The contraceptive pill is sometimes associated with weight gain, water retention or an increase in appetite. How many kilos on average? After how long? What are the pills to favor? To avoid? What to do? Responses from DRS Sophia Taieb and Odile Bagot, gynecologists.
Even if the pill remains a reliable, discreet means of contraception, which preserves the freedom of users, and rather well suited to those who have regular sexual intercourse, one in two women (study carried out by the Sofres Health Institute) believes that the pill has incomplete adverse effects like weight gain or water retention. What about? How many pounds taken on average? After how long? What to do? Change pill? Opt for another contraception? Let’s unravel the true of the false with the explanations of Dr. Safia Taieb and Dr Odile Bagot, gynecologists.
Almost all pill manufacturers mention weight gain in the list of undesirable effects on the user manual. However, according to the High Authority for Health, it does not exist “No proof of weight gain under estroprogestative pill, the relationship between weight gain and progestins alone being poorly documented“. Dr. Odile Bagot, gynecologist, share this opinion.”Studies have shown that weight gain was unimportant. Progestin can, in fact, cause A water retention phenomenonbut The weight variation directly attributable to the pill is generally not more than 1.5 kg. Weight gain must always be correlated with the context. Generally, the weight gain coincides with a change in lifestyle promoting weight gain such as Eating more often outside, consuming more alcohol, doing less sport“Explains the gynecologist. The pill can therefore cause a phenomenon of water retention and an increase in the volume of the breasts But rarely more. Especially since we do not have, as in a natural cycle, a premenstrual syndrome that makes you want to throw yourself on sugar so it limits weight gain. “”It is so anchored in the heads of women that the pill will make them fat that they attribute the slightest variation in the pill. In reality, most of the women affected by weight variations were already before. Certain pills, whose progestin has a diuretic effect due to an antialdosterone effect, are even likely to cause a small weight loss. Let’s say that out of 10 women who will take the pill, there is one who will gain weight, one who will lose and 8 that will remain stable“Indicates the specialist.
“”The weight gain under pill is mainly due to estrogens it contains. Indeed, these hormones intervene in the manufacture and storage of fat, promote water retention and can cause edema at the level of the lower limbs, the upper thighs, the lower abdomen and the breasts thus bringing undesirable effects such as heaviness, tension or breast pain, or pelvic gravity (from the basin)“. It is progesterone, a second hormone contained in certain pills, which helps to counter the effects of estrogens.”Estrogenic hormones can cause weight gain when the latter are widely secreted by ovaries or when they are not countered by progesteroneexplains Dr. Safia Taieb. Estrogens overdose, stress, early age of the first catch or a long time of pill use There are many factors that promote weight gain under pill. Likewise, changing the pill often (every year or every two years) can potentially cause weight gain. Indeed, at the beginning of each new means of contraception, estrogens try to dominate the effects of progesterone to block ovulation, and their effects can thus result in weight gain. Over time, the body gets used to this hormonal change and the weight stabilizes.“”
If there is weight there, She occurs in the first three months. “”This type of side effect does not occur after five years“, Adds our interlocutor.
The effect of the pill on the body is the result of two things: the estro-progestogen balance that we will bring with the pill and the reaction of the woman. “”It is often believed that a very low -balanced pill will limit weight gain but some women will develop A reactive hyper estrogenthat is to say that their ovaries will still make estrogens to compensate. As a result, they will have more water retention and pain in the breasts. Conversely, a stronger pill will put their ovaries at rest and improve their symptoms“, Details Dr. Odile Bagot. For example: Leeloomonophasic, is dosed at 20 micrograms of Ethinyl Estradiol on the whole brochure, while Daily G, threefoldhas tablets dosed at 35 micrograms in certain tablets.
The recommendations require that a second generation pill are prescribed in first intention
“”The recommendations require that a second generation pill are prescribed in first intention, the least dosed in estrogens, For vascular reasons. But we cannot say that there are good or bad pills because it depends on the reaction of each woman“, nuance the expert. In general, First generation pills are those that can be considered as “worst” due to their very high hormone levels, They are no longer marketed in France. Third generation pills have been controversial a few years ago, but we know today that in the absence of vascular risk we can prescribe them safely. Their advantages: some have a profit on the skin or have a progestogen (dropspirnone) which decreases the risk of water retention. Their disadvantage: none is reimbursed. Certain pills whose progestin is of third generation but whose vascular risk is equivalent to that of a second generation also have an anti-acne action. These are:
- Ore,
- Triafemi,
- FEMI and its generics (Naravela, Optikinzy). (no reimbursement either, but lower prices for generics)
Most women do not gain weight at all. When this is the case, Weight gain should not exceed 1.5 kg. Weight gain is variable from one woman to anotherbecause we metabolize hormones in the pill differently: “A person with a slow metabolism, will feel more the undesirable effects of the pill than an active person“, Specifies Dr. Taieb.
Today, contraceptive pills have become much less dosed in estrogens and the use of new generations’ progestins considerably reduces the risk of weight gain. Good news also, since various scientific studies have highlighted a new progestogen, Drospirenone, which by opposing the retention of water induced by ethinylestradiol (the estrogen contained in contraceptive pills), would show better control of weight gain. “”If the woman is concerned about a certain weight gain, her doctor can advise her to reduce dosages in estrogen and opt for a recent generation pill, micro-dosed (3rd or 4th generation), either completely change means of contraception and choose an intrauterine device (Sterilet) which, unlike the pills, the implant or the contraceptive patch, does not diffuse hormones“Explains Dr. Taieb.
If despite the change of contraception, the weight gain continues, the latter may be due to poor eating behavior or stress. Finally, the contraceptive pill would have consequences for appetite and promote snacking. “”Indeed, from my experience, I noticed that the majority of women say that the pill would increase appetite, the pill is “diabetogenic”, that is to say that it increases the insulin rate in the blood and insulin is hungry. It is therefore important to restore your snacking desires and make the difference between real hunger and a simple desire to eat“Concludes the gynecologist.
“We can try to change the pill but that will not change much because they are quite close to each other. Weight gain is more linked to lifestyle and nature person that in the pill itself, “warns the specialist. The only real alternative is the IUD with copper or progesterone – especially Kyleena weakly dosed – which, even if it contains a hormone does not interfere with the general hormonal balance.
Thank you to the DRS Sophia Taieb and Odile Bagot, gynecologists.
