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What will the contraceptive pill do to my weight?

What will the contraceptive pill do to my weight?

Whilst our weight and size shouldn’t define who we are, for some the potential for weight changes can play a big part in how they choose a contraceptive. The contraceptive pill contains synthetic versions of hormones which, when introduced into the body, can potentially cause a number of side effects. Noticing changes when you take the pill can be quite normal.

A number of women report weight gain, or at the very least notice weight fluctuations, when they start taking the pill. This can impact the type of pill they decide to take in the long run.

But is there a genuine link between the pill and weight? Are certain pills more or less likely to affect your weight? And what can you do if you think the pill you’re currently taking is impacting your weight?

We’ll delve into these questions and more, so that you feel confident when it comes to choosing a contraceptive to suit you.

Daniel Atkinson
Medically reviewed by
Daniel Atkinson, GP Clinical Lead
  • Weight gain is one of the most commonly reported side effects of the combined contraceptive pill.
  • Studies haven’t found a conclusive link between birth control pills and weight gain.
  • Factors such as body composition, fluid retention, and hormonal effects may contribute to weight changes.
  • Some fourth generation pills have been found to reduce the risk of some side effects and even cause weight loss.
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Medically reviewed by
Dr Daniel Atkinson
GP Clinical Lead
on August 02, 2022.
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Does the pill make you gain weight?

Weight gain is one of the most commonly reported side effect of the combined contraceptive pill. This is considerable given that more than 100 million women worldwide use combined oral contraceptives. But can the pill actually make you gain weight?

Well, a lot of studies and medical papers fail to establish a clear link between taking birth control pills and weight gain. This was found to be true in all pills, including those which contained different versions of progesterone.

Yet, we can’t ignore the fact that huge numbers of women report online about the side effects of the pill, from acne to sweating to unwanted hair growth and, of course, weight gain and stories about the pill making them fat. So what is the truth? Do you gain weight on the birth control pill?

How do hormones in the pill affect weight?

One of the most comprehensive reviews looking at a potential relationship between the pill and weight found no link, but reported that more research was needed. The review considered 49 studies of the combined pill and found ‘no large effect’ was evident.

But these reviews and studies consider weight, not shape or composition – which the pill may impact.

In 2009, a psychological researcher at an American University studied a group of women over 10 weeks in relation to resistance training. He found, inadvertently, that women on the pill had gained 40% less muscle than those who didn’t take it.

The pill may also impact the way women store fat. Hormones are responsible for the development of women’s bodies when they experience puberty, and affect how fat is distributed. It’s possible that introducing more hormones into the body when you take the pill could affect weight distribution and subcutaneous fat.

Lastly, it’s thought that certain contraceptive pills could make you more bloated or retain more fluid. Oestrogen impacts how the body deals with water and retains it. All combined pills contain ethinyl estradiol, a synthetic version of oestrogen. Taking the pill could, in theory, impact fluid retention which may contribute to weight gain or impact perception of weight.

Yet, a relatively small study involving 150 women who have used oral contraceptives for three to four months reported no significant changes in weight, BMI or body composition (the total amount of water in the body, body fat, fat mass, and fat free mass). The oral contraceptives used in the study contained either 20mcg ethinyl estradiol (EE) and 100mcg levonorgestrel (LNG), or 30mcg EE and 150mcg LNG (hormones used in contraceptives like Microgynon 30, Rigevidon, Levest, Logynon).

More studies are needed though, involving more people, monitored over longer periods of time.

Is it right to say the contraceptive pill causes weight gain?

The medical consensus seems to be that the contraceptive pill does not cause weight gain. But many women who take the pill have shared personal stories online, suggesting otherwise – women believe they are gaining weight while on the pill.

But evidence does demonstrate that the pill can impact muscle growth, fat storage and fluid retention. It could be argued that what might be perceived as weight gain, is actually changes to body shape and composition.

Unfortunately, much more research is needed to establish whether there is a true link between birth control pills and weight gain.

Non pill contraceptives

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There are lots of different types of contraceptives available with a variety of benefits. If you want to explore your options let us help you find the best one for your needs.

What combined contraceptive pills are linked with weight gain?

To understand how combined pills link with weight gain, it can help to understand what is meant by 1st, 2nd, 3rd and 4th generation pills.

