Ask your MetaFilter if birth control pills are right for you!

March 8, 2011 5:50 PM

This is a long boring question about birth control pills (specifically Yaz and Levlite) and weight gain.

I'll attempt to be concise, and make this make sense, though it may not work because this is a long crazy-making saga.

From roughly 25-31, I was on Levlite. (Though there were two periods during that time when I was off the Pill for something like 6 mos- 1 year, then I went back on.) It made my life easier in a million ways. Then Levlite was discontinued. Around that time I moved, and started going to a new Gyno. She gave me a Rx for Yaz. OK, fine. I took the Yaz, and had none of the obvious side-effects, so I assumed I'd easily found a replacement Pill.

Around that time I started gaining weight. I didn't connect this to the Yaz, first of all because I hadn't gained weight on Levlite (I'd lost it, in fact) and also because when I'd moved my routine had been disrupted. I figured I'd gained the first 5 lbs because I had stopped my usually thorough calorie counting, and had eaten more than usual for a few weeks. But when I went back to my normal eating habits, I didn't lose the weight like I usually did after a short period of laziness. Instead, I kept gaining. I gained ~45 lbs that year. I asked my Gyn. if it could be the Yaz. She said no, that of any Pill Yaz would be the least likely to cause weight gain, and she told me to eat fewer carbs. But, she said if I wanted, I could try Ortho Tri Cyclen Lo instead. So I did, for several months. No weight loss, and there was some minor but annoying difference with that, worse cramps or something, so I went back to the Yaz. I was freaking out this whole time, of course; I have the body type where an extra 5 lbs is obvious and not in a nice curvy way. Also I'd been fat for a few years in High School, and hated it. I'd lost almost all the weight I wanted and maintained that, about 5 lbs above my ideal, for over a decade. Occasionally I'd gain ~10 lbs, but I could always correct that. So I really hated not being able to apply my usual strategies. Stupidly in retrospect, I stayed on Yaz, and stayed fat, for about another 8 months.

Finally I decided to go off the Yaz as an experiment. It took a year, but I lost about half the extra weight without changing anything else. (I was careful about what I was eating, but no more than usual, like I said, I always am.) The last 20-ish lbs have been much harder to lose; I'm still working on that.

Now to the question(s), I promise. I would love to go back on the Pill, because it made my skin clearer, my PMS negligable, my periods lighter,and my cycle predictable. It seemed, even, though I could be wrong here, that it made it easier to maintain my weight. But I don't want to go on another new Pill and risk gaining weight again or hampering my efforts to lose the rest of the extra lbs. And now my dependable Levlite is gone. I assume if I could get some other Pill with the same active ingredients (Ethinyl Estradiol/ Levonorgestrel), that will work equally well. Question #1 - is this assumption correct?

There's a generic of Levlite that AFAIK is still produced (Aviane.) But, wouldn't you know, I'm allergic to it. The other brands with Ethinyl Estradiol/ Levonorgestrel are, according to this, as follows: Alesse®-21, Alesse®-28, Enpresse™ 28, Jolessa™, Lessina™-28, Levlen®, Levora®, Lutera™, Lybrel™, Nordette®, Portia™, Preven®, Quasense™, Seasonale®, Seasonique™, Sronyx, Tri-Levlen®, Triphasil®-21, Triphasil®-28, Trivora®. Question #2 - are any MeFites in the US currently taking any of the above pills? Or have they been discontinued too? (Or in Canada, even? If it's legal I could order from there, or get my family there to send me some, or even drive up there to a pharmacy if I had to.) You'd think it would be easy enough to ask my Dr. or a pharmacist for this info, but I spent hours trying to find out during the Years of Fatness, and got nowhere. Which is why I'm asking here. My insurance does not cover Rx's, so I don't care whether it's generic or not. I do tend to be allergic to generics, but I'd try anything that might be the same, aside from Aviane which I'm definitely allergic to, that is.) If I asked for a Rx for a certain Pill I'm sure my Dr. would give it to me - she's great, she just seems to think the only options are Yaz, Ortho Tri Cyclen, some other similar low-dose Pill whose name I've forgotten now, and the Nuva Ring which I don't want to use.

