Obesity Associated With Contraceptive Pills - A Discussion

Introduction:

There are many methods to prevent pregnancy. One of the most popular methods is a birth control pill. These hormone pills are taken every day to help prevent conception (pregnancy). Birth control pills are commonly prescribed in the United States and world over to prevent pregnancy.

Birth control is called contraception, which prevents pregnancy, and there are different contraceptive pills. It contains hormones that prevent pregnancy. Oral contraceptive pills are made up of either combined or single hormones. For example, estrogen with progesterone or progesterone only. The pill is very effective when consumed consistently.

Most women take them as a contraceptive, but some also use them to address health conditions such as irregular menstrual cycle, endometriosis-related pain, and menstrual-related pain and migraines. However, in recent times weight gain has been one of the common concerns for many people who consume contraceptive pills.

What Hormones Are Involved in Birth Control Pills?

Estrogen and progesterone are two main hormones used in birth control pills in a synthetic form. Ovulation is a natural physiological process in which the dominant follicle from the ovary is released into the fallopian tube, where it gets fertilized. The fertilized egg is placed inside the uterus after the fertilization of the egg by the sperm. The fertilized egg implants in the uterus, where it develops into a baby. The release of eggs from the ovary is controlled by hormones. The ovulation process is controlled or regulated by follicle-stimulating hormone or luteinizing hormone. The hormones involved in ovulation are as follows:

• Gonadotropin-Releasing Hormone- It is a peptide hormone released from the hypothalamus. It stimulates the follicle-stimulating hormone (FSH) and luteinizing hormone from the anterior pituitary gland. The FSH and LH (Luteinizing hormone) are gonadotropin hormones.

• Follicle Stimulating Hormone - It is a hormone from the anterior pituitary gland in response to the gonadotropin-releasing hormone. FSH is responsible for the growth of estrogen and progesterone hormones.

• Luteinizing Hormone - The luteinizing hormone induces production of progesterone and testosterone. It stimulates ovarian changes and regulates menstrual cycle and supports pregnancy.

What Is Ovulation?

The process of ovulation involves the following steps:

• Ovulation is a phase in the menstrual cycle where the ovary releases an egg. The egg travels to the fallopian tube, where it gets fertilized by a sperm.

• Ovulation happens on the 14th day of a 28-day menstrual cycle. The Gonadotropin-releasing hormone stimulates the anterior pituitary gland to secrete FSH and LH. The FSH causes the follicle to mature in one ovary.

• During the 11th to 14th day, one of the growing follicles develops into a fully mature egg. A sudden surge in LH hormone during the 14th day released the egg from the ovary. After ovulation, the progesterone level increases, which prepares the uterus for pregnancy.

• After ovulation, the egg travels to the fallopian tube, where it gets fertilized. The egg meets the sperm in the fallopian tube. The fertilized egg travels down to the uterus and attaches to the uterus. This process is called implantation.

How Does Birth Control Pills Work?

The birth control pill works by the following mechanism:

• The most commonly used pill is a combined hormonal pill that contains synthetic estrogen and progesterone. Progesterone hormone prevents pregnancy and estrogen in the pill controls menstrual bleeding.

• The main mechanism of the pill is to prevent ovulation process by inhibiting follicular development.

• It decreases the release of FSH and LH.

• So eventually, the estrogen production from the follicle becomes less as the follicle isn't developing. The lack of estrogen stops the LH hormone.

• Estrogen inhibits action on follicular development by its negative feedback mechanism on the anterior pituitary gland.

• Progesterone inhibits sperm penetration through the cervix.

Why Does Contraceptive Pills Cause an Increase in Body Weight ?

The main cause of weight gain is:

• Fluid retention.

• Increase in body fat.

• Muscle gain.

The mechanism of birth control pills in obesity is as follows:

• Hormonal contraceptives have synthetic (human-made) estrogen and progestin to restrict ovulation process. It consists of hormonal combinations of patches and drugs. The excess estrogen retains more water in the body. The more estrogen in the body, the higher bloating thus increase in weight.

• The combined hormonal contraceptives contain two hormones - estrogen and progestin. Estrogen can increase water and fluid retention, whereas progestin increases appetite. The mini pill contains only progestin.

• Progestin and estrogen cause fluid retention in the body. These contraceptive pills lead to weight gain because of fluid retention and increased fat. It is believed that they increase an individual’s appetite. During the early days of contraceptive pill evalution, there were high levels of estrogen and progesterone.

• The body swells up with water retention, which usually affects the legs, ankles, and face. A small amount of water retention does not cause much weight gain.

• A birth control implant is a hormonal birth control that releases progestin hormone into the body to prevent pregnancy.

• While progestin stimulates hormones for hunger that directly affects weight gain as they start eating more. Higher estrogen can stimulate more insulin production. The high insulin levels convert glucose into fats by activating carbohydrate metabolism.

Weight gain due to synthetic estrogen have higher effect on women with history of abnormal carbohydrate metabolism.

• Hormonal birth controls such as pills, hormonal IUDs (Intrauterine devices), implants, patches, and rings can potentially cause weight gain. Some birth control shots are known to increase appetite and has glucocorticoid side effects.

• Glucocorticoids cause weight gain by stimulating appetite and metabolism of fats, sugars, and proteins. They increase the fat in the abdomen and face.

• Contraceptive implants cause weight gain as it releases synthetic hormones called etonogestrel into the circulation. The etonogestrel interferes with the hormone balance and leads to weight gain. These hormonal implants are long-term forms of reversible birth control.

What Measures Prevent Excessive Weight Gain Due to Birth Control Pills?

The weight gain can be controlled by following methods:

• Low-dose hormonal pills can be considered in place of high-dose. Any hormonal birth control pill with less than 30 milligrams of estrogen can be considered.

• Some studies suggest that progestin-only contraceptives cause weight gain.

• Regular exercises, hydration, nutrition, and calorie restriction can help with weight loss.

• Non-hormonal birth control methods like intrauterine devices or birth control vaginal rings can be used.

• The Copper IUD is a T-shaped plastic frame inserted into the uterus. It is a long-acting reversible non-hormonal contraceptive. The other non-hormonal methods include condoms, birth control sponges, and cervical caps.

Conclusion:

There is no scientific evidence to prove that taking birth control pills increases weight. Sometimes aging and lifestyle is also responsible for weight gain. The synthetic estrogen and progestin used are responsible for fluid retention and fat accumulation due to their actions on the body's normal metabolism. To avoid this, alternative methods of contraception can be used. Proper diet and exercise help a great deal to lose weight during the contraceptive time.