The pill has been around since 1960, and it’s undergone a lot of changes since then – called generations. This refers to the type of lab-created progesterone that’s used as the second active ingredient. The most commonly used version of oestrogen is ethinyl estradiol.

First generation pills, you guessed it, were the first contraceptive pills to be introduced in the 1960s. They contained higher levels of oestrogen and progesterone than is typically used today. Versions of the progesterone used in first generation pills included norethynodrel, norethindrone, lynestrenol and ethynodiol diacetate. First generation pills were linked with a number of dangerous side effects, which led to their discontinuation throughout much of the world.

Second generation pills contain lower levels of hormones, and were therefore considered a lot safer than first generation pills. If you continue to experience side effects with second generation pills, you may be prescribed third or fourth generation pills which were created much later and with the intention of further lowering the risk of side effects. But although later generations generally have fewer or milder side effects compared to the second generation, they can increase the risk of venous thromboembolism (VTE)—when a blood clot forms in a vein. So, if you’re more prone to VTE, like after surgery or if you have lupus, they might not be the safest choice for you.

If you feel that you are gaining weight while taking a particular pill, you may benefit from switching to one which contains different versions of progesterone or different quantities – or switch to a different generation of the combined pill.

Microgynon 30, Rigevidon, Logynon and weight gain

Microgynon 30, Rigevidon, Logynon are all combined pills which contain the same synthetic version of oestrogen and progesterone - ethinyl estradiol and levonorgestrel respectively.  Because each pill contains levonorgestrel, they are all second generation pills. 

Second generation pills like Microgynon 30, Rigevidon and Logynon are less likely to cause certain side effects including heavy bleeding, breast fullness, headaches, fluid retention, tiredness, irritability, nausea and bloating. 

Like we’ve mentioned earlier, the second generation of oral contraceptives has a lower risk of VTE compared to the next generations. However, it’s worth remembering that all medications have the ability to cause side effects, including changes to weight and size.

Studies looking at combined contraceptives which have 30mcg ethihylestradiol and 150mcg levonorgestrel (same as Microgynon 30, Rigevidon and Logynon) found no significant link between weight gain and use of these birth control pills. But, of course, everyone reacts to medication differently, and some of the people involved in these trials reported weight gain.

For example, some women who take Microgynon 30 do notice weight gain or changes to their appetite. There are currently no specific studies on Microgynon and weight gain.

Rigevidon is one of the most affordable pills for the NHS to provide, so a lot of women use it. But side effects have been reported with the use of it, including changes in weight. If you’re taking Rigevidon and weight gain is something you notice, or you experience any other side effects you’re not comfortable with, talk to your doctor about switching.

Studies on the Logynon pill and weight loss, or weight gain, are limited. On the Logynon patient information leaflet, weight gain is listed as a common side effect - affecting 1 in 100 women. However, fluid retention is also listed as a side effect which can impact weight and our perception of it. 

Mercilon, Gedarel and weight gain

Mercilon and Gedarel both contain 20mcg or 30mcg ethinyl estradiol and 150mcg desogestrel. Desogestrel is a synthetic progesterone used in third generation pills. This means Mercilon and Gedarel were created to try and reduce certain side effects associated with second generation pills.

When it comes to weight changes, a study with 445 participants who took 20mcg ethinyl estradiol and 150mcg desogestrel (same active ingredients as in Mercilon and Gedarel) found that 79% either lost more than two kg of weight or didn’t gain weight during the study.

But there aren’t any specific studies on Mercilon and weight gain. Common side effects associated with Mercilon include tender breasts, discharge, reduced acne, headaches and vaginal dryness.

What about Gedarel and weight gain? Weight gain is listed as a side effect on the Gedarel patient information leaflet, but weight may also naturally fluctuate during the menstrual cycle. If you do experience uncomfortable side effects, discuss switching the pill with your doctor or prescriber.

Dretine, Yasmin and weight gain

Dretine and Yasmin are both combined oral contraceptive pills containing ethinyl estradiol and drospirenone. This makes them fourth generation pills. They’ll often be prescribed if you’ve tried other pills and have experienced side effects.

