[cathyxxx]

I posted this on another thread under "dieting with health problems" but thought I would post it here too in case someone doesn't see it there.

I was wondering if anyone would mind talking about their experiences with birth control pills?

I only ask because I'm wondering how birth control pills mess with our weight and especially those of us that have low thyroid also?

I have been taking birth control pills on and off for 25 years. They are low dose but I have concerns about them, even tho my doctor always explains that the side effects of low dose birth control pills are very minimal.

Yesterday I was doing some reading and it explained that birth control pills can cause insulin levels to increase which make you hungry all the time (which I am) and I was just wondering how they might interact with a low thyroid condition.

One of the main things I read was about weight gain and fluid retention on the pill. The thing that I read that really bothered me said …

"Any weight gain after starting pills of more than 5% of body weight may be a signal of a woman's tendency toward insulin resistance or abnormal glucose metabolism. With this amount of weight gain associated with an oral contraceptive, I would suggest the woman be evaluated for possible insulin resistance. If this condition is present, she will have to adopt a low carbohydrate diet. Simple sugars in any amount and high carbohydrate only snacks or meals will negate all other dieting efforts on a daily basis and frustrate any long term ability at weight control."

That last sentence really bothers me - maybe ALL my dieting efforts are being "NEGATED" by the little bit of sugar or carbs that I eat???

I was just wondering if anybody had any thoughts on the subject?

thanks,
cathy

[StarPrincess]

Wow. That's an eye opener!

I don't have any thyroid issues. I'm on the patch and think it's the most wonderful thing ever, and I haven't noticed it affecting my weight. Still, what you posted is good info to have for the just-in-case file.

Thanks, Cathy!

[Suzanne 3FC]

It was my understanding that birth control pills do not cause weight gain. I'm not referring to water weight, but to fat gain. When the pill was originally developed, it was much higher in hormones and it did cause weight gain. However, the pill today is very low in hormones and has not been shown to affect weight. The information is interesting about birth control and insulin resistance, I've not heard that before! If it is true, then I don't think it will affect your weight as long as you continue to follow a weight loss plan and exercise program. Exercise is great for balancing insulin levels. Regarding diet, your sugar and carbs may not be bad for you, even if you do develop insulin resistance.

I would suggest the woman be evaluated for possible insulin resistance. If this condition is present, she will have to adopt a low carbohydrate diet. Simple sugars in any amount and high carbohydrate only snacks or meals will negate all other dieting efforts on a daily basis and frustrate any long term ability at weight control."

This statement bothers me. A lot of books on PCOS and insulin resistance do claim that low carb is the only way to go. I'm certainly not an expert on any of this and don't wish to debate or speculate this. BUT, there was a huge study done by Penn State which begain in 2002, and they released information this April which calls the low-carb requirement into question.

This quote is from a long article published in the Washington Post in April:

Both high-protein, low-carb and high-carb, lower-protein diets have been
tested in overweight women with PCOS; a recent study by researchers at
Penn State tied both diets to weight loss as well as improved menstrual
regularity, lipid profiles and insulin resistance in obese women with PCOS.

It appears that the act of losing weight is what helps pcos symptoms (including insulin resistance) and that this can be achieved through either diet. The study by Penn State proved that those with insulin resistance could still lose weight from either low carb or high carb. They also stated that what was more important was the amount of exercise involved,

Physical activity may be even more important than dietary changes, Nestler
says, citing research findings that regular exercise can improve the body's
ability to regulate insulin.

[Marti]

My experience of being on the pill.....

I was on it for 10 yrs. (at a lose dosage) I enjoyed knowing when and how long each cycle would be. BUT--for me (I don't know if anyone else had this) it contributed to my high blood pressure. I had reached 175lbs. (and counting...stopped weighing myself by then) and my doctor told me that I need to do something with my weight. Lower my sodium, cut down on my caffeine, eat healthier and quit smoking.

I did just that. I lost 45lbs., cut my sodium intake so much that to this day ham is just too much to eat! I cut down on the caffeine (stopped drinking pots of coffee a day) and had quit smoking...(oops....I started that back up) I was at a very healthy weight and was in great shape. But my BP was still high and I had to take medication for it.

After 6mos.they suggested I take myself off the pill. Within a month, my BP was down at a normal rate and after another 6mos. or so I was able to stop taking the medication. And my BP has been "normal" ever since.

