Rewire is partnering with Planned Parenthood of New York City to provide evidence-based information on the contraceptive pill.  See also the feature article this week by Kirsten Moore and Aimee Thorne-Thompsen examining the case for over-the-counter access to the contraceptive pill.

The Birth Control Pill: it’s one of the most widely used forms of contraception, so is there any wonder that it carries so many misconceptions?

We here at Planned Parenthood of New York City field all kinds of questions about birth control pills — will they make me fat, will they make me unable to have kids, do I need to take a break after eight straight years of hormones? So we decided it was time to break it down for you, and give you the straight facts about what is and isn’t true and just where all those rumors come from.

Keep in mind that we’re not giving anyone medical advice, and that making good decisions about sexual health and birth control is vastly different for each person. That means that no matter how much what we explain rings true, you should always discuss these topics with your health care provider to figure out what works best for your health, body, and lifestyle.

Before we get started, let’s go over some birth control basics: 

So what is the Pill anyway? The birth control pill is an oral hormonal contraceptive that’s taken daily. While there are many different brand name and generic versions of the Pill, they all basically work the same way. Made up of estrogen, progesterone, or a mix of both, these hormones suppress ovulation, ensuring that a woman’s ovaries don’t release eggs. And they thicken a woman’s cervical mucus, thereby blocking sperm from getting past the cervix.

Even though pills all work the same way, that doesn’t mean they’re all the same. They have different mixes and levels of hormones. Some may even include extras, like iron supplements. Because of this, they all affect us differently – meaning that the side effects you get with one pill may disappear once you change brands. Often finding the right birth control is a process – trying many different brands until you find one that mixes well with your body’s chemistry.

The Myth: The Pill Will Make Me Fat. Heard about the “Freshmen 15” — the extra pounds you gain in your first year of college? Well word on the street is that it’s nothing compared to the “Progesterone 15” – the weight you gain when you start on the birth control pill. We at Planned Parenthood of New York City often have patients come into our centers complaining about weight gain, bloating, or extra poundage once they start taking the Pill.

Let’s debunk this one right now. The birth control pill cannot make you gain weight. It will not make you fat, it will not add on pounds, it will not make you heavier.

So what gives?

Well, a few things may be going on. First of all, while the Pill won’t make you gain weight, what the Pill can make you do is retain water – creating the appearance of weight gain. This isn’t a permanent change, and will usually go away once your body has adjusted to the new hormones, after about a month or two.

Second of all, if your birth control pill contains progesterone (most do), that might be to blame. See, while progesterone doesn’t make you gain weight, it can, for some people, cause an increase in appetite. Increased appetites can lead to eating more, which, yes, will lead to weight gain.

Our medical staff has a favorite saying about this: “The Pill doesn’t make you gain weight, calories do.”

Keep in mind, however, that this increase in appetite is not exponential. Your appetite will increase slightly and then level out, meaning that once your body adjusts you shouldn’t continue to gain weight.

So what can you do if this is happening to you?

Always discuss any concerns you have about your birth control method with your health care provider. But, as mentioned above, most of these effects will disappear over time, as your body adjusts to the new hormone levels.  Wait a few months and see what happens. And if you’re still unhappy with the results, talk to your provider about finding a method that works better for you.