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What will the contraceptive pill do to my weight?

What will the contraceptive 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.

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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A number of 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.

Does the pill make you gain weight?

Weight gain is the most commonly reported side effect of the combined contraceptive 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 in 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 and stories about the pill making them fat. 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 reported 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, not shape or composition – which the pill may impact. 

In 2009, a psychological researcher at an American 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 affect bloating. Oestrogen impacts how the body deals with water and retains it. All combined pills contain ethinyl estradiol, a synthetic version of oestrogen. Taking the pill could, in theory, impact fluid retention which may contribute to weight gain or impact perception of weight. 

Is it right to say the contraceptive pill causes weight gain?

The medical consensus seems to be that the contraceptive 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. It could be argued that what might be perceived as weight gain, is actually changes to body shape and composition.

Unfortunately, much more research is needed to establish whether there is a true link between birth control pills and weight gain.

Woman with curly hair leaning out of car window and smiling

What combined contraceptive 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 changes since then – called generations. This refers to the type of lab-created progesterone that’s used as the second active ingredient. The version of oestrogen, ethinyl estradiol, always remains the same.

First generation pills, you guessed it, were the first contraceptive pills to be introduced in the 1960s. They contained higher levels of oestrogen and progesterone than is typically used today. Versions of the progesterone used in first generation pills included norethynodrel, norethindrone, lynestrenol and ethynodiol diacetate. First generation pills were linked with a number of dangerous side effects, which led to their discontinuation throughout much of the world.

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.

Microgynon, Nordette, Logynon and weight gain

Microgynon 30, Nordette, Logynon are all combined pills which contain the same synthetic version of oestrogen and progesterone – ethinyl estradiol and levonorgestrel respectively. Because each pill contains levonorgestrel, they are all second generation pills.

Second generation pills like Microgynon, Nordette and Logynon 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 Microgynon do notice weight gain or changes to their appetite. There are currently no specific studies on Microgynon and weight gain.

The UK equivalent of Nordette, Rigevidon, is one of the most affordable pills for the UK NHS to provide, so a lot of women use it. But side effects have been reported with the use of it, including changes in weight. If when taking Nordette you notice any weight gain or experience any other side effects you’re not comfortable with, talk to your doctor about switching.

Studies on the Logynon pill and weight loss, or weight gain, are limited. On the Logynon patient information leaflet, weight gain is listed as a common side effect – affecting 1 in 100 women. However, fluid retention is also listed as a side effect which can impact weight and our perception of it.

Marvelon, Madeline and weight gain

Marvelon 28 and Madeline both contain ethinyl estradiol and desogestrel. Desogestrel is a synthetic progesterone used in third generation pills. This means Marvelon and Madeline were created to try and reduce certain side effects associated with second generation pills.

There are no specific studies on Marvelon 28 and weight gain. Common side effects associated with Marvelon include tender breasts, discharge, reduced acne, headaches and vaginal dryness.

What about Madeline and weight gain? Weight gain is listed as a side effect on the Madeline 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.

Yasmin, Isabelle, Petibelle and weight gain

Isabelle, Petibelle and Yasmin are all 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 Isabelle pill and weight gain as a side effect have not been largely studied. Yasmin, in effect, is the same drug as Isabelle, and Yasmin has not been associated with weight gain.

Yasmin and Petibelle have been linked to weight loss however. When Yasmin was first introduced, it was heralded as a pill that could reduce the risk of certain side effects including weight gain, headaches and mood swings. The creators of Yasmin claimed it could help you lose weight as well. Studies on Petibelle showed women using it lost weight compared to Marvelon.

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 progesterone-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 progesterone-only pill is making you gain weight – you can talk to your doctor about switching.

Microlut, Locilan, Micronor, Noriday and weight gain

There are four brands of progesterone-only pills (POP), or mini pills, available in Australia. Microlut, which contains levonorgestrel, and Locilan 28, Noriday 28 and Micronor, which all contain norethisterone.

The mini-pill is usually of a lower dose and doesn’t contain oestrogen so is associated with less risk than the combined pill. When taken correctly, it is 99% effective as birth control.

Microclut’s patient leaflet contains no mention of weight gain or change in its list of side effects. Locilan 28, Noriday 28 and Micronor all mention weight change in their patient leaflets. However, they also mention fluid retention which causes bloating. This may be the reason for weight change. In the clinical trial for Micronor, it found that 55% of patients gained less than five pounds and no change in weight was found in 19.5% of the patients.

In a study comparing norethisterone and levonorgestrel on metabolism, there were no significant differences between the two.

As of October 2022, Locilan 28 and Micronor are no longer listed on the Australian Register of Therapeutic Goods (ARTG).

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

If you’re concerned about weight gain and its association with hormonal contraceptive 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 sterilisation – none of which affect your weight.

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. The only other contraceptive injection in Australia is Depo Ralovera and works the same way.

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. Sometimes referred to as the coil, it 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 oestrogen 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 don’t 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’ contraceptive 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.

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. Pills such as Yasmin, Zoely and Qlaira are all fourth generation contraceptive pills created to limit weight gain.

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 with acne may be prescribed hormonal contraceptives to help get their symptoms under control. Contraceptives that contain the progesterone cyproterone acetate and the oestrogen ethinylestradiol have been shown to improve acne, and even hirsutism (excess hair growth). Some of these include: Brenda-35 ED, Estelle-35 ED, Diane-35 ED and Juliet-35 ED. However, there are currently no contraceptives approved to treat both acne and weight loss in the Australia.

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 contraceptive pill that doesn’t cause weight gain 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 stopping the pill, you may have wondered whether coming off the pill makes you lose weight. This is a common concern for many women. But the answer isn’t so easy because just as introducing additional hormones into the body can result in a number of changes and side effects, no longer taking the pill 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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