If you track your weight regularly, you know how disconcerting it can be to look down at the scale and see a higher number than you were expecting. Indeed, unexplained weight gain can present a mystery that just has to be solved. Even after accounting for lifestyle factors like diet and exercise, many people wonder if certain medications might be having an impact. One category of medication that sometimes seems to be the culprit is birth control, and an example that is often cited is the birth control shot called Depo-Provera.
DR. CHRISTOPHER MCGOWAN
Dr. Christopher McGowan, MD, a leader in endobariatrics, specializes in non-surgical obesity treatments and is triple-board-certified in Internal Medicine, Gastroenterology, and Obesity Medicine. Renowned for pioneering endoscopic sleeve gastroplasty (ESG) with over 2,000 procedures, his global influence and research contributions define him as a top expert.
Facts About Birth Control
Birth control—also known as contraception—is a term that can refer to a broad range of approaches to preventing pregnancy. All methods of birth control can be divided into two basic groups: hormonal contraceptives and non-hormonal contraceptives. Non-hormonal birth control, as the name implies, prevents pregnancy without manipulating the natural hormones that the body produces in the lead-up to pregnancy. This includes options like spermicide, copper intrauterine devices (IUD), natural family planning, and physical barriers like condoms and diaphragms.
Hormonal birth control, by contrast, relies upon the critical role that hormones play in the ability for a woman to become pregnant. The ovaries are responsible for secreting both of the two main hormones that prepare the body for pregnancy during the menstrual cycle. Estrogen is released by the ovaries prior to ovulation, and progesterone is released after ovulation. Yet both hormones are involved in preparing the uterus and breasts for the possibility of fertilization. Hormonal birth control methods interrupt or inhibit the release of these hormones so that eggs can’t be fertilized.
What is Depo-Provera?
Depo-Provera is one of the brand names for a birth control medication called depot medroxyprogesterone acetate (DMPA), an injectable, hormonal contraceptive. Depo-Provera contains progestin, a synthetic version of the natural hormone progesterone. In addition to being a method of contraception, it can be used to treat endometriosis, uterine bleeding, certain types of cancer, and symptoms related to menopause. The Depo-Provera shot doesn’t contain estrogen like some birth control pills, and it must be injected every three months.
Depo-Provera works by disrupting the menstrual cycle at a hormonal level. As noted above, the ovaries naturally secrete estrogen and progesterone as a means of preparing the body for the presence of a fertilized egg. When progestin is introduced through the Depo-Provera shot, it essentially “switches off” normal hormone production. As a result, the ovaries won’t release an egg; the progestin also makes the mucosal lining of the uterus thicker, which in turn makes it harder for sperm to get through.
Possible Side Effects of Depo-Provera
One of the most common side effects of Depo-Provera is a change in symptoms related to the menstruation cycle. Normally, estrogen and progesterone produced by the ovaries cause a thickening of the uterine lining that is then shed during the bleeding phase of a period. For women on Depo-Provera, however, estrogen stops being produced by the ovaries. This can lead to having significantly less bleeding or, for some women, the uterine lining never thickens and therefore they will stop having periods. Other side effects may include:
- headaches
- abdominal pain or discomfort
- mood changes
- nervousness
- depression
- reduced libido
- tenderness in the breasts
- fluid retention or bloating
- hair loss or excessive hair growth
- changes in appetite
Does Depo-Provera Cause Weight Gain?
Most types of birth control don’t cause weight gain, but there is some evidence that the Depo-Provera shot can. One study tracked more than 700 women over three years to compare the effects of various forms of birth control. On average, the women who chose the injection saw a body weight increase of 11 pounds and a 3% increase in body fat. By comparison, the women who chose other forms of contraception went up only 3-4 pounds in body weight and around 1% in body fat.
More research is needed to explore this question further, but there definitely are some women who have experienced weight gain with the Depo-Provera injection. It is not currently known why it only affects some women in this way or even the precise mechanism that causes the actual gain. One theory is that the higher amount of progestin compared to other hormonal methods reduces metabolic activity at the same time as increasing appetite. Some weight gain may also be temporary and largely due to fluid retention.
In the same study of 700 women noted above, the researchers also tracked what happened after women stopped taking Depo-Provera. Women who switched to oral contraceptives actually gained 3 pounds over the course of two years while women who switched to non-hormonal methods lost 3 pounds. So while it’s still not fully clear if or in what way Depo-Provera causes weight gain, it can at least be said that it does cause weight gain for some people. It also seems likely that other hormonal methods that contain progestin might have a similar effect.
Can Weight Gain Be Prevented?
Healthcare providers who prescribe Depo-Provera often recommend making changes to diet and physical activity levels as a way to compensate for any weight gain. While this works for some people and is beneficial for overall health, there is some evidence that weight gain from the contraceptive injection might be resistant to such changes. In one study that recorded calorie and nutrient intake, the women on average still gained weight even though they stuck to a regimented diet. These results lend credence to the proposed impact on metabolic activity.
Finding Long-Term Weight Loss
Women who experience weight gain from getting the Depo-Provera shot can consider switching to a non-hormonal method of birth control. It may prevent further gain and even cause the loss of a few pounds. But for many people, that won’t really get them the freedom they seek. Regardless of the cause of weight gain, it’s hard to lose it, especially with restrictive diets or punishing exercise plans; these methods are rarely sustainable and the weight often comes back.
At True You Weight Loss, we understand the challenges of trying to lose weight, and we want to help you start a new journey with a different approach. One example is a gastric balloon. In this non-surgical procedure, a deflated silicone balloon is placed in the stomach by endoscope. It is then filled with an inert saline solution until it takes up a significant portion of stomach space. This reduction in stomach volume helps you eat fewer calories and feel full faster so that you’ll eventually be in a calorie deficit. If you’d like to learn more about gastric balloons or any of our other weight loss solutions, please contact us today to request a consultation. Freedom is waiting!
