How does the birth control pill affect your weight, exercise and nutrition (assuming youre a woman if youre a dude, I hope youre not taking birth control pills )? Thats what well talk about in this article.

            After all, there are a lot of myths and misconceptions about the pill, and a good number of women are taking it, but not knowing how it affects their body. Well talk about that here. What we wont talk about is whether or not you should be using the pill. Im a fitness professional. Not a doctor or a pharmacist. If you want to know whether or not you should be using it, ask a doctor or pharmacist.

            If you want help improving your fitness, your mood, and more, we have a specific program for women with all kinds of hormonal profiles, called Fit and Feminine. If youd like to learn more about this program, and if its something youd like to participate in, just email me with the words Fit and Feminine in the subject line.

            But before we get there, we should first talk about why birth control pills are used in the first place.  

Image result for woman taking birth control

         

Reasons to Use Birth Control

            The original reason oral contraceptives (birth control pills) were invented was the obvious to prevent unwanted pregnancies. The way it did that is by tricking the body into thinking its already pregnant, by raising progesterone levels.

            Then, researchers saw that for some women, it helped regulate their periods. For others, it improved skin quality, etc.

            So nowadays, a lot of women are using the birth control pill for reasons other than contraception.

Hormonal Regulation

            As noted in the previous section, one of the main reasons women these days use the birth control pill is because before, they were having very difficult periods:

  • They would get debilitating cramping, to the point where they would have to take time off work/school, stay in bed all day, and take painkillers.
  • Some were getting depression during their periods
  • Some women bleed more than theyre supposed to, which decreases their iron levels, and with that, their energy plummets
  • Some women got acne or oily skin

and other nasty symptoms.

            And because of these, they turn to the pill for a quick fix. However, I believe that its important to look for the underlying causes of these hormonal issues. A huuuuugggeee chunk of hormonal dysregulation in women is due to only 2 reasons (there are others, but these 2 will cover the vast majority of bases):

  1. Stress
  2. Xenoestrogens (foreign/environmental estrogens) and other endocrine disruptors.

Since this is not an article specifically on those 2 issues (Ive written other articles about them), Ill just make a few brief suggestions.

Stress

            Of course, theres mental/emotional stress, and if you want to learn how to deal with it, you can read my article, that gives you 7 stress management strategies.

            The other big source of stress is poor sleep. Study after study repeatedly finds that the less sleep women get, the more menstrual problems theyll have.

            Are you now patting yourself on the back, thinking I get 7-9 hours of sleep. Im good. Not so fast. Its not just the total quantity of sleep its also when you go to sleep. If youre a night owl, and get your hours later in the night (and a good chunk of the morning), compared to earlier, one study found that youre 200% more likely to have difficult periods compared to if you sleep the right amount, at the right time. So its better to get your sleep from say 10/11PM until 6/7AM, than from 1AM-9AM.

Xenoestrogens and Other Endocrine Disruptors

            Xenoestrogens are foreign/environmental estrogens. In other words, they are chemically very similar to estrogen, but theyre not estrogen. So they can have 2 possible effects:

  • They can block the effect of real estrogen
  • They can amplify the effect of real estrogen, so you have too much estrogen in your body

Xenoestrogens have names like phthalates, parabens and bisphenol A.

Endocrine disruptors is a broader term that refers to other chemicals that can alter other hormones, like testosterone, progesterone, thyroid, etc.

            Ya know how I like to throw around studies? Well, I dont have any for this one yet. Ill put it right out there to say there are no studies yet backing up endocrine disruptors/xenoestrogens with menstrual cycle irregularities/PMS. But theres a difference between unproven and disproven. Unproven means we dont know. Disproven means we know. It doesnt work.

            So although there are no studies on this (again, yet), a lot of experts believe that these chemicals are responsible at least in some part for difficult menstrual cycles. And there is mechanistic evidence to indicate that it makes sense.

            What can you do about it? Head on over to https://www.ewg.org/skindeep/ (thats the website of the environmental working group). Start typing in your personal care items, skin lotions, cosmetics, and household cleaning items, etc. This database will tell you how toxic (or non-toxic) your current product is, and recommend less toxic alternatives.

            Women often find their periods get easier within 2-3 cycles of switching their items.

The Challenges with Writing About the Birth Control Pill

            There are certain challenges with writing about the pill. Namely, that theres more than 1 pill.

            When the pill first came out, in 1960, it really was just a single pill. So when you said the pill in 1960, you knew what that meant.

            Eventually, this first generation pill was phased out due to negative health consequences among them, weight gain. And thats why to this day, birth control pills have a bad rap for weight gain even though modern-day oral contraceptives dont really have that effect anymore. But well talk about that later.

            The second-generation pill came out in the 1970s, and some of them are still in use today. I believe that the most popular one would be Tri-Cyclen. This generation contained much lower amounts of estrogen and progesterone.

            The third-generation pill came out in the 1980s, which had different ratios of estrogen to progesterone, and used different progestins (the term progestin means synthetic progesterone) and estrogens.

            The fourth-generation pill is the one most in favour now (although second and third generations are still in use), and probably the most popular one is Yasmin (which is not the same as Yaz another popular birth control pill).

            So the 2nd, 3rd, and 4th generations have more than 1 pill. For instance, although Yasmin is a pill used in the fourth generation, its not the only pill. There are others.

