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Oral contraceptive pills

The oral contraceptive pill is one of the most commonly used birth control methods. It gained popularity quickly because it is easy to use, cheap, freely available and does not usually cause serious adverse effects.

There are many types of oral contraceptive pills:

  • Combined oral contraceptive pills
  • Progesterone only pills
  • Anti-progestogens
  • Estrogen receptor modulators

The combined oral contraceptive pill is the most widely used method. It contains a balanced concentration of estrogen and progesterone. The progesterone only pill is as the name suggests. The high doses suppress the autonomic hormonal control of menstrual cycle, arrests ovum development and ensures contraception. Estrogen receptor modulators interfere with estrogen receptor binding. Anti-progestogens are a type of drug that interferes with progesterone action on the reproductive system.

Oral contraceptives have their own set of advantages and disadvantages, like any other drug. Regular use of the OCP ensures regular, less painful menstrual periods. Pill use is known to reduce the risk of endometrial and ovarian cancer. Oral contraceptive pills are often used therapeutically to treat endometriosis and polycystic ovarian syndrome. Associated risks/disadvantages are:

  • A possible rise in the risk of breast, cervical and hepatic cancer
  • Mood changes and depression caused by a reduced brain serotonin level
  • Excessive vaginal secretions
  • Gastrointestinal upset
  • Breast pain
  • An increased tendency to clot (resulting in deep vein thrombosis, stroke and ischemic heart disease)
  • Possible worsening of migraine

It is better to use an alternative method of birth control if there you have:

  • A history of stroke, Deep Vein Thrombosis, ischemic heart disease
  • Migraine
  • Heart failure
  • Severe obesity
  • Uncontrolled hypercholesterolemia
  • Active hepatitis
  • Uncontrolled/malignant hypertension
Weight gain while taking OCP - Is it a myth or not?

Early oral contraceptive pills may indeed have caused weight gain due to retention of water and increased appetite.Modern oral contraceptive pills have a lower, yet more effective combination of hormones. Modern pills hardly cause any weight gain, if at all.

No study to date has able to prove a causal relationship between OCP use and weight gain.

A systematic review of studies done in 2011 showed no statistically significant weight gain with the use of oral contraceptive pills.

Current research suggests that there may be a correlation between modern OCPs and water retention. Researchers have shown a small degree of water retention due to oral contraceptive pills. Therefore they are detrimental to women with compromised cardiac function (like heart failure or uncontrolled hypertension).

Weight gain after going off the pill

Studies have not shown any significant correlation between oral contraceptive pills and weight gain. Evidence for weight gain after stopping oral contraceptive pills is either anecdotal or theoretical.

Polycystic ovarian syndrome patients can benefit from oral contraceptive pills to relieve menstrual symptoms. Oral contraceptives reduce appetite and help with weight reduction. If a woman who is unaware of her PCOS stops the pill, her appetite and weight will increase. Each individual responds differently to the OCP and its cessation. Therefore not all will gain weight after stopping the OCP.

Additional steps such as dietary control and regular exercise will help you maintain a healthy weight.

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