My doctor explained to me about how the pill was the main reason that my BP was up (never heard of this problem before!) and the weight I was packing on wasn't helping. So even losing the weight and taking care of myself....in the end I had to get off the pill. It has been 4yrs. since I have been off medication for the HBP and I have since gained 20lbs. back of the 45lbs. (not to proud of that!) I had lost and I'm still reading at normal.

As for the weight gain...I didn't see much difference before or after, maybe 5lbs. due to water retention. I don't think being on the pill will make you gain weight.

I may sometime go back and talk about the pills they have out now...maybe the dosage is different and wouldn't contribute to the blood pressure rising, but I'm still hesitant. It took time to lower it, don't want to have it again.

As for all your efforts.....don't let this ever stop you from acheiving what you're trying to accomplish. Everyone is different and everyone loses differently...no matter what technique they try. What works for one, doesn't necessarily work for the next person. Find what works for you and just keep at it.

Ok...I've written much more than I intended too....(sorry)
Marti

[LilDudesMomma]

My experience w/ the pill is ok, i guess. I didn't gain any weight with the pill ( I did with depo tho-- EVIL EVIL STUFF) but, the pill I was on, I got pg! Mainly b/c (according to a study that was out AND my OB) was because I was overweight.. it was showing that on that pill, people who were over weight had a 1-5% chance of getting pg.

[cathyxxx]

ok another question about birth control pills....

I was wondering if anyone that is one birth control pills notices that they crave sugar all the time? I am dying for some sugar or some chocolate right now. This happens to me all the time! Out of nowhere I will just crave sugar soooooooo bad!

Because I always crave sugar I don't eat much sugar (but I do use splenda) and I even have to keep my fruit intake very low (maybe 1 fruit a day if any) because even the natural sugar in fruit seems to make me crave it worse.

Just wondering if anybody else has this problem?

[SeekInnerThinChick]

I have PCOS, and my experiences with the Pill have been nothing short of unmitigated disaster. I can't even bear to go into the details, but I've been on a couple of different kinds over the past 30 years, the first time to "cure" PCOS symptoms, and it's been horrible. I wouldn't take the Pill today if you put a gun to my head. I seem to be unusually sensitive to any sex hormone imbalance-- I'm on a testosterone blocker now, it's been great, the first thing to help my PCOS ever.

I must say too, although I have PCOS I've never had insulin resistance and I've never been on a "classical" low carb diet-- in the sense that I do eat cereal, bread, pasta, etc. FWIW, my ratios are about 25% protein, 25% fat, 50% carb. We're talking high-fiber low-sugar carbs with lots of veggies and fruits, of course.

Can you give the reference for the Pill/low carb comment? I just wonder who said that. Thanks!

[goeatanapple]

I gained weight after going on the pill, but that's because at the same time I left home and started eating some very very naughty food!!

[cathyxxx]

SeekInner, I will look and see if I can find it. I had done a search for "low thyroid & birth control pills" and "birth control pills & weightgain" and came across a good article. I don't remember if I saved it tho. I will look on my computer at work tomorrow.

I think the comment tho was about being insulin resistant and needing to adopt a low carb lifestyle. From everything I had read someone who is insulin resistant needs to eat a low carb diet, but the comment that bothered me was that it said "If this condition is present...sugars in any amount and high carbohydrate only snacks or meals will negate all other dieting efforts on a daily basis and frustrate any long term ability at weight control."

I mean sometimes I crave sugar so bad that I may have an m&m or 2, and I'm wondering/afraid that even a bite once a week of something sugary may be messing up everything else I am doing to lose weight ????

but I will try to locate the article again and post it.

cathy

[cathyxxx]

SeekInner - i can't believe it - I found the article again The last paragraph is what I quoted in my original post. Here it is at...

http://www.wdxcyber.com/ncontr11.htm

Weight Gain and Fluid Retention on Oral Contraceptive Pills Frederick R. Jelovsek MD, MS
"I have been taking birth control pills for about six months now. I am thrilled at the idea of not becoming pregnant, however, my problem is tremendous weight gain as a result of water retention. I have experienced no increased appetite, however my breasts are a full cup size larger and I feel that I have an added layer onto my body that makes me very uncomfortable. Is there anything that can be done about this problem?"

Anon

Before we know if there is any way we can treat weight gain associated with oral contraceptives, we need to know if birth control pills cause fluid retention and by what mechanism, do they cause increased appetite and how, and do they cause temporary or long term weight gain by those or any other mechanisms?

