Weight change with oral contraceptive use and during the menstrual cycle. Results of daily measurements

Abstract

Although weight gain is among the most common complaints of women using oral contraceptives (OC) and a frequent reason for discontinuation, studies demonstrate little basis for this perception. We explored this issue by analyzing the daily weights of 128 women during four cycles of triphasic OC use. The mean weight at the end of the fourth cycle of use was the same as baseline weight (average weight change, 0.0 pounds). The largest proportion of women, 52%, remained within 2 pounds (0.9 kg) of their starting weight, and 72% of women had either no weight change or a loss. Over each menstrual cycle, regular but minor weight shifts were observed, with the mean weight rising by one-half pound (0.2 kg) during the first weeks of each cycle and falling by the same amount during the last few days. These results emphasize the lack of association of OC use with weight gain but OC may be blamed at least in part, based on cyclic fluctuations. Counseling should emphasize weight gain as a misperception and stress the fact that a highly effective and safe form of contraception should not be ruled out or discontinued because of concern about weight.

PIP: Although weight gain has been identified as the most common single reason for discontinuing oral contraceptive (OC) use, the few studies that have addressed this issue have found little or no OC-related weight change. The present study analyzed the daily weights of 128 US women, 18-35 years of age, over the course of 4 cycles of use of a triphasic OC (Tri-Norinyl). The mean weight change between study start and completion was 0.0 pounds. 52% of study participants experienced no weight change (defined as remaining within 2 pounds of their starting weight) and an additional 33% experienced a gain or loss of less than 5 pounds. Overall, 72% of subjects had either no weight gain or lost weight. These results did not differ for the various age, race, and parity groupings. Analysis of daily weight measurements indicated that women tended to gain a small amount of weight (about one-half pound) during the first few weeks of each treatment cycle and to lose approximately the same amount during menstruation. Thus, at least some change in weight blamed on OC use may be attributable to normal cyclic fluctuations. Contraceptive counseling should stress the fact that the empirical research has failed to document weight gain as a side effect of OC use.