Birth Control Pill and Weight Gain

[JulioFly]

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Just throwing this out there to those of you who should know a little by now...clinicians are now saying that there are no conclusive studies that show the pill causes weight gain in women. They say that women simply go through stages in life in which they gain weight and happen to be starting the pill, which is why women think that their weight gain is associated with the pill.

Some say that, sure, the pill doesn't directly make you gain weight, but it increases your appetite, and therefore you put on pounds.

What do some of you think about this? Agree? Disagree? Have you done any research yourself on this subject?

 

[ShyRem]

Well, when I'm on certain pill formulations I gain up to 15 pounds. This weight disappears within two months of stopping those formulations. I'd say the correlation between those particular BC pills and my weight is pretty distinct.

There are liars, damn liars, and statisticians. You can make the numbers of a study say whatever you want.

 

[user2]

I've been on ortho tri-cyclen for 6 years and haven't gained a pound (I started on it when I was 20). It probably just depends on the individual.

 

[dara678]

agreed. depends on the individual.

 

[MissMuffet]

Well, when I'm on certain pill formulations I gain up to 15 pounds. This weight disappears within two months of stopping those formulations. I'd say the correlation between those particular BC pills and my weight is pretty distinct.

There are liars, damn liars, and statisticians. You can make the numbers of a study say whatever you want.

Indeed. It reminds me of the post-tubal ligation controversy.

 

[DrKitty]

I gained 2 pounds after having been on the pill for 3 months. Don't know if it's due to the pill or being more relaxed and with a healthier appetite due to having acceptances 🙂

 

[MexiGirl]

I have been on ortho-tri cyclen for two years and it has not caused me to gain weight. But the depo shot did cause me to gain 15 lbs 👎

 

[Cinnameg]

I have been on ortho-tri cyclen for two years and it has not caused me to gain weight. But the depo shot did cause me to gain 15 lbs 👎

Both BC pills and the depo shot -- don't worry, not at the same time! -- caused me to feel very tired and have downward mood swings. Neither should have been prescribed to me because I have a history of migraines, but student health care center doctors can be very pushy about chemical birth control and poo-poo alternatives. I thought that the lack of energy and low mood was more of a cause of any weight gain I had than the pills themselves.

 

[OSUdoc08]

Just throwing this out there to those of you who should know a little by now...clinicians are now saying that there are no conclusive studies that show the pill causes weight gain in women. They say that women simply go through stages in life in which they gain weight and happen to be starting the pill, which is why women think that their weight gain is associated with the pill.

Some say that, sure, the pill doesn't directly make you gain weight, but it increases your appetite, and therefore you put on pounds.

What do some of you think about this? Agree? Disagree? Have you done any research yourself on this subject?

Who cares if you gain weight? Learn to exercise.

It's worth it to prevent pregnancy, ovarian cancer, uterine cancer, and gonorrhea.

 

[LadyJubilee8_18]

I have been on ortho-tri cyclen for two years and it has not caused me to gain weight. But the depo shot did cause me to gain 15 lbs 👎

I went on the pill as a 110 pound 5'8 seventeen year old with no boobies. I hoped it would make me gain weight (and have boobs) but it didn't 🙁 My best friend went on the pill and went up from an A cup to a C cup. Stoopid body variations

 

[Smurfette]

Who cares if you gain weight? Learn to exercise.

It's worth it to prevent pregnancy, ovarian cancer, uterine cancer, and gonorrhea.

Um...gonorrhea? You might want to do a little safe sex education.

 

[OSUdoc08]

Um...gonorrhea? You might want to do a little safe sex education.

Have you taken pathology?

Oral Contraceptive Pills reduce the risk of Neisseria gonorrhoeae infection due to the alteration of cell types in the vaginal and cervical epithelium. They become resistant to infection.

Reference:

Rapid Review Pathology, Edward Goljan, MD, 2006 Edition.

 

[dbhvt]

Have you taken pathology?