With studies of recent low dose oral contraceptives, the whole premise as to whether there is any change in weight at all with beginning oral contraceptives is in question (1). This and other studies indicate that, on the average, women do not gain weight because of the pills. Remember this means that if 5-10% of women report weight gain when starting oral contraceptives, there is an identical 5-10% of women who gain weight even though they did not get active birth control pills. In other words the weight gain with pills was coincidental but not a cause and effect.

We know from older birth control pill studies, however, that weight gain was a problem both from fluid retention and from more fat deposition so we need to look at what was learned from those studies because those factors may be active in some women who are sensitive to them even at today's low pill hormone doses.

Do most women gain weight when starting on oral contraceptives and if so how much?
For the most part, older studies using higher dose pills tend to show an average of about 5 lb weight gain using pills. One study looked at adolescents who were using DeproProvera® (DMPA) for contraception and compared them to other teens using birth control pills (1). They found that after one year of contraception, the average weight gain was 6.6 lbs (3.0 kg) in the adolescents using shots (DMPA) and 5.3 lbs (2.4 kg) when using oral contraceptives. More importantly, only 7% of pill users gained more than 10% of their body weight while 25% of the DepoProvera® users gained more than 10%. If you just look at the average weight gain of 6.6 lbs vs 5.3 lbs, you would conclude that DMPA had only a slightly higher weight gain than pills. The fact that these averages include 18% more woman who gained greater than 10% of body weight can be hidden by average weight changes. Thus DepoProvera® has a greater side effect of weight gain than oral contraceptives.

In another study with a fairly high dose pill (50 mcgm) from 20 years ago, investigators found an 11.4% weight increase of over 4.4 lbs (2.0 kg) but also a 14.3% incidence of over a 4.4 lbs weight loss on the same pill (1). In other words there was just as much weight loss as weight gain. This finding could be interpreted as the pills cause no overall weight change in woman on the average, but an alternative explanation is that some women get nauseated from pills and have a net weight loss while the others who did not get nauseated gained a substantial amount of weight.



Do oral contraceptives cause water retention and how much?
Estrogen in high doses is known to cause weight gain especially that due to fluid retention (1). The more estrogen there is in a pill, the more tendency to gain weight such that a 50 mcgm pill will result in more weight gain than a 35 mcgm pill (1).

The mechanism of action is probably direct stimulation by the estrogen in pills of kidney substances called renin-angiotensin that cause water retention. The water retention then causes sodium (salt) retention. A lower estrogen level pill, e.g., 20 mcgm, will help reduce weight gain due to fluid retention.This was confirmed in a more recent study with 30 mcgm pills in which there was essentially no difference in weight gain or weight loss between the placebo group and the oral contraceptive group (1). Again, however, 30% of these women had a weight gain of more than 1 lb but the net result was the same in the control group. Those who did have weight gain had increased fat but no difference in fluid retention amounts indicating that fluid weight gain may be less of a problem with the newer, lower estrogen pills.



Do birth control pills stimulate your appetite?
There have been reports through the years, especially with the older, higher dose pills, of adverse effects on insulin resistance (1). Even recent studies seem to indicate that current pills can raise insulin levels (1, 1). Insulin resistance is a condition in which insulin levels rise in response to carbohydrates and drive all energy into the fat cells and essentially prevent weight loss even with dieting (1).

Not all women are susceptible to insulin resistance and thus not all women gain weight using oral contraceptives. Those that have a tendency to abnormal glucose metabolism, however may be the ones who gain weight. If a woman gains weight upon starting oral contraceptives and there are not other explanations, she should be checked out for possible insulin resistance.



Are there other mechanisms by which pills cause weight gain?
In one study of pills, a formulation containing desogestrel as the progestin and slightly less estrogen had significantly less weight gain when compared to a pill containing norethindrone (Ortho Novum 7/7/7®) (1). This may imply that the specific progestin has a role in weight gain, possibly through a lesser degree of insulin resistance. Or it could be the combination of lower estrogen and the specific progestin but in any case, there was less weight gain. Currently marketed pills with desogestrel as the progestin are Desogen® and Ortho-Cept®.



What can you do if you have weight gain on the pills?
Using the lowest possible estrogen containing birth control pill should minimize weight gain and swelling from water retention. Current 20 mcgm pills which are the lowest estrogen doses available are:

Alesse®
Levlite®
Loestrin-Fe®
Mircette®
If you are not taking one of the lowest dose pills, ask your physician or health care provider to switch you to one of the lowest dose pills, especially if you are having any weight gain or fluid retention symptoms.

