Pill: afraid of gaining weight? That’s not true

The fear of weight gain and water retention pushes many women to choose contraceptives alternative to hormonal ones. But studies are reassuring.

According to a survey conducted a few years ago in 12 European countries, the fear of weight gain and water retention is the main perplexity towards an oral hormonal contraceptive and the main reason why you choose to suspend or replace it.

Over the years things have not changed: even a recent Italian survey, which considered the data of 1,809 women visited at the outpatient clinics of the Department of Obstetrics and Gynecology of the Santa Chiara Hospital in Pisa between 2010 and 2015, found that over a third of patients (34.9%) stopped using the contraceptive method they were following, Most often for minor side effects, including especially weight gain. But the fear of gaining weight and water retention are now increasingly unfounded: here’s why.

Steps forward with the most modern pills

In the past, weight gain due to fluid retention was a real side effect: the first birth control pills, which contained high hormonal dosages, especially estrogen, could more easily give this unwelcome consequence.

Today, however, preparations with lower dosages are used that have greatly reduced this inconvenience, maintaining the contraceptive efficacy.

Combined contraceptives also contain progestogen hormones, i.e. synthetic substances with activities similar to those of progesterone.

The formulations of the last ten years can count not only on lower doses of progestogens, but also on compounds very similar to natural progesterone and therefore able to perform the same antimineralocorticoid action.

This means that they are able to oppose the action of another hormone, aldosterone, and to promote the elimination of water and sodium from the body, counteracting the water retention favored by estrogen.

What the latest research says

Several recent studies have tried to verify the existence of a link between the pill and weight gain.

In 2014, a systematic review by Cochrane on the subject was published, which analyzed 49 studies in which different contraceptives were compared with each other or with placebo. According to this review, in four trials in which contraceptive use was compared to placebo or lack of therapy, there was no association between weight changes and combined contraceptives.

Even most comparisons between different contraceptives combined showed no substantial difference in the weight of those taking them. There were also no differences in weight between subjects who discontinued therapy and those who continued to use combined contraceptives.

According to the authors, the available evidence is not sufficient to determine the effect of combined contraceptives on weight, but there does not seem to be a correlation between contraceptives and weight gain.