Oral Contraceptive Pills Prevent Neisseria gonorrhoeae infection due to the alteration of cell types in the vaginal and cervical epithelium. They become resistant to infection.

Reference:

Rapid Review Pathology, Edward Goljan, MD, 2006 Edition.

I'm proud of you, OSUdoc08. Reference and everything.

 

[Trail Boss]

Well, when I'm on certain pill formulations I gain up to 15 pounds. This weight disappears within two months of stopping those formulations. I'd say the correlation between those particular BC pills and my weight is pretty distinct.

There are liars, damn liars, and statisticians. You can make the numbers of a study say whatever you want.

wow, anecdotal evidence--someone get NEJM on the horn!!

 

[bigfrank]

Have you taken pathology?

Oral Contraceptive Pills Prevent Neisseria gonorrhoeae infection due to the alteration of cell types in the vaginal and cervical epithelium. They become resistant to infection.

Reference:

Rapid Review Pathology, Edward Goljan, MD, 2006 Edition.

Esoteric and clinically irrevelant.

 

[SoCuteMD]

I found the pill made me retain a little more water. I also found that it made me crave salty, fatty foods when my normal diet is very rich in whole grains and other healthy stuff (ok, well it was at the time, now I'm in med school!). I gained weight secondary to eating those foods. Of course, when you eat crap like that you feel more sluggish, making exercise more of a challenge.

I also found it made me cranky. Even more so than my usual self...not a good thing.

I honestly don't know what I will do when I am next in a serious relationship, as I have tried the lowest dose ocp available.

 

[SoCuteMD]

Have you taken pathology?

Oral Contraceptive Pills Prevent Neisseria gonorrhoeae infection due to the alteration of cell types in the vaginal and cervical epithelium. They become resistant to infection.

Reference:

Rapid Review Pathology, Edward Goljan, MD, 2006 Edition.

And OSUdoc - let's not forget that there are better ways to prevent STDs.

 

[dbhvt]

OSUdoc08, don't pay any attention to them. They are all jealous.

 

[shantster]

It definitely depends on the person. After I went on the pill, I actually lost a few pounds, but that could be because when I went on the pill correlated to when I started working out regularly. I've gained it back now, but I haven't gained a significant amount of weight.

The only real thing that happened that I think is because of the pill is that my skin has gotten much more sensitive to the sun. I'm half Asian Indian and so I never burn even without sunscreen, but that's happened to me more than once since I've started taking it. 👎

 

[SexyLexie729]

I found the pill made me retain a little more water. I also found that it made me crave salty, fatty foods when my normal diet is very rich in whole grains and other healthy stuff (ok, well it was at the time, now I'm in med school!). I gained weight secondary to eating those foods. Of course, when you eat crap like that you feel more sluggish, making exercise more of a challenge.

I also found it made me cranky. Even more so than my usual self...not a good thing.

I honestly don't know what I will do when I am next in a serious relationship, as I have tried the lowest dose ocp available.

Try the nuva ring. It has a lower dose of hormones than the pill or the patch.

 

[OSUdoc08]

Esoteric and clinically irrevelant.

Odd that it is on our path review for boards, then isn't it?

 

[OSUdoc08]

And OSUdoc - let's not forget that there are better ways to prevent STDs.

You can tell patients to use condoms all you want, but that doesn't mean it will happen 100% of the time.

(Just like you can tell them to exercise, eat healthy, and quit smoking.)

 

[Doctor Bagel]

Personally, I've never had any weight gain related to bc pills. I get to skip my periods (great because I have horrible cramps), and my skin is so much clearer than it was pre-pill. If I ever try to conceive, I'll be bummed to have to go off the pill. I've taken ortho-cyclen, ortho-nova, ortho-evra (didn't like it -- I couldn't find a good, secure, private place to keep the patch) and zovia (my current pill -- generic for demulin, cheap and works great, imo).

