From the Guidelines
Hormonal contraceptives do not reliably cause weight gain, according to the most recent and highest quality evidence. The effects of hormonal contraceptives on weight are varied and depend on several factors, including the type of contraceptive and individual responses to hormones 1.
Key Points to Consider
- Combined oral contraceptives (COCs), which contain both estrogen and progestin, have been found to have minimal effects on weight, with neither weight gain nor mood changes reliably linked to their use 1.
- The potential for weight gain with hormonal contraceptives is often attributed to fluid retention, changes in appetite, or alterations in muscle mass, rather than actual fat gain.
- If concerns about weight gain arise, switching to a lower-dose pill or exploring non-hormonal contraceptive methods may be advisable, under the guidance of a healthcare provider.
- It's crucial for individuals to discuss any side effects, including weight changes, with their healthcare provider to determine the best contraceptive option for their specific needs and health profile.
Important Considerations for Healthcare Providers
- Counseling patients about the potential effects of hormonal contraceptives on weight and other aspects of health is essential.
- Monitoring and addressing any adverse effects, including those related to weight, can help in managing patient concerns and improving adherence to the chosen contraceptive method.
- The decision to use or switch contraceptive methods should be made on a case-by-case basis, considering the individual's medical history, lifestyle, and personal preferences, alongside the risks and benefits associated with each method 1.
From the Research
Hormonal Contraceptives and Weight Gain
- Hormonal contraceptives, also known as birth control, have been associated with weight gain in some studies, but the evidence is not conclusive 2, 3.
- A review of studies on the influence of different contraceptive methods on weight change found that weight fluctuates by about 3 kg over an observation interval from 6 to 24 months during use of hormonal contraceptives 2.
- However, another study found that the available evidence was insufficient to determine the effect of combination contraceptives on weight, but no large effect was evident 3.
Specific Contraceptive Methods and Weight Gain
- Depo Provera users may experience a higher increase in weight compared to other hormonal contraceptives, with a higher proportion of women gaining more than 3 kg/year 2.
- Intrauterine devices (IUDs) have also been associated with weight gain, approximately double that of the average female population 2.
- A review of hormonal contraceptives for contraception in overweight or obese women found that the evidence generally did not indicate an association between higher BMI or weight and effectiveness of hormonal contraceptives 4.
Importance of Individual Factors
- Optimal contraceptive selection requires patient and clinician discussion of the patient's tolerance for risk of pregnancy, menstrual bleeding changes, other risks, and personal values and preferences 5.
- Counseling women interested in using progestin-only pills (POPs) about the variable bleeding patterns associated with this method may improve compliance and acceptance 6.
- The age-associated weight gain has been described to be 0.1 kg/m(2) annually, corresponding to about 300 g/year, which should be considered when evaluating the effect of hormonal contraceptives on weight 2.