High-quality systematic reviews and clinical handbooks indicate that combined oral contraceptives are weight-neutral and lack consistent evidence for causing weight gain, whereas individual studies, surveys, and animal models report patient perceptions or findings of weight gain.
Combined oral contraceptives (COCs) are known to cause weight gain and alter metabolic and immunological pathways. However, modifications in arterial or venous thrombotic risk profiles of women of reproductive ages on COC remain unclear. The study aimed at assessing the impact of COC on immune activation in diet-induced obesity. We further established whether the dietary intervention of switching from a high-fat diet (HFD) to a low-fat diet (LFD) attenuates immunological responses. Twenty (n=20) five-week-old female Sprague Dawley rats were randomly divided into two diet groups of HFD (n=15) and LFD (n=5) and were monitored for eight weeks. After eight weeks, animals in the HFD group switched diets to LFD and were randomly assigned to receive high-dose COC (HCOC) or low-dose COC (LCOC) for six weeks. Animals on HFD significantly gained weight and had a higher lee index when compared to the LFD group (p < 0.05). Moreover, the triglyceride-glucose index, insulin, and other metabolic parameters also increased in the HFD group compared to the LFD group (p < 0.001). Consistently, the levels of interleukin (IL)-6 and tumor necrosis factor-alpha (TNF-α), were elevated in the HFD group when compared to the LFD group (p < 0.05). Upon switching from a high-fat to a low-fat diet, insulin levels persistently increased in animals receiving HCOC treatment compared to the LFD and HFD/LFD groups (p < 0.05). Thus, in a rat model of HFD-feeding, short-term HCOC treatment induces long-term metabolic dysregulation, which persists despite dietary intervention. However, further studies are recommended to confirm these findings.
The perception that hormonal contraception causes weight gain is a general belief that frequently hinders the initiation and continuation of effective family planning. This narrative review analyses data from Cochrane systematic reviews and recent pharmacogenomic studies to separate patient perception from metabolic reality. Analysis of high-quality data, including Cochrane systematic reviews, indicates that the association between Combined Hormonal Contraceptives (CHCs)-including oral pills, the transdermal patch, and the vaginal ring-and weight gain is not supported by consistent high-quality evidence. Placebo-controlled trials demonstrate that these methods are weight-neutral on average. Perceived weight increases in CHC users are likely mediated in part by fluid retention linked to the estrogenic stimulation of the Renin-Angiotensin-Aldosterone System (RAAS), rather than adipose tissue accumulation. Conversely, Depot Medroxyprogesterone Acetate (DMPA) represents a verified clinical risk for weight gain, showing a demonstrated clinical association with significant fat mass accumulation. Hypothesized biological mechanisms for this increase include hypothalamic appetite stimulation and glucocorticoid-like activity. The etonogestrel implant occupies a complex middle ground. While population-level data suggests weight neutrality, recent exploratory pharmacogenomic research has identified a specific variant in the Estrogen Receptor 1 (ESR1) gene. For the minority of women carrying this variant, the implant may trigger clinically significant weight gain, suggesting a biological basis for their subjective experience despite statistical evidence. Ultimately, the persistence of the weight gain concern is fueled by the nocebo effect and the misattribution of natural age-related weight trajectories to contraceptive use.
Heavy menstrual bleeding (HMB) is a common gynecological condition among women of reproductive age that significantly affects quality of life and often leads to iron deficiency anemia. Hormonal treatments are usually prescribed in combination to include combined oral contraceptives (COCs) and progestin-only pills (POPs) in treating HMB. This systematic review aims to compare the effectiveness and safety of COCs and POPs in the management of HMB in terms of menstrual blood loss, hemoglobin levels, side effects, and patient satisfaction. The literature search was conducted on PubMed, Scopus, Web of Science, and Google Scholar and covered articles published between 2000 and 2025. Blood loss reduction, hemoglobin levels, side effects, and patient satisfaction data were extracted, and a narrative review was conducted. The review included 10 studies. Both POPs and COCs had a great impact on minimizing menstrual blood loss and enhancing hemoglobin index. There were no mean differences in the two treatments concerning the improvement of hemoglobin, with a mean change of 2.75-2.71 g/dL in both treatment groups (p = 0.84). The heterogeneity within the companies made the calculation of confidence intervals impossible, and the comparison was done regarding the differences in mean only. COCs were linked with an increased incidence of nausea, headaches, and weight gain, whereas POPs were found to have more desirable side effects. Drospirenone (POP) showed reduced unscheduled bleeding days and patient satisfaction with the medication compared to other POPs. Risk of bias was moderate to low across studies, with some concerns regarding randomization and blinding in certain trials. Further research with larger sample sizes, longer follow-up periods, and head-to-head comparisons between COCs and POPs is needed to confirm these findings and evaluate the long-term impact of these treatments.