 

[betty7]

I was recently prescribed ortho-tricyclin and when I went to the pharmacy to fill it the pharmacist asked me if the generic (tri sprintec) would be ok. I said yes after confirming it has the same medications as ortho-tricyclin.
I went on the internet to see if this was the case and got mixed results. Do generics have to have the same exact medications as the brand name?? Thanks for the help!

 

[MexiGirl]

I was recently prescribed ortho-tricyclin and when I went to the pharmacy to fill it the pharmacist asked me if the generic (tri sprintec) would be ok. I said yes after confirming it has the same medications as ortho-tricyclin.
I went on the internet to see if this was the case and got mixed results. Do generics have to have the same exact medications as the brand name?? Thanks for the help!

I also tried the generic brand of ortho-tricyclen which was Trinessa. Trinessa claims to be "Therapeutically equivalent to Ortho Tri-Cyclen" BUT Trinessa made me very moody, retain water, and have heavier periods. 👎 👎

 

[OSUdoc08]

I also tried the generic brand of ortho-tricyclen which was Trinessa. Trinessa claims to be "Therapeutically equivalent to Ortho Tri-Cyclen" BUT Trinessa made me very moody, retain water, and have heavier periods. 👎 👎

You should use Yasmin.

 

[LadyJubilee8_18]

You should use Yasmin.

yeah, I'm on Yasmin also. It's pretty good, no major changes for me

 

[Doctor Bagel]

yeah, I'm on Yasmin also. It's pretty good, no major changes for me

It costs a fortune, though. My current insurance is so cr@ppy (stupid hsa plan), so I don't want to take anything that's not generic. Some people don't like generic bc pills, but I'd recommend giving them a try.

 

[VCU07]

Have you taken pathology?

Oral Contraceptive Pills Prevent Neisseria gonorrhoeae infection due to the alteration of cell types in the vaginal and cervical epithelium. They become resistant to infection.

Reference:

Rapid Review Pathology, Edward Goljan, MD, 2006 Edition.

I would like to read through this reference. OC do not reduce your risk of aquiring a sexually transmitted disease, including Gonorrhea. Additionally, I do not know of any special cell types that are "resistant" to bacterial colonization.

 

[shantster]

yeah, I'm on Yasmin also. It's pretty good, no major changes for me

Yasmin = 👍

 

[dbhvt]

I would like to read through this reference. OC do not reduce your risk of aquiring a sexually transmitted disease, including Gonorrhea. Additionally, I do not know of any special cell types that are "resistant" to bacterial colonization.

Ehh? I don't know much, but in freshman biology we all learned that sickle cell anemia provides resistance to malaria infection, most likely through a change in the morphology of affected RBCs. So there is pretty well known example of a special cell type that provides resistance to colonization by an intracellular parasite.

 

[Elysium]

I've worked in family planning clinics on and off for five years and I can tell you that it doesn't seem to matter if a woman is on COCs or not as far as getting gonorrhea is concerned. We see lots of GC/CT in women 24 and younger who are on the pill. So, not sure what the story is with that...

The pill has definitively been proven (in the latest round of studies, anyway) to NOT cause weight gain in women. The only one that does is the depo provera shot because it increases appetitie. Most women tend to gain around 1-2 pounds a year from the time they are 18 and women's metabolism also goes through a fairly marked decline in their mid 20's (remember all the crap you ate in college after going to a party? Think you can do the same thing at 28 and not notice a difference? It ain't pretty) regardless of what hormones they're on.

As far as the best tolerated pills, from my experience (seeing women who are on various kinds of pills every day) are Desogen, Mircette, Alesse (though some women get freaked out that they don't get a period on Alesse sometimes), Loestrin (Microgestin) 1/20 and Loestrin 1.5/30. Women don't seen to do well on Ortho Tri Cyclen or Ortho Tri Lo at all. Ortho Novum 1/35 seems to work ok in older women who don't smoke.

A lot of people really LOVE the nuva ring, esp. women in their 20's who aren't squemish about putting the ring inside them. You can't feel it when it's in there and you don't need to take a pill every day. All my coworkers at the clinic I work on are on them.

