Welchen Einfluss hat die Verhütung wirklich auf die Gewichtszunahme?

We women know better than any man ever could that our hormones send our bodies on many a roller coaster ride. So it's no surprise that we sometimes blame hormone-based contraceptives for causing us to gain weight. In science, this connection is highly controversial, not least because of countless studies, so that the question inevitably arises as to what our contraception actually has to do with weight gain or whether it is all just imagination. In the following article, we would like to address this tricky topic and answer at least the most burning questions.

A little time travel into puberty

Before we turn in detail to understanding the mechanisms of action between the hormones estrogen and progesterone, which are contained in most contraceptives for women, it may help if we first take a short trip back in time to our puberty, which will help build a basic understanding. Our puberty was not only characterized by crushes and conflicts with our stuffy parents, but above all by physical changes, all of which we have our sex hormones to thank for. In addition to the obvious changes such as the growth of our hips and breasts, the estrogen-induced physical changes take place mainly under the surface through the maturation of the internal sex organs as well as the influence on the metabolism. All this in combination leads to the fact that the body composition starts to change strongly from girl to girl depending on different metabolic factors. For example, during menopause, the estrogen level in many women drops to a very low level, which in some cases causes the organism to develop an above-average tendency to deposit fat around the abdomen and hips. Another influencing factor in this regard is the hormonally induced reduction in the metabolic rate.

Interaction between estrogen and progesterone

You may have noticed that your body weight fluctuates when you are not taking contraceptives. This rapid increase and decrease in body weight during the menstrual cycle is primarily due to the storage of water in the tissues. Estrogen acts on some special receptors in the kidneys that signal water retention. Progesterone, on the other hand, has the opposite effect. Since the concentration of both hormones in the blood changes considerably during the menstrual cycle, this also has a significant effect on the storage of fluid in the tissues. It is therefore equally obvious that the use of contraceptives, which may well differ in terms of estrogen and progesterone concentration, has an influence on how your weight develops. In detail, the use of hormone-based contraceptives represents an intervention in what is probably the most complex and sensitive system of the organism, which is why it often reacts in unforeseen ways in order to compensate for this influence by its own measures. The bottom line is that this can lead to characteristic weight fluctuations, especially during the first months of contraceptive use.

What does science have to say about this issue?

In order not to get too scientific at this point, we will content ourselves with a few basic studies that nevertheless allow very meaningful findings and deal with the topic of weight gain in the case of the three most common contraceptive methods. A meta-study from the year 2011 dealt with the evaluation of different investigations, which referred to contraceptives, which exhibit a combination of the hormones oestrogen and progesterone. The bottom line was that 49 studies concluded that there was no statistically significant increase in body weight in the case of these preparations. A few studies, on the other hand, conceded at least a minor influence. However, it is problematic that only four studies included a placebo test group, which is why the results are not beyond doubt. However, while it may at least be assumed that balanced contraceptive preparations have a significantly lower influence on body weight, this seems to be at least partially different with progesterone-only preparations. In science, it is assumed that the cause is to be found in the fact that the organism tries to restore the hormonal imbalance by increasing estrogen production, which can lead to weight gain in some women.

From the laboratory into practice

Well, science does not see a significant universal connection between contraception with the help of hormonal preparations and weight gain, but admits that in some cases it is quite possible and explainable. However, we should be fair at this point, because scientific studies are usually conducted on a statistical basis and accordingly represent only an average of the large mass of individuals concerned, so the effects that contraceptives have on a small proportion of individuals do not really matter. After all, no one would think of calling peanuts dangerous in principle just because a few people suffer sometimes fatal anaphylactic shock from eating them. Strictly speaking, however, it does not change the fact that this possible consequence exists. The situation is similar in the area of contraception with the help of hormone preparations. As a woman, I would like to take a small side blow at this point, because even if a weight gain of two kilograms within half a year does not seem to be statistically relevant from a scientific point of view, it certainly is for us women. Much more, it is even dramatic!

What can you do?

So, at the end of the day, there is still the question of how you should best act. On the one hand, science cannot confirm that weight gain due to contraceptives is not a mass phenomenon and, accordingly, only takes place within a manageable range depending on individual preparations. On the other hand, personal stories and anecdotes are piling up which make it seem that it is a widespread phenomenon after all. However, we should not forget that the factors that influence our weight gain are much more numerous and cannot be attributed exclusively to a specific form of contraception, although this is of course particularly tempting. So if you have been prescribed a new contraceptive and notice weight fluctuations in the course of taking it, you should not panic immediately, but give your body two to three months to get used to the new hormonal environment. If the situation does not improve, you can finally take action and visit your gynecologist to consider possible alternatives such as other contraceptives.

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