Which types of birth control don’t cause weight gain?

Weight gain is a dreaded topic for most women. Whether it’s always been a struggle, or a recent life event has caused you to start packing on the pounds, most women experience weight issues at some point in their lives. It’s even harder to understand why the weight gain is happening. Common sense will tell you it’s because you’re eating more food than you’re burning off, but it’s really not that simple.

Hormones, organ health, and underlying illnesses all play a role in how your body metabolizes and burns off energy. Depending on your individual health, you may be gaining weight for any number of reasons. If you’re gaining weight, or afraid of doing so, it makes sense that you wouldn’t want to do anything that might exacerbate the issue. Many women believe that specific types of birth control cause weight gain or weight loss. There have been various studies conducted with regard to this, but scientists have seen no direct correlation between birth control and weight gain or weight loss. That being said, change in hormones and diet can definitely contribute to change in weight and some amount of anxiety around starting a new birth control is understandable.

The good news is that not all birth controls cause weight gain and birth control isn’t proven to cause weight gain. However, birth control can indeed impact fluid retention, muscle gain, and body fat percentage, and these in turn could affect perceived overall body weight. On the other hand, weight gain attributed to birth control can actually be caused by changes in lifestyle.

While it’s important to consider whether your birth control is causing your weight gain, you should also be aware of common methods to control your own weight.

Ways to prevent weight gain include:

• Exercise — at least 30 minutes of exercise every day of the week
• Hydration — helps reduce bloating and thirst-related hunger
• Calorie control — reduce the amount of sodium in your diet (because it can cause bloating) and watch your serving sizes in general
• Nutrition — eat more whole foods, less processed foods, more nutrient-rich vegetables, fruits, and nuts

With that being said, different types of birth control can each may have varying effects on body weight. Let’s examine them below:

Implants (such as Nexplanon):

Scientists are unclear whether the implant contributes to weight gain. Some studies show that after a year, the implant causes 0.1 kg (0.22 lbs) in weight gain, which was similar to the weight gained by people using a copper IUD (1). Apparently implant users also showed no significant difference in body fat percentage after one year compared to copper IUD users (1). A different study showed that implant users gained more weight than copper IUD users, 2.1 kg (4.6 lbs), after a year of use, but this was only when data from all races was combined (2). When the participants were separated based on race, there was no difference in weight gain between implant and copper IUD users (2).

Hormonal IUDs (such as Mirena, Liletta):

Hormonal IUDs don’t seem to cause weight gain, but might result in increased body fat. Several studies show that hormonal IUDs cause a weight gain of 0.5 kg (1.1 lbs) to 2.9 kg (6.4 lbs) after one year of use, similar to the weight gained by copper IUD users (1–4).

After 10 years of continuous use, hormonal IUD users had gained an average of 4.0 kg (8.8 lbs), which was no different than the amount of weight gained by people who had been using the copper IUD for 10 years (2). Keep in mind, however, that people not on birth control will also gain weight as they age, as a result of natural processes unrelated to birth control. Body fat percentage results are mixed: one study showed no increase in body fat after a year of hormonal IUD use (1) while another did find an increase (4).

Other hormonal IUDs such as Kyleena, Jaydess, or Skyla have lower doses of progestin than Mirena or Liletta, but changes in weight on these particular types of IUDs have not been well studied.

The Shot (such as Depo-Provera):

Some studies suggest the shot causes weight gain while others show no proof of weight change attributable to the shot. Longitudinal studies even yield mixed results. In one study spanning 10 years, users gained 6.5 kg (14.3 lbs), more than the weight gained by copper IUD users (3). In another study, however, users gained 9.5 kg (20.9 lbs) over the 10-year period, which was the same as the weight gained by copper IUD users in that study (7).

We must remember that many, many other factors are at play when considering body fat percentage or overall weight. Race, socioeconomic status, and job type all affect our diet, frequency / intensity of exercise, hours of sleep, etc. So many different forces affect our body weight that it is very difficult to singularly accredit birth control (in any form) with particular weight gain.

Then again, research appears even to suggest that combined hormonal contraceptives such as the pill, patch, and ring do not cause weight gain:

The pill (various brands):

After six months of using the pill, participants in two studies did not gain any more weight than people who weren’t using any kind of birth control (8,9), gaining 0.88 kg (1.94 lbs) on average (8). Pill users also didn’t show changes in body fat after six months (9) or a year (10). Among pill users, 10 out of 100 gained more than 7% of their body weight in one year of use, and 5 out of 100 lost more than 7% of their body weight (11).

The patch (such as Xulane):

After one year of patch use, research subjects gained an average of 0.4 kg (0.88 lbs) (12,13), which was the same amount gained by pill users (13).