For continous cycling, our medical director (on faculty at OHSU) did a study that showed that Loestrin 1/20 and I.5/30 showed the least amount of breakthrough bleeding and had the best side effect profile.

There's also the possibility of IUDs as well. If you've had children (or even been pregnant) you're considered a good candidate for the IUD if you don't want to have kids for the next 5-7 years. The paragaurd is copper and has no hormones and the mirena has a bit of progesterone in it. We do a lot of IUD inserts with no problems.

 

[Doctor Bagel]

The pill has definitively been proven (in the latest round of studies, anyway) to NOT cause weight gain in women. The only one that does is the depo provera shot because it increases appetitie. Most women tend to gain around 1-2 pounds a year from the time they are 18 and women's metabolism also goes through a fairly marked decline in their mid 20's (remember all the crap you ate in college after going to a party? Think you can do the same thing at 28 and not notice a difference? It ain't pretty) regardless of what hormones they're on.

For continous cycling, our medical director (on faculty at OHSU) did a study that showed that Loestrin 1/20 and I.5/30 showed the least amount of breakthrough bleeding and had the best side effect profile.

Oh yeah, I know about the mid-20 weight gain. It's so hard to realize that you can't eat (or drink!) whatever the hell you want. The joys of aging.

Thanks for posting the pills that are best for continuous cycling! I don't know why everyone doesn't do it. I also don't get why people shell out several hundred bucks for seasonale (isn't that what it's called) when you can do it with other bc pills.

Oh yeah, I guess I took ortho novum, not ortho nova. I start to break out a bit, which is why I switched to zovia.

I know people who love their IUDs, but I've heard they can be a pain to get. I have a coworker who had to basically fight with her doctor to get one because she wasn't married.

 

[happydays]

Try the nuva ring. It has a lower dose of hormones than the pill or the patch.

would the ring ever fall out?

 

[VCU07]

Ehh? I don't know much, but in freshman biology we all learned that sickle cell anemia provides resistance to malaria infection, most likely through a change in the morphology of affected RBCs. So there is pretty well known example of a special cell type that provides resistance to colonization by an intracellular parasite.

Your post has nothing to do with birth control making cells resistant to bacterial infection. Malaria is a parasitic infection. Plus, if OCs did make women resistant to Gonorrhea then it would have been clinically implemented, which it has not. Just because something is statistically significant does not make it clinically significant.

 

[OSUdoc08]

I would like to read through this reference. OC do not reduce your risk of aquiring a sexually transmitted disease, including Gonorrhea. Additionally, I do not know of any special cell types that are "resistant" to bacterial colonization.

Buy the book when it is published this summer.

OCPs reduce the risk of GC, whether you believe it or not.

 

[OSUdoc08]

repeat post

 

[SexyLexie729]

would the ring ever fall out?

It doesn't fall out...thankfully 🙂

 

[VCU07]

Buy the book when it is published this summer.

OCPs reduce the risk of GC, whether you believe it or not.

So, I assume your were one of the principle investigators in this study? Your statment has not changed clinical practice. There are many women that come into clinics with gonorrhea that are on OCs. Perhaps OCs reduce the risk in a special population of women?

 

[Trail Boss]

Ehh? I don't know much, but in freshman biology we all learned that sickle cell anemia provides resistance to malaria infection, most likely through a change in the morphology of affected RBCs. So there is pretty well known example of a special cell type that provides resistance to colonization by an intracellular parasite.

I thought that they still get infected, they just get cleared quicker by the spleen because they are already defective, hence infection but with no major systemic presentation.

 

[OSUdoc08]

So, I assume your were one of the principle investigators in this study? Your statment has not changed clinical practice. There are many women that come into clinics with gonorrhea that are on OCs. Perhaps OCs reduce the risk in a special population of women?

Women get pregnant on birth control pills.

That does not mean OCP's don't prevent pregnancy.

If you want to disagree with the author of Rapid Review Pathology, that's your business. You'll find that most USMLE reviewers don't, however.