Background: Contraceptive use during a woman's reproductive years can help prevent unintended pregnancies, maternal deaths, and other non-reproductive problems. However, there is also a risk of running into various health challenges. The study aimed at finding out if women in the Greater Accra and Ashanti regions of Ghana encounter health issues during and after use of contraceptives was conducted. Methods: Questionnaires were administered to 600 women out of which 401 responses were carefully gleaned for analysis using SPSS version 25. The questionnaire probed side and adverse effects women encountered in their use of contraceptives as well as the types of contraceptives they preferred. Results: The study revealed that the use of contraceptives was widely prevalent, especially amongst women aged 21-30 years (61.8%). The preferred types of contraceptives were the oral-progestin only (42.9%) and combined oral contraceptives (31.4%). Spotting or bleeding between periods (menstrual-related) was the highest reported side effect (33.2%), followed by weight gain (metabolic-related), 21.7%. Pearson’s Chi squared test showed an association between the age of respondents and the choice of contraceptive type at p<0.01. Hypertension and deep vein thrombosis (DVT) were the highest reported adverse effect (10.2% and 9.2% respectively). Conclusions: It was concluded that contraceptive use (especially the oral type) may cause discomfort with the side effects reported in women of reproductiv
Aim. To determine awareness about family planning and contraceptive preferences among young people. Materials and methods. Internet questioner about knowledge, preferences, personal experience of contraception usage. 1010 responders (935 from Russia, 75 from other countries) were processed by statistical methods in the IBM SPSS Statistics program. The group was a simple random sample. Results. 92.5% of foreign and 54.2% of Russian respondents with medical specialties do not consider a stroke as a contraindication to combined oral contraceptives COCs (p0.001); 45.3 and 42.2% respondents have similar views about breast cancer in the anamnesis. Uncomplicated varicose veins and uterine fibroids are mistakenly considered contraindications to COCs by 26.4 and 20.8% of foreign participants and 54.5 and 44.4% of Russian participants, respectively. 25.1% healthcare providers from Russia consider hormonal contraception (HC) a possible cause of infertility. Only 4% of Russians of non-medical specialties know about strokes and heart attacks as complications of COCs, 13.8% about arterial hypertension; almost half of foreign participants have such knowledge (p0.05). Every second respondent from Russia and every third from other countries does not know about the timing of use of emergency contraception. Russian and foreign participants, when they were using HC, respectively noted: decreased libido (29.1 and 13%), increased body weight (15.0 and 34.8%), headache (21.8 and 17.4%), mastalgia (
Combined oral contraceptives (COCs) are increasingly used by adolescents. The aim of this review is to investigate the evidence regarding COCs' influence on weight, height and bone mineral density (BMD) in girls younger than 18 years.Systematic literature search using PubMed/Medline and Scopus (January 1990-February 2012) on COCs for girls under 18 years of age and the possible influence on body parameters. MeSH terms: Oral contraception; Adolescent; Weight; Body composition; Height; Bone mineral density.There is no evidence that COCs induce weight gain in girls younger than 18 years. Obese girls are not at higher risk of gaining weight. COCs do not cause changes in body fat and lean mass beyond the changes caused by natural development. Moreover, growth and stature are unaffected. Few studies indicate that COCs have a negative impact on BMD, but the evidence is presently too limited for definite conclusions.Studies in young users are few. Presently, there are no indications of a negative impact of COCs on weight, body composition or height. Lesser increases in BMD cannot be excluded. As the demand for COCs is increasing among the youngest girls, there is a need for prospective studies addressing this issue.
that there is no evidence that combined oral contraceptives cause weight gain. Randomised trials evaluating … pregnancy while using combined oral contraception. Interventions: Combined oral contraceptives of different … pregnancy while using combined oral contraception. INTERVENTION: Combined oral contraceptives of various
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