Does hormonal birth control cause weight gain?
The research suggests no — so why do so many women think the pill packs on pounds? Here’s what you should know.
It’s one of the first things many women wonder when they go on hormonal birth control: Will it make me gain weight?
For years, women and doctors alike have considered weight gain a common side effect of hormonal birth control. A fear of packing on pounds keeps many women from using it.
Is there any truth to these claims? Let’s unpack the facts.
Hormonal birth control basics
First, a quick refresher on what exactly hormonal birth control is. These medications and devices work to prevent unplanned pregnancies in several ways. They prevent your ovaries from releasing an egg. They also thicken mucus in your cervix to keep sperm from swimming up into your uterus.
Hormonal birth control options include:
- The pill (oral contraceptives that you take daily)
- Hormonal IUD (a small device placed in your uterus by an OB-GYN)
- Shot (an injection given every 3 months)
- Vaginal ring (a flexible plastic ring you place in your vagina)
- Implant (a small flexible rod inserted under the skin of your upper arm)
- Patch (a small skin patch that you change weekly)
Learn how to get your birth control online, step by step.
What the research says about weight gain
“The biggest concern about hormonal birth control for girls and women of all ages is weight gain, but the data is lacking,” says Maureen Whelihan, MD. She’s a board-certified OB-GYN in Greenacres, Florida.
The most common form of hormonal birth control in the U.S. is the pill. Most pills contain a combination of estrogen and progestin, according to Planned Parenthood. It’s the estrogen that was thought to be the culprit in weight gain in the past. But back in 2014, a large review of 49 studies showed that combination birth control pills either did not lead to weight gain at all or only showed small weight differences. That was true even with pills that contained higher levels of estrogen.
Progestin-only birth control methods, on the other hand, may cause minimal weight gain. (Implants and the mini-pill are the two progestin-only methods.) The reason? "These options have a side effect of increasing appetite," says Brittany Robles, MD. She’s an OB-GYN associated with Wyckoff Heights Medical Center in New York City.
The one hormonal birth control method that can cause noticeable weight gain is the shot (also called Depo-Provera). Even so, the average weight gain is less than 5 pounds, according to the American College of Obstetricians and Gynecologists.
Why the myth persists
Most common forms of hormonal birth control don’t appear to have any effect on weight. Yet the myth persists, largely thanks to personal anecdotes. “Many women either know someone who reports gaining weight after starting hormonal birth control or they themselves feel that the birth control caused them to gain weight,” Dr. Robles says.
It’s true that combination birth control options such as the pill, vaginal rings and skin patches may cause you to hold on to more fluid. This can make you feel bloated — but that’s not the same as weight gain. Also, many women add pounds over the years, whether or not they use hormonal birth control. This makes it tricky to tell if contraceptives play a role.
Many experts believe poor eating and lifestyle choices are the most likely culprit. “But it’s human nature to blame it on the pill or other medication,” says Dr. Whelihan.
How to handle weight gain
Are you on hormonal birth control and gaining weight? Take a look at the amount and type of calories you’re consuming. “Diet is usually the main contributing factor,” Dr. Robles says.
Think about what you eat and drink on an average day. Then identify a few high-calorie, low-nutrition items you could cut or swap out. For example, you could:
- Replace your morning latte with a cup of black coffee
- Skip the sugary flavored yogurt with mix-ins and have plain yogurt with fresh berries
- Try a handful of nuts for a snack instead of chips or cookies
- Drink water with lemon instead of sugary soda
- Top your salad with oil and vinegar instead of bottled ranch dressing
If tweaking your diet doesn’t do the trick, consider whether those extra pounds outweigh any benefits you get from contraceptives.
Hormonal birth control can help prevent unwanted pregnancy, regulate your menstrual cycle and improve endometriosis symptoms. (Endometriosis is a painful condition in which the tissue that normally lines the uterus develops outside the uterus.) “I wouldn’t recommend that you stop using [hormonal] birth control solely because of weight gain,” Dr. Robles says.
The best place to start is at your OB-GYN’s office. Your doctor may be able to suggest a birth control option that doesn’t have such an impact on your weight.
Pill facts. Planned Parenthood (n.d.). “Birth Control Pill”
Study about pills and weight gain. Cochrane Library (2014). "Combination contraceptives: effects on weight"
Shot and weight gain. American College of Obstetricians and Gynecologists (2020). ““Progestin-Only Hormonal Birth Control”