
The birth control pill or the “pill” is used to prevent an undesired pregnancy. Over years, the pill has been blamed to cause weight gain, sex drive, and even affect the skin in a bad way. Which part is true? Which part is a myth? Let’s find out.
The following are the side effects of birth control pills:
- Weight gain or weight loss: Many women believe that the pill can cause weight gain, but there is no sustained evidence for this claim. However, the pill may alter the body fat storage and thus, may change the body shape. For most women, any birth control tools, pills, vaginal rings, or skin patches are very unlikely to affect their weight much. Some women gradually gain weight over the years due to water retention or suspected fat storage. Research has shown very contradictory results. Some women have claimed that they have gained weight whereas some reported losing weight. Therefore, both weight gain and weight loss can be listed as possible side effects of birth control pills.
- Improves or worsens skin issues: Birth control pills can be used to treat the signs of hyperandrogenism. This is especially seen in women who suffer from polycystic ovarian disease (PCOD). Hyperandrogenism can cause excessive hair growth, excessive acne, or hair loss in women. Birth control pills finetune the body’s hormonal setting and prevent hyperandrogenism. Thus, they can make the skin clearer, reduce facial hair, and increase the volume of the hair.
- Some women have the following skin issues while on the pill:
- Melasma (dark, blotchy rash over cheekbones) due to estrogen content of the pill.
- Autoimmune progesterone dermatitis (a rare cyclic premenstrual allergic skin reaction that includes itching, swelling, and redness)
- Spider telangiectasis (dilated blood vessels visible under the skin)
- Lowers or increases acne formation: Combination birth control pills improve the body’s estrogen to progesterone ratio. This helps resistant acne, which is resistant to acne gels and creams.
- Lower or increase unwanted hair growth: Birth control pills make the body produce fewer androgenic hormones. With regular use of certain types of birth control pills (especially estrogen and anti-androgenic progestin combination), there will be less facial hair. However, some women reported that they had experienced an increase in facial hair growth. The estrogen component could help decrease testosterone, which is also responsible for causing excessive facial hair growth (known as hirsutism).
Consult the doctor for other conditions that may cause these issues, such as PCOD (hormonal disorder). The doctor may switch to a different brand or another method of birth control if the pills causing an allergic reaction.
Why some gain weight during birth control?
Many women claim weight gain due to birth control pills. However, women usually put on weight due to one of the following changes.
- Fluid retention
- An increase in muscle tissue
- Increase in body fat
Hormonal birth control pills could contribute to weight gain (if they lead to fluid retention) and increase body fat. Some combination pills are claimed to increase appetite that can make women consume excess calories, leading to weight gain. However, it is not evident because women who do not use hormonal birth control pills can also put on weight as they age. Rarely, some women do put on a little bit of weight when they start taking birth control pills. It is often a temporary side effect that is due to fluid retention and not extra fat. Studies have shown no evidence of weight gain.
If facing any side effects, such as weight gain, it will generally be minimal and resolves within two to three months. There are two types of pills: the combination of estrogen with progestin and only progestin pills. Consult the doctor if putting on a few pounds, the doctor may change the prescription.

QUESTION
Which of the following are methods for contraception? See AnswerHow does birth control pill work for skin problems?
The combination birth control pills suppress a hormone called luteinizing hormone (LH) that stimulates androgen (male trait hormones) production and increases female sex hormone-binding substance, globulin. This results in a lowering of free androgen levels, leading to improvement in acne and reduction in excess hair growth. Progestin hormone is weak androgen. Estrogen hormone can reduce acne production and androgens (male trait hormones that can aggravate acne).
The action of combination birth control pills depends on their estrogen-progestin (female trait hormone) balance. In these pills, the effects of estrogen outweigh the effects of progestin, therefore overall, it decreases androgen levels.
However, some older first and second-generation progestin may sometimes activate the androgen receptor and might worsen the acne outbreak. Therefore, consult the dermatologist before taking any pills for acne.
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What are other side effects of birth control pills?
There are not many serious side effects of birth control, such as:
- Nausea
- Trigger migraines
- Vomiting
- Constipation
- Unusual spotting between periods
- Swelling, redness, irritation, burning, or itching of the vagina
- White vaginal discharge
- Sore or swollen breasts
- Mood changes
- Reduced sex drive
- Blood clots (rare)
- Swollen gums
- Coughing up blood
- Shortness of breath
- Tiredness
- Dark-colored urine
- Depression
- Trouble sleeping
- Loss of energy
- May increase incidence of noncancerous breast lumps
Teens Health. Birth Control Pill. https://kidshealth.org/en/teens/contraception-birth.html
Medline Plus. Estrogen and Progestin (Oral Contraceptives). https://medlineplus.gov/druginfo/meds/a601050.html#if-i-forget
WebMD. Will Birth Control Pills Make Me Gain Weight? https://www.webmd.com/sex/birth-control/birth-control-pills-weight-gain
InformedHealth.org [Internet]. Contraception: Do Hormonal Contraceptives Cause Weight Gain? Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006. https://www.ncbi.nlm.nih.gov/books/NBK441582/
WebMD. Hirsutism. https://www.webmd.com/women/guide/hirsutism-hair-women
Jiang C. Oral Contraceptives and the Skin. DermNet New Zealand. https://dermnetnz.org/topics/oral-contraceptive/
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