And a sort of bonus Question # 3, for anyone else who has gained weight on a Pill and then gone off that Pill - what was your weight loss like? How long did it take? I'm afraid I might be fucked up permanently somehow and will never get back to the weight I was at before, though logically I don't see how that could be. (Pre-epmtively, in case anyone thinks I'm being unrealistic, I should say I was not thin before this weight gain. Just normal, a bit pudgy in places, but I was comfortable. I feel very uncomfortable with these extra ~20 lbs, it's obviously not the right weight for me. Also pre-emptively, I know I'll have to work harder at 34 than I did in my late 20s, I'm not expecting to be able to eat a ton of food and still lose weight. I've always had the metabolism of a drowsy snail, normal thyroid test results notwithstanding, so I'm used to hard work and sacrifice and I'm totally OK with that. I just want to know about the Pill side-effect fallout.)

If anyone read all that, thanks for reading all that!

posted by DestinationUnknown to health & fitness (12 answers total)

I can only speak to #2. I was on Seasonique for about 4-5 years, and LOVED it. I had no side effects. The downside was that it was really expensive because there was no generic to the time. Its my understanding that there is one now, and a low dose version.

Unfortunately for some reason, as I got older my hormones changed and I started getting BTB while on Seasonique. My doc switched me to Sprintec, which is fine but its not the 4-cycles-a-year kind that Seasonique was. If my body would let me go back I would.
posted by halseyaa at 6:08 PM on March 8, 2011

My partner takes Seasonique. No weight gain, no side effects (well, unless only four or so periods a year is a side effect).

But: it took experimenting with like a million different versions of the pill to find the one that works well for her. A not-just-good-but-great obgyn will know the ins and outs of gazillions of formulations of the pill, and will be able to cycle you through them in an order that makes sense for your conditions and needs. If your current doctor can't do this, you need to find one that can. It's not a bad thing to be reading opinions about the variations here, but that's no substitute for having an excellent doctor working with you through the process.

The US has crappy, crappy healthcare options for many people, so if accessing a better doctor is not possible, I understand -- but if you can, it really is the right way to go.
posted by Forktine at 6:33 PM on March 8, 2011 [1 favorite]

Have you been checked for insulin resistance/PCOS? Some BCP can cause severe weight gain in PCOS patients but not in others because of how PCOS bodies work. IF you happen to be PCOS, look for a reproductive endocrinologist to Rx you BCP because they are more likely than your GYN to know which ones will work best with wonky hormones. I have no long term personal experience with BCP as they make me PsychoBitch Crazy so I try to stay away from them. Luck!
posted by PorcineWithMe at 6:46 PM on March 8, 2011

There are so many studies that show the pill, in itself, doesn't cause weight gain. Weight gain often happens because 1. many women who go on the pill are doing so because they're entering happy relationships and things like dieting go out the window or 2. you're getting older which means lifestyle changes and simply that your metabolism is starting to slow down. Gaining 45 lbs in one year sounds very, very, very abnormal. Even among all the women I know who swear up and down that the pill made them gain weight, we're only talking 5 or 10 lbs over a year. Are you sure there's not something else going on?

I guess what I'm saying is, don't give up hope on the pill. Remember that your body is not the same as it was in your 20s, whether or not you're on the pill. Also, I agree about getting a better doctor. Offering you basically only 3 choices and writing off your concerns seems not so good.

One final note: I'll throw in a shoutout for Yasmin, my favorite pill of all time. NOT the same as Yaz, and in fact, Yaz made me crazytime while Yasmin did not even though they contain the same active ingredients (just different amounts and on a different schedule).
posted by joan_holloway at 6:48 PM on March 8, 2011 [3 favorites]

I'm on Alesse-21 and don't have any problems with it. I'm in Canada and pay about $15 a month for it.

My understanding is that both Yasmin & Yaz have class action suits going ahead due to severe complications; I'd be wary of them but they're the only option for some women.

45lbs sounds like a crazy amount to gain through birth control pills, as with other commenters I'm used to hearing about 5-10lb.

Have you looked into non-pill contraception? I would recommend if you're unable to get answers from your doctor, get in touch with your local woman's centre or planned parenthood group.
posted by Salmonberry at 7:58 PM on March 8, 2011

I did not gain weight on Nordette, fwiw.