The Dretine pill and weight gain as a side effect have not been largely studied. Yasmin, in effect, is the same drug as Dretine and Yasmin has not been associated with weight gain. During clinical trials, the majority of women who used Yasmin for up to two years were able to maintain their weight within a range of plus or minus two kilograms from their starting weight.popover id=ref16]

Yasmin and weight loss may be linked, however. When Yasmin was first introduced, it was heralded as a pill that could reduce the risk of certain side effects including weight gain, headaches and mood swings. The creators of Yasmin claimed it could help you lose weight as well.

How will the mini pill affect my weight?

Mini pills are different from combined contraceptive pills because they only contain one synthetic hormone, always a version of progesterone. They’re sometimes referred to as progesterone-only pills (POP).

Mini pills are prescribed for women who have migraine-type headaches or cardiovascular risk factors which make the combined pill unsuitable for them. They also tend to stop menstrual periods so many women prefer them for this reason. They’re ideal for women who suffer more greatly with oestrogenic side effects.

However, most studies show that the mini pill does not cause weight gain. But it is still a commonly reported side effect associated with the mini pill, and if you think the progesterone-only pill is making you gain weight – you can talk to your doctor about switching.

Cerazette, Cerelle, Desogestrel and weight gain

Cerazette and Cerelle are both progesterone-only pills, or mini pills. They both contain desogestrel as their sole active ingredient. (They don’t contain oestrogen.)

Is there a link between Cerazette and weight gain? Or does the Cerazette pill affect weight loss? On the Cerazette patient leaflet, increased body weight is listed as one of the most common side effects affecting up to 1 in 10 women. But in clinical trials, even though they involved relatively small groups of people, no significant changes in body weight were observed.

It’s a similar story in relation to Cerelle and weight gain. Cerelle and weight loss are not linked, but weight gain is listed on the Cerelle patient information leaflet as a side effect.

If you take either Cerelle or Cerazette and you notice changes to your weight that bother you, speak with your doctor.

Norgeston and weight gain

Norgeston is another progesterone-only pill, or mini pill, that is up to 99% effective with perfect use. But does Norgeston make you gain weight?

On the Norgeston patient information leaflet, both weight gain and weight loss are listed as less serious side effects. This means a small minority of women who take Norgeston have reported changes to their weight. But in a clinical study where 331 women were given levonorgestrel 30mcg (the same dose as in Norgeston), no significant changes in relation to body weight were reported.

What about other birth control methods? How will these affect my weight?

If you’re concerned about weight gain and its association with hormonal contraceptive pills, there are a number of non-hormonal methods of contraception available to you.

Examples include barrier methods like condoms, fertility awareness methods, withdrawal and sterilisation – none of which affect your weight.

Evra patch and weight gain

The Evra patch is a combined contraceptive patch that releases hormones to prevent pregnancy. When used correctly, it is up to 99% effective.

While studies have not found a direct link between hormonal contraceptives and weight gain, , the Evra patch patient information leaflet does list weight gain as a common side effect affecting up to 1 in 10 women.

DepoProvera and weight gain

Depo-Provera is a contraceptive injection that intravenously releases the female hormone progesterone which works to prevent pregnancy. It has to be administered once every 13 weeks. Other examples of contraceptive injections include Sayana Press and Noristerat.

Some women gain weight while using Depo-Provera. ‘Studies show that over the first 1-2 years of use, the average weight gain was 5-8 lbs. Women completing 4-6 years of therapy gained an average of 14-16.5 lbs.’

So if you’re worried about this side effect or you’ve experienced it, talk to your clinician to find other options that are better suited for your lifestyle and preferences.

IUDs and weight gain

The Intrauterine device (IUD) is a small, T-shaped device that is placed in the uterus to prevent pregnancy. It’s made from plastic, and releases copper which stops you getting pregnant. Sometimes referred to as the coil, it can protect you for between five and 10 years.

Current scientific knowledge doesn’t give any evidence that the IUD will affect your weight or increase the risk of cervical, uterus or ovarian cancers.

Should I be taking the pill if I’m overweight?

There is some information you may need to be aware of in relation to the pill and being overweight. If you’re overweight, the contraceptive pill is usually safe to take.

However, some women who have a body mass index (BMI) of 25 or over appear to have an equivalent or higher risk of unintended pregnancy when using combined pills, contraceptive patches and emergency contraceptive pills, compared with women of a normal weight. Intrauterine devices and implants, on the other hand, seem to be highly effective in women with a BMI over 25. But some studies refute this, and claim the pill works equally well in women no matter their weight.