Any weight gain after starting pills of more than 5% of body weight may be a signal of a woman's tendency toward insulin resistance or abnormal glucose metabolism. With this amount of weight gain associated with an oral contraceptive, I would suggest the woman be evaluated for possible insulin resistance. If this condition is present, she will have to adopt a low carbohydrate diet. Simple sugars in any amount and high carbohydrate only snacks or meals will negate all other dieting efforts on a daily basis and frustrate any long term ability at weight control."

Cathy

[MrsJim]

I've been on Loestrin-FE (actually, a generic version) for, oh, about five years or so now. Never had a problem, with the exception of occaional breakthrough spotting from time to time - nothing to worry about per my doc!

[SeekInnerThinChick]

Personally, I would question very carefully any information from a site that's trying to sell me something. I would be far more inclined to trust information from a known group of scientists or doctors who are working in the public interest. Another thing that bugs me is the lack of any references I can cross-check for myself. The person who wrote this stuff cites "studies" but doesn't tell you what those studies are, for example. In fact, we don't even know who this person is, since we have no way to check whether he really is a medical doctor. Even if he is a doctor, is a a gyno or a bariatric? You see where I'm going with this.

There are literally millions of sites with purported medical information on the net. Some are great, some are criminal. It's not only "buyer beware" out there, it's "reader beware." I'm not saying don't read this stuff, just make sure that what you are reading can be checked and double-checked.

As far as your question about sugar and the Pill, I just can't say. If you read the BACK of the ads for various versions of the Pill, the list of possible side effects and contraindications is significant. But the basic problem is, even if the Pill were causing a sugar-craving problem for you, there's no way to predict that in advance from the science, because medical science works on the basis of accumulated averages after the fact, over many studies. The only way to determine whether you are having an "individualistic" reaction is to discontinue the Pill and see if the cravings go away. Which then leaves you with the problem of how to handle birth control. If I had to deal with that myself, I'd get my tubes tied or my DH "fixed."

My personal feeling is: use exteme caution when taking any medicine, particularly with something that interferes with the endocrine system. Ever since the HRT scandal broke, I've been adamant about not taking the Pill or HRT, although doctors have pushed them on me with ferocious intensity. (And I hope to get off Spiro in a few months, as well.)

I think we are conducting an enormous poorly-controlled mass experiment with hormone-manipulating drugs. The fruits of this experiment will only be seen as the Boomers pass through menopause and into late middle age-- tens of millions of them. But I'm none too sanguine.

[Leenie]

Cathy I was on OrthoNovum 777 for over 10 years, during those 10 years I lost 150 lbs and kept most of it off for numerous years. If you think the pill is your problem talk to your doctor and see if there is an alternate route you can take (or hubby snip snip )

As far as sugar is concerned, I've been off of b/c for almost 3 years now and my sugar cravings are worse now than ever, I don't know if its related to just getting older or what. Eating LC does help keep the cravings down (not stopped but down). I do notice that about a week - 2 b/4 TOM I will be soooo incrediably hungry, especially for sweets and a day or two b/4 TOM, same thing. Don't forget to much diet sweetners can trigger you to want sweets even more (does me for sure).

[cathyxxx]

Leenie - thanks! you bring up a very good point about the sugar cravings. I have been thinking since I am eating low carb and rarely have any sugar (maybe one fruit a day) that I should not be craving sugar. You know, like it's out of my system so why am I craving it. After reading about bc pills messing with your glucose levels I was just thinking maybe they are the problem. But ya know what, I have a caff free diet coke every day at lunch time. Then around 3:00 I am craving sugar so bad that I could scream. Maybe the caff free diet coke is doing it? DANG! am I gonna have to give them up completely? I thought I had done so well going to only 1 a day and then drinking 100 oz or more of water.

I will think about cutting out the diet coke all together and see if it helps with the sugar cravings. *sigh*

Thanks everyone for your input - I really appreciate it!!! I'm just trying to figure out what is going on with me!

Thanks again!

Cathy

[Leenie]

Cathy, not only does questions like this help the ones who posted it, it helps everyone who reads them.

Things surely do work differently for everyone and until one really investigates, how would you know.

Hugs !!!!

Hey I'm doing 20 - 30 gms carbs per day and I still want sugar, well M&M's I'm just able to control it better thats all.