 

[OSUdoc08]

I thought that they still get infected, they just get cleared quicker by the spleen because they are already defective, hence infection but with no major systemic presentation.

People with sickle cell anemia do not have spleens.

(And no, they don't get infected.)

 

[BooMed]

Try the nuva ring. It has a lower dose of hormones than the pill or the patch.

😍

I think some women gain weight when they go on birth control because they are in relationships, eating more (maybe this explains how I ate 1/2 lb of cheese last night). People get fatter when they get married, too.

 

[BooMed]

It doesn't fall out...thankfully 🙂

Actually one of my friends can't use it because hers did fall out. 😱 But I think that's pretty rare.

 

[FDoRoML]

Actually one of my friends can't use it because hers did fall out. 😱 But I think that's pretty rare.

If you've got an odd uterine position (retroverted) and other not so standard anatomy, it can come out. However, generally, when it is placed properly it not only stays in but also is unnoticeable (or nearly so).

Aha, but yes, for those asking in their heads but afraid to ask "out loud" on the forum... you *can* have intercourse with it in but certain, er, positions can make it uncomfortable (for you and/or him) or come out.

One benefit from the Nuvaring that doesn't come with BCPs-- it seems to normalize natural organisms. Women prone to yeast infections *or* bacterial infections have found that the incidence has either dropped dramatically or gone away completely after using the ring. It's also a lower dose b/c it's localized and seems to have fewer systemic effects (break outs, nausea, etc). It's a good option for those with Gyn problems who've been prescribed constant hormones (like taking the pill with no week off) because it seems to do the trick and is less harsh on the system.

But, yeah, not everyone can be comfortable using it for more reasons than just physical discomfort.

 

[akpete]

I love Depo, and no one can convince me otherwise!! 😀

As for weight gain...I can't really say. I did not gain weight when I was on the pill for 2 or 3 years, but I've since gained ~30 lbs. since depo that I am struggling right now to take off. But when I started depo I also quit smoking and was not quite as active as before (eating habits the same), so I think all 3 played a role. As far as I know, it's been shown that depo increases appetite and smoking cessation causes weight gain, correct?

 

[FenderHM]

I feel like I've heard more cases of b.c. pills resulting in depression, which can lead to weight gain. But maybe getting laid more and the accompanying exercise offset those things?

 

[Stitch626]

Yasmin is nice because it has anti-androgenic and anti-mineralocorticoid properties so less acne, less bloating. You just have to watch out for hyperkalemia.

 

[bubbles!]

Try the nuva ring. It has a lower dose of hormones than the pill or the patch.

I'm on the nuva ring currently. I have to be on some form of BC to keep my cycle regular since I have PCOS so I've tried just about every pill available.

I did have stomach-related side effects on every other pill I've been on (queasiness if I don't eat every few hours, wierd fatty/salty food cravings), no matter how low the dose- and I've had none of those problems on the nuva ring. Yay!

But- the ring seems to be making me wildly moody. I'm still trying to figure out if it's just medical school (I started them at the same time) but I definitely feel significantly happier/saner during the 1 week I have the ring out.

Has anyone else out there noticed that with the ring?

 

[haleyrockx]

I was recently prescribed ortho-tricyclin and when I went to the pharmacy to fill it the pharmacist asked me if the generic (tri sprintec) would be ok. I said yes after confirming it has the same medications as ortho-tricyclin.
I went on the internet to see if this was the case and got mixed results. Do generics have to have the same exact medications as the brand name?? Thanks for the help!

I know I respond better to non-generics. I have PCOS and have to be on the pill until I can get insurance and properly treat the hormonal imbalance. Some of the ortho brands work ok for me but not great. The generics make the androgenization symptoms that I get from the PCOS much worse.

I think it all depends on how your body responds to the fillers in the generics. Also, your ob/gyn can vary the dose level if you are having side effects. Not one dosage/brand of pill fits everyone. 🙂