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Question: Since I started taking the pill for contraception, I've gained probably 10 pounds. I know this is a fairly common side effect, but surely there's something I can do or some product that's been developed that won't cause me to bloat. Any help?
Answer:
Today's oral contraceptives (OCs) are much safer than their 1960s predecessors. With lower amounts of estrogen and progestogen in the combined pill and of progestogen in the minipill, serious side effects -- such as venous thromboembolism, heart attack, and stroke -- have been greatly reduced.
There is still potential for OC side effects -- positive and negative -- though not every woman experiences side effects of any type. That's because there is a wide range of OC choices (from Triphasil, Brevicon, and Ortho-Cyclen to Micronor and Ovrette, to mention a few) and a wide range of responses a woman can have to each.
Side Effects: The Good and Bad
That said, some of the possible positive side effects of OCs include:
clearer skin
relief of mild PMS symptoms
regulation of periods for women with menstrual disorders
reduced risk of ovarian, endometrial, and possibly colorectal cancers
low-doses in the years before menopause may help protect women against anemia and osteoporosis
And there are the possible negatives:
nausea and vomiting
bleeding between periods
changes in menstrual flow
weight changes
migraine headaches
depression
Weight Gain
One of the more commonly lamented side effects of oral contraceptives is weight gain. That's because the estrogen in birth control pills can sometimes lead to a 5-10-pound retention of body fluids, probably due to changes in a woman's metabolism. In addition, the estrogen may also increase a woman's appetite.
According to the late Dr. Arnold Kresch, to avoid weight gain when taking OCs, most women need birth control pills containing progestin low in androgenic potency because androgens build tissue that can lead to increase in weight. So some women may have improved results with weight gain issues if they substitute ethinyl estradiol (which is in most oral contraceptives) for mestranol (found in Ortho-Novum 1/50 and Norinyl 1+50).
On the other hand, if a woman has side effects such as headaches or malaise, Kresch would have said her pill may have too little estrogen. This is more likely to be true if headaches typically occur just before or just as menstruation begins.
No Easy Answers
So how can a woman avoid not only the possible side effect of weight gain, but all pill side effects?
There's no easy answer to that. In part, this is due to the incredible range of responses individual women have to oral contraceptives. It's also due to the lack of medications that can specifically preserve sexual functioning while avoiding the potential for negative side effects. If you decide OCs are your preferred birth control, work closely with your healthcare providers to find which pill works best for you.
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