FSRH press release: New guidance reassures women about contraception and weight gain

There is a perception that weight gain is a common side effect of contraceptive use and this is often given as a reason why women do not initiate or do not continue contraception. New guidance by the Faculty of Sexual and Reproductive Healthcare (FSRH) reviews the available evidence on the effect of contraception on weight.

The new guidance concludes that:

• Women of reproductive age tend to gain weight over time regardless of use of any contraceptive method.
• While some users of contraception do gain weight during use, there is no evidence that intrauterine contraception (the IUD and IUS), the implant, the progestogen-only pill or combined hormonal contraception (the combined pill, the patch and the vaginal ring) cause significant weight gain.
• Data is insufficient to confirm or exclude a causative relationship between use of the contraceptive injection and weight gain.

Dr Sarah Hardman, Director of the Clinical Effectiveness Unit of the Faculty of Sexual and Reproductive Healthcare (FSRH), said:

“Women often tell us that they do not want to start or to continue contraception because they are worried that it will make them gain weight.”

“In studies, women gain on average a similar amount of weight over time whether they are using hormonal contraception or not. In other words, women may gain some weight during use of a contraceptive method, but so, on average, do women who are not using contraception.”

“After looking at all the studies available, we can say that average weight gain during use of contraceptive pills, the implant and the hormonal coil is modest and is not significantly different to weight gain with no contraception or non-hormonal contraception.

"The studies don’t rule out the possibility that some women might gain some extra weight when they are using the contraceptive injection, but we don’t know for certain. It should be said that we do see lots of women who don’t put on weight while they are using the injection.”

“Effective contraception is really important to enable women to avoid unplanned pregnancy, and hormonal contraception can have additional benefits like helping with heavy, painful periods.

"We’ve put this guidance together so that contraceptive providers can give women advice that is based on evidence; I hope it will help to make sure that women don’t miss out on the benefits of effective contraception because they are worried about weight gain.”

“Women are all individual: not everyone has the same experience with any method of contraception. The studies confirm that weight change can vary widely between individual women using the same method of contraception (or none). If a woman feels that her contraceptive method isn’t suiting her, I would encourage her to speak to her contraceptive provider about different options so that she can continue to have the benefit of effective contraception.”

ENDS

For further information please contact Camila Azevedo, FSRH External Affairs & Standards Manager, at externalaffairsmanager@fsrh.org or 02037945309.

Notes to Editors

• This FSRH statement reviews the evidence for the effect of contraceptive methods on weight; it is intended for use by contraceptive providers to support women in making contraceptive choices. It can be found here.
• FSRH has recently published updated guidelines on contraception for women with overweight or obesity. It makes recommendations about effective contraception during use of weight loss medications and after weight loss surgery. It can be downloaded here.
• Public Health England has pointed out that rates of obesity are increasing among women of reproductive age. An increasing number of women who become pregnant are obese – around 19% of women of reproductive age in England are obese, 3.6% are severely obese, and of these obese women 5.3% will become pregnant each year.
• The Faculty of Sexual and Reproductive Healthcare (FSRH) is the largest UK professional membership organisation working at the heart of sexual and reproductive health (SRH), supporting healthcare professionals to deliver high quality care. It works with its 15,000 members, to shape sexual reproductive health for all. It produces evidence-based clinical guidance, standards, training, qualifications and research into SRH. It also delivers conferences and publishes the journal BMJ Sexual & Reproductive Health in partnership with the BMJ.