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Does the birth control pill make me fat, crazy and infertile?

2/14/2017

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The birth control pill has revolutionized the way women lead their lives.  It allows us to control our lives and decide when it is best to start a family.  The birth control pill can also help control symptoms of heavy bleeding and pain during the menstrual cycle.   Unfortunately, hormonal birth control pills can also cause all sorts of unpleasant side effects.  They include nausea, breakthrough bleeding, decreased libido, breast tenderness...the list goes on and on!  The most common questions I get from patients are: Does my pill make me fat? Crazy?? What about infertile???  Let's explore these below. 

1.       Does the birth control pill make me fat?  No.  Multiple studies have found no evidence that the birth control pill can cause you to put on extra fat or affect your metabolism. Now, can the pill make you bloated? Maybe.  The pill can cause some water retention associated with fluctuating hormone levels.  However, any weight gain from this is minimal and goes away within two to three months.  Talk to your gynecologist about this.  If you remember from my last blog, all pills are different.  Some pills contain a mild diuretic that can help with fluid retention if this has been a problem for you.  Now, while the pill and the IUD have not been associated with weight gain, the Depo Provera shot (birth control shot that you receive every three months) can cause 20% of women who are on it to gain weight.  If you feel that you are gaining weight and constantly bloated on the pill, we strongly encourage you to talk to your provider and make sure that you are on a regimen that will help with those symptoms.

2.       
Does the birth control pill affect my mood?  Depression and mood swings are commonly reported side effects of the pill and the most common reason that patients stop taking the pill.  However, studies have been unable to prove or disprove a link between depression and the pill.  If you experience depression while on birth control pills, you should stop taking the pill and talk to your provider about other options.  Again, the Depo Provera shot (birth control shot that you receive every three months) has been linked in studies to worsening symptoms of depression in women with pre-existing depressive symptoms. 


3.       
Will the birth control pill affect my fertility?  No.  There is no evidence that shows that long term use of the birth control pill interferes with fertility.  In fact, 20% of women who discontinued the pill became pregnant within the first month and 80% within the first year after discontinuation!  These numbers were similar for women who were not using any contraceptive method. These numbers were also similar for users of the IUD, the patch, and the ring.  Again, for users of the Depo Provera shot, studies did show a delay of up to eight months after stopping the shot.  Also remember, the pill is used to treat conditions like endometriosis which if left untreated can lead to scarring and lead to infertility. 


For many women, the birth control pill can be a great reliable and reversible contraceptive option.   Even for those women who are concerned about side effects, there is generally a pill that can minimize those side effects due to the large number of formulations available.  If you have any questions about the birth control pill, be sure to discuss these with your doctor to find out if it might be a good choice for you.

​Dr. Pam

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