The ring (such as Nuvaring):

After a year, people using the ring gained 0.4 kg (0.88 lbs), which was the same weight gained by people using the pill (10). There was also no difference in body fat among Nuvaring users after a year (10). For ring users, 8 out of 100 people gained more than 7% of their body weight after a year, and 7 out of 100 people lost more than 7% of their body weight (11).

Of course, we must remember that these numbers are just averages. Some people in these studies gained weight while others lost weight. Some people may be more prone to gaining weight on birth control than others. If you are in your 20s or 30s and experience weight gain and acne and/or male pattern hair growth, you should talk to a doctor about a medical condition called polycystic ovarian syndrome.

Additional research is needed to fully understand how and why different types of birth control cause weight gain in some, but not others.

When To See A Doctor

If you are taking hormonal birth control and experience any of the below side effects, you should speak to a doctor immediately:

• abdominal or stomach pain
• chest pain, shortness of breath, or both
• severe headaches
• eye problems such as blurred vision or loss of vision
• swelling or aching in the legs and thighs
• redness, swelling or pain in the calf or thighs

These conditions may suggest a more serious condition.

Talk to an Alpha Provider Today

If you are considering birth control, there are many options for you. With Alpha, you can consult with a doctor or nurse practitioner, be examined, and receive your treatment quickly and conveniently from your own home. Our doctors are experts in building custom treatment plans and are happy to walk you through any questions or concerns.

While not for everyone, birth control can be used for many purposes in addition to preventing pregnancy, including managing acne and decreasing menstruation pain. If you are concerned about or unsure of the possibilities of weight gain with birth control, you can be assured that with Alpha, you are always able to consult a professional without the weeks- or months-long wait at a physician’s practice.

References

1. Silva Dos Santos PN, Madden T, Omvig K, Peipert JF. Changes in body composition in women using long-acting reversible contraception. Contraception. 2017;95(4):382–9.

2. Vickery Z, Madden T, Zhao Q, Secura GM, Allsworth JE, Peipert JF. Weight change at 12 months in users of three progestin-only contraceptive methods. Contraception. 2013;88(4):503–8.

3. Modesto W, Silva dos Santos PN, Correia VM, Borges L, Bahamondes L. Weight variation in users of depot-medroxyprogesterone acetate, the levonorgestrel-releasing intrauterine system and a copper intrauterine device for up to ten years of use. Eur J Contracept Reprod Health Care. 2015;20(1):57–63.

4. Dal’Ava N, Bahamondes L, Bahamondes MV, de Oliveira Santos A, Monteiro I. Body weight and composition in users of levonorgestrel-releasing intrauterine system. Contraception. 2012;86(4): 350–3.

5. Dal’Ava N, Bahamondes L, Bahamondes MV, Bottura BF, Monteiro I. Body weight and body composition of depot medroxyprogesterone acetate users. Contraception. 2014;90(2):182–7.

6. Silva Dos Santos PN, Modesto WO, Dal’Ava N, Bahamondes M, Pavin E, Fernades A. Body composition and weight gain in new users of the three-monthly injectable contraceptive, depotmedroxyprogesterone acetate, after 12 months of follow-up. Eur J Contracept Reprod Health Care. 2014;19(6):432–8.

7. Taneepanichskul S, Reinprayoon D, Jaisamrarn U. Effects of DMPA on weight and blood pressure in long term acceptors. Contraception. 1999;59(5):301–3.

8. Coney P, Washenik K, Langley RG, DiGiovanna JJ, Harrison DD. Weight change and adverse event incidence with a low-dose oral contraceptive: two randomized, placebo-controlled trials. Contraception. 2001;63:297–302

9. Reubinoff BE, Grubstein A, Meirow D, Berry E, Schenker JG, Brzezinski A.. Effects of low-dose estrogen oral contraceptives on weight, body composition, and fat distribution in young women. Fertil Steril 1995;63:516–21.

10. Milsom I, Lete I, Bjertnaes A, Rokstad K, Lindh I, Gruber CJ, et al. Effects on cycle control and bodyweight of the combined contraceptive ring, NuvaRing, versus an oral contraceptive containing 30 µg ethinyl estradiol and 3 mg drospirenone. Hum Reprod. 2006;21:2304–11.

11. Oddsson K, Leifels-Fischer B, de Melo NR, Wiel-Masson D, Benedetto C, Verhoeven CH, et al. Efficacy and safety of a contraceptive vaginal ring (NuvaRing) compared with a combined oral contraceptive: a 1-year randomized trial. Contraception. 2005;71:176–82.