In some combined contraceptive pills, certain risk factors can increase if you are seriously overweight or obese. Your risk of breast cancer and blood clots does rise slightly if you’re overweight and take certain pills, but still remains considerably small.

For the most part, combined contraceptives that contain synthetic versions of oestrogen and progesterone are generally safe for women who are overweight to use. If you’re worried or concerned about the pill and your weight, you can speak more with your doctor or pharmacist.

Can the birth control pill also help you lose weight?

The answer isn’t completely straightforward, and can vary from person to person. Most studies show hormonal contraceptives don’t cause weight gain, but it’s still a widely reported side effect among women.

Some evidence does show that the pill can affect body size and composition. But is there any contraception that doesn’t cause weight gain? Certain fourth generation pills, such as Yasmin or those containing ethinyl estradiol and desogestrel like Cerazette , have been found to reduce the risk of certain side effects and even cause weight loss.

However, both weight gain and weight loss are reported side effects in the majority of contraceptive pills. Patient information leaflets often list both as potential side effects. The introduction of additional hormones into the body will affect different people in different ways, so finding a pill that could potentially help you lose weight, or at the very least not gain weight, may come down to switching pills a few times before you find the one for you.

Is there a ‘best’ contraceptive pill for weight loss?

Birth control pills are not licensed treatments for weight loss, but some women do find that certain pills aren’t as likely to cause weight gain, or they lose weight while they’re on certain other pills.

So establishing the ‘best’ contraceptive pill for weight loss is mostly preferential and down to what works best for you. Studies analysing each of the main contraceptive pills used in the UK and how they impact weight have yet to be conducted.

However, there may be certain pills which are more likely to cause weight loss than others. Fourth generation pills were introduced to combat a lot of side effects associated with older birth control pills, or at the very least reduce their severity. For some women, fourth generation pills are the best option of birth control for weight loss. Pills such as Yasmin, Zoely and Qlaira are all fourth generation UK contraceptive pills created to cause no weight gain.

While some women respond better to fourth generation pills, weight gain is still a reported side effect associated with them. Some women notice they lose weight on certain pills, some gain weight - and some see no changes at all. Fourth generation pills are also associated with a slightly higher risk of blood clots. The increase is very small, as is the overall risk of developing a blood clot associated with the pill, but it’s worth keeping in mind.  

Is there a ‘best’ birth control pill for acne, or a ‘best’ birth control for both acne and weight loss? Some women who suffer with acne may be prescribed hormonal contraceptives to help get their symptoms under control. Co-Cyprindiol is a UK treatment that can be prescribed specifically for acne, and also excess hair growth. There are currently no contraceptives approved to treat both acne and weight loss in the UK.

Is there a pill that definitely doesn’t cause weight gain?

Unfortunately, it’s almost impossible to say decisively whether there is one single best birth control to avoid weight gain. Finding a contraceptive pill that doesn’t cause weight gain in the UK is difficult because they all affect women in different ways. Everyone responds differently to hormonal contraceptives, and it’s often a case of trying different pills before you find a birth control that doesn’t personally cause you weight gain.

It’s important to maintain regular communication with the medical professional that prescribes your contraception, especially if you’re seeking a pill without weight gain as a noticeable side effect. You may have other side effects you’re keen to avoid - like acne, for example. Talk to your doctor about what you’d most like to avoid, and they can work with you to find the best pill.

Can coming off the pill help me lose weight?

If you’re thinking about stopping the pill, you may have wondered whether coming off the pill makes you lose weight. This is a common concern for many women. But the answer isn’t so easy because just as introducing additional hormones into the body can result in a number of changes and side effects, no longer taking the pill can also affect you in certain ways as you adjust.

For example, coming off the pill will see your periods return to normal relatively quickly - within a month or two. (That is, if the pill affects your periods to begin with.)

What can I do if I’m worried about my weight on the pill?

If you have questions or concerns about taking the pill and your weight, we have answers. If you think switching pills might help with your weight, or any other issue you’re concerned about with contraception, it’s really important that you share your concerns with a clinician. Read more about contraception here.

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