Monday, June 5, 2017

Oral Contraceptives and Weight Gain - What is the Truth?

The first oral contraceptives on the market contained much higher doses of hormones than those prescribed today and weight gain and fluid retention are two 'associated 'side effects' that seem to have lingered on. An average of five pounds gain in weight was estimated to be the result of taking oral contraceptives. Studies have concluded that overall, today's low dose oral contraceptives do not cause weight gain.

Before you jump up and down with a 'Look at me, I've gained 2 kgs!' it is a fact that those women who got nauseous on the pill actually LOST just as much weight as others (who didn't get nauseous) gained. However, there will still be some women who have certain factors in their bodies that respond even to today's low dose pills and this may account for their weight gain when they take oral contraceptive pills.

One of the active ingredients in the contraceptive pill is estrogen, which in high doses is known to cause weight gain due to fluid retention. The fluid retention in turn causes increase in salt (sodium) retention. With the lower dose pills of today, this problem has been greatly reduced.

Do oral contraceptives increase your appetite?

They could do if they raise your insulin level - known as 'insulin resistance'. Insulin levels rise in response to carbohydrates and drive all energy into the fat cells and essentially prevent weight loss even with dieting Not all women are susceptible to 'insulin resistance', therefore not all women will gain weight when they take oral contraceptives. This 'condition' can be diagnosed by a doctor and if you have it- it causes your blood insulin levels to be chronically higher which stops your fat cells from giving up their energy stores to let you lose weight.

Oral contraceptives can affect your metabolism- what's that?

Your metabolism or metabolic rate is the rate at which your body burns the fuel (food) that you put in it to 'run' it and give you energy - like putting petrol into a car. Not everyone has the same 'metabolic rate' or 'metabolism' - the heavier you are, the higher is your metabolic rate.

Many women complain about gaining weight when they start taking oral contraceptives. Did you ever notice that when you weren't on the pill you also put on extra weight in the latter half of your menstrual cycle? This is quite normal and is due to the change in hormone levels.

Other medications can also cause weight gain, including pills for depression so it can be unfair to blame only the contraceptive pill. An honest conversation with a health care provider about weight gain as a side effect of taking an oral contraceptive and maybe a change of pill type may reduce the anxiety over this sensitive 'image' issue.

Oral contraceptives are less effective in overweight or obese women Studies have found that a female with a body mass index (BMI) of 25 to 29.9 who is on oral contraceptives has a 60% greater risk of pregnancy than a woman of normal weight (BMI 18.5 to 24.9). The percentage rises to 70% if she is has a BMI of over 30. Why is this?The reason is still not clear and there are probably many reasons but it could be that since the hormones in oral contraceptives are soluble in fat, they dissolve in the fat of an overweight person rather than entering the bloodstream.

The higher metabolism of an overweight person also reduces the 'lasting effect' of medications.

Your liver helps to metabolize the hormones in oral contraceptives. If you are overweight, the enzymes in your liver increase so you metabolize or 'burn' up the hormones in oral contraceptives much faster than normal. Today's oral contraceptive pills contain much lower doses of hormones than they used to so if you are overweight they could quickly become 'burned' up hence their effect in your body could be of a shorter duration and thereby increase your risk of becoming pregnant.

What can you do if you have weight gain on the pills?

Use the lowest possible estrogen containing birth control pill - this should minimize weight gain and swelling from water retention. Two of the current 20 mcgm pills which are the lowest estrogen doses available are: Alesse and Mircette.

Carole Pemberton brings you up to date on contraceptives, including Alesse and Mircette to empower you to enjoy your sexuality and successfully manage your birth control.

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