Now that I am in my 30s and my hormones have settled down, I got a copper IUD and love it. my cycle is predictable, and after a few months my bleeding returned to its normal rate. I do get some PMS/pre-period breakouts now, which the Pill had suppressed, but again, since I'm long out of adolescence, it's manageable. So I throw that out as an alternative if you're not willing to go through a systematic trial of possible replacement pill formulas.
posted by thinkingwoman at 8:09 PM on March 8, 2011

Triphasil-28 (or some equivalent generic) is still available in the US. I like it, but I figure this sort of thing is highly subjective. (For instance, I couldn't do the Seasonale/Seasonique 4 periods/year thing. More power to those who can, but weeks of on-again, off-again not-really-period I experienced during my half-year trial was not what I'd call better.) If do you go the triphasic route, be sure to read up on their limitations of skipping periods, if that's a thing you do sometimes. There are some ways to get around it, but due to the three different dosage levels, they're more complicated than just skipping the placebo week and going straight to the next pack.
posted by deludingmyself at 8:20 PM on March 8, 2011

I'm on Lutera, and I have no problems filling that prescription in NYC (so, you won't have to rely on Canada for it!). Without insurance coverage it runs about $30 a pack.

As for Qs #1 and #2, no clue, sorry.
posted by Fuego at 9:57 PM on March 8, 2011

I was on Ortho like one hundred million years ago and eventually stopped it. Folks may disagree with me, but I tell you that the pill isn't natural for your body generally and you probs shouldn't take it at all.

That said, similar to you -- I gained 45+ pounds on a newer formulation of a medication (not bc) that also wasn't supposed to cause gain and my doctors ignored my concerns -- this happened 5 years ago and I'm only now losing it because I am pregnant.

Yep. You read that right. Pregnancy seems to have finally straightened my system out.

And yes, after the ridiculously uncontrollable quick weight gain I went to other doctors and had my thyroid, insulin, and all other levels tested. Nothing showed up.

I few years ago I lived with a pharmaceutical rep. You'd be surprised to find out how these drugs are marketed to doctors, and then how little the doctors actually know about before prescribing them. (You can thank the government's deregulation of drug oversight and advertising in the mid 90's for this.)

I think you are asking the wrong questions here. If you do decide to return to hormonal birth control, maybe pick something that has been in use for a long long time? But really. Think about other alternatives.

Good luck getting your system back in balance. IMHO, that's the real issue for you here.
posted by jbenben at 10:44 PM on March 8, 2011

There are so many studies that show the pill, in itself, doesn't cause weight gain.

I recently read through a meta-study summarizing these studies. Most of them compared one formulation of the pill with a second formulation. There were a total of three placebo-controlled studies that compared weight gain in women on the pill and off the pill, all of which ran for short durations (4, 6 and 9 cycles.) The meta-study concluded, "The evidence was not strong enough to be sure that these methods did not cause some weight gain."

The New York Times reported the study with the headline "Don’t Blame the Pill for Weight Gain."

To answer your last question, I gained 25 pounds while I was on Nordette, and lost 25 pounds over about 3 months immediately after stopping it.
posted by Ralston McTodd at 4:43 AM on March 9, 2011 [1 favorite]

I took Enpresse for four years, and I didn't realize how much I hated it until I stopped taking it. It is the first and only pill I was ever on. I switched to Nuvaring simply because I'm forgetful and bad at taking the pill at the same time everyday.

Nuvaring is the best thing that ever happened to birth control for me. I've lost 15 lbs without really trying, and I feel like a fog has been lifted that I hadn't even noticed had descended.
posted by CharlieSue at 12:41 PM on March 9, 2011

All I can tell you is that you don't need to just find a pill that has the same active ingredients as the one you liked, but also the same amounts (or at the very least, the same proportions) of each ingredient. So the long list you give above could probably be narrowed if you can find out the more exact amounts of each of those three ingredients.

And I don't really understand why you are allergic to the generic. Is it some non-active ingredient that you are allergic to? Like the coating on the pills or something?
posted by lollusc at 11:03 PM on March 9, 2011