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Will the Pill cause weight gain?

There are no ‘absolutes’ when dealing with birth control pills. Much of how people react to medicines depends on how much of the drug is metabolised, where it is metabolised, the contents of the stomach, and the time of day it is taken, for example.

Some women lose weight on birth control pills, some gain and, of course, some stay the same.

Robert Hatcher, in his text Contraceptive Technology, states: ‘In most instances, weight change is minimal and is unrelated to pill use. Approximately as many women lose weight as gain weight while taking oral contraceptives. In some women, however, weight gain is definitely caused by oral contraceptives. Rarely, pills can cause a gain of ten to 20 pounds or more.’

When it is related to the Pill, weight gain can be caused by one or more factors:

• Fluid retention due to the oestrogen or progestogen component of the Pill. This pattern of weight gain occurs in the month or so after starting the Pill.
• Oestrogen-induced weight gain increases subcutaneous fat, particularly in the hips, thighs and breasts, typically occurring after several months on the Pill.
• Increased appetite and increased intake of food occurring over several years.
• Depression accompanied by an increased intake of calories and/or a decrease in exercise.

You can try to decrease the oestrogen, progestogen or both. You can also try to increase the oestrogen potency, if the weight gain is due to increased breast tissue and subcutaneous fat, particularly in the thighs and hips.

Finding which Pill works best for a woman experiencing side-effects is a complex task, which sometimes becomes a frustrating, trial-and-error search.

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