studies have shown no causal relationship between hormonal contraceptives and weight gain, individual experiences may vary. If any women experience weight gain as a side effect of the use of some hormonal contraceptives, studies have shown that this effect is small and can be managed with lifestyle changes.
Overall, the benefits of birth control usually outweigh the side effects, making it an important option for individuals seeking to prevent pregnancy; therefore, it’s crucial to dispel these misconceptions and encourage informed discussions about the benefits and consideration of different methods.
1. Gallo MF, Lopez LM, Grimes DA, Schulz KF, Helmerhorst FM. Combination contraceptives: effects on weight. Cochrane Database Syst Rev. 2006 Jan 25;(1):CD003987. doi: 10.1002/14651858.CD003987.pub2. Update in: Cochrane Database Syst Rev. 2008;(4):CD003987. PMID: 16437470.
2. Lopez LM, Ramesh S, Chen M, Edelman A, Otterness C, Trussell J, Helmerhorst FM. Progestin-only contraceptives: effects on weight. Cochrane Database Syst Rev. 2016 Aug 28;2016(8):CD008815. doi: 10.1002/14651858.CD008815.pub4. PMID: 27567593; PMCID: PMC5034734.
3. 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. Arch Pediatr Adolesc Med. 2006 Jan;160(1):40-5. doi: 10.1001/archpedi.160.1.40. PMID: 16389209.
4. Ibrahim H, Tengku Ismail TA, Hashim N. Comparison of body weight among hormonal and non-hormonal users in a Malaysian cohort. J Taibah Univ Med Sci. 2018 Dec 21;14(1):25-30. doi: 10.1016/j.jtumed.2018.11.012. PMID: 31435386; PMCID: PMC6694937.
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- Robbins CL, Ott MA. Contraception options and provision to adolescents. Minerva Pediatr. 2017 Oct;69(5):403-414. doi: 10.23736/S0026-4946.17.05026-5. Epub 2017 Jun 22. PMID: 28643995.
- Benagiano G, Gabelnick H, Brosens I. Long-acting hormonal contraception. Womens Health (Lond). 2015 Nov;11(6):749-57. doi: 10.2217/whe.15.68. Epub 2015 Dec 2. PMID: 26626534.
- Lesnewski R. Initiating Hormonal Contraception. Am Fam Physician. 2021 Mar 1;103(5):291-300. PMID: 33630554.
- InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Contraception: Do hormonal contraceptives cause weight gain? [Updated 2017 Jun 29]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441582/
- World Health Organization. Departamento de Salud Reproductiva e Investigaciones Conexas data. Recomendaciones sobre prácticas seleccionadas para el uso de anticonceptivos, tercera edición [Selected practice recommendations for contraceptive use, 3rd edition] Switzerland: World Health Organization; 2018. Available from: 2018https://apps.who.int/iris/bitstream/handle/10665/259814/9789243565408-spa.pdf;jsessionid=A806362E1BE232BC0D40EBAD9480662C?sequence=1
Franco Gabriel Cuevas is a physician who graduated from the National University of Cordoba, Argentina. His focus is on writing medical content to improve the access of physicians to medical information relevant to daily practice. He has participated in some research projects and has a special joy in writing and medical knowledge.