            And all these pills vary based on:

  • The amount of estrogen and progestins used
  • The ratio of them relative to each other
  • The type of progestin used (theres more than 1 type)

Hence the challenge with writing about the pill generically there are a lot of pills all known as the pill.

To cover all bases, a book would need to be written. However, Ill write as specifically as I can in this article, and youll have to forgive me where I group them into 1 category.

Does Being on the Pill Make it Harder to Lose Weight?

            This is the most common question Im asked in regards to the pill. The reason that this question is often asked is because first-generation oral contraceptives certainly caused weight gain.

            And one birth control method (an injection, not a pill) also causes weight gain in a large number of women who take it: Depo-Provera. But again, this isnt a pill.

            Heck, one type of birth control pill even has a tendency towards weight loss, according to this study.

            Other than that, the majority of studies show no long-term increases in weight with 2nd, 3rd, and 4th generation oral contraceptives. However, thats not to say there arent short-term increases in weight. Thats an effect that does occur, but thats usually water weight, and will go away in a few weeks, or a month or two.

            Now, I know some ladies reading this will protest: hey, I gained more than 10 pounds when I started the birth control pill years ago, and it hasnt gone away since. This is usually the minority, but it does happen. Why? A few possible explanations:

  1. It might not affect your metabolism, but it might give you cravings. So now youre eating more.
  2. If a woman started taking birth control in her teens, she would have gained weight anyway (with the pill or without), because shes growing and maturing. Even if shes reached her full adult height, muscle mass and bone mass keep growing until about age 25-30, albeit, not very quickly.
  3. Emotional eating. Youre taking hormones, and among the many things hormones regulate is your emotions. Perhaps youre more emotional than you were before you started using the pill, and youre turning to food.

So yes, there is a minority of women who do gain weight on modern-day birth control pills. About 1 in 4 women has a propensity for weight gain on the birth control pill. Also, women who were previously overweight can tend to gain weight when they get on the pill, largely due to the mechanisms mentioned above.

What can you do if youre in the minority of women who does tend to gain weight on the pill? A couple things:

  1. Consider what youre using it for actual contraception, or hormonal regulation? If youre using it for contraception, consider non-hormonal methods instead, like condoms, or IUDs. If youre using it for hormonal regulation, start there. Get your hormones tested, and use exercise, nutrition, supplementation, sleep, and stress management strategies to help.
  2. Speak to your doctor or pharmacist about using another birth control pill, with a different ratio of estrogen to progestin.

Does Birth Control Change Your Body Shape?

            We know that on average, body fat percentage doesnt change, but does your body shape change? Do you change where you store your body fat? After all, Ive written extensively, and its one of the most popular talking points in my TV interviews, about how the location of your body fat tells us about your hormonal profile.

            So since the birth control pill does change your hormonal profile, does it also change where you store your body fat? Is there a redistribution?

            Although Im not aware of any research that directly answers this question, I would be tempted to say that it depends on a womans hormonal profile to begin with.

            If she was pear-shaped (bottom-heavy), birth control is unlikely to change the location of her body fat.

            However, if she had more of an apple shape (stored more fat in the belly than the thighs), then birth control is likely to shift the location of the fat from the belly to the buns and thighs, although I would venture to say that even that depends on the estrogen to progestin ratio in the specific pill shes using.

Does Birth Control Affect Muscle Gain?

            The jury is out on this one. One study has found that women taking oral contraceptives actually increased muscle mass by 3% more than women who werent taking them (this is over a 10-week period). However, another study found the opposite: women on oral contraceptives gained 60% less muscle than women not on oral contraceptives.

            Usually differences in studies can be attributed to a few different factors, like:

  • Training status of the subjects (trained vs. untrained)
  • Ages: young vs. older
  • Type of exercise
  • Type of oral contraceptive

and more.

            I wish I had a clear answer, like birth control definitely increases muscle mass or birth control definitely decreases muscle mass. But unfortunately, in this situation, I have to give the intellectually-honest, but unsatisfying answer of more research is necessary.

Exercise and Nutrition While on Birth Control   

            Now you know what happens to the body when you use birth control. So the big question is so what? How does that affect my exercise and nutrition? Thats what well cover in the next section.

Exercise

            In an article I wrote a while back, about the key biochemical differences between men and women, I mentioned that womens performance between the follicular phase and the luteal phase can vary from a little bit, to a lot. In my own practice, Ive seen womens strength vary by as much as 40% between the two phases. So one day, a female client might be kicking butt with a 100-pound weight, and just 2 weeks later, she may be struggling with 60.

            Because birth control decreases the differences between the follicular and luteal phases, strength either doesnt vary as much, or at all between cycles, so your lifting can be more consistent.

            However, women not on the birth control pill are at a higher risk of injuries during the luteal phase of the cycle, because along with progesterone, the body releases another hormone called elastin, which loosens ligaments. Loose ligaments are a recipe for injury.

            The minor preliminary evidence that does exist suggests that the birth control pill decreases the risk of injury. Yay! But if I may put in my 2 cents: again, research talks about the pill as if theres just 1. As you read in the section earlier, there are a bunch of different birth control pills. So its possible that one pill that raises estrogen more than progesterone would decrease risk of injury, whereas another pill that raises progesterone more than estrogen would increase risk of injury. Again, this is just my opinion, and not backed by research, so take it for what its worth.

For the most part, second-generation birth control pills (the most common ones are probably Alesse and Aviane) give you a progesterone-dominant state, and 3rd and 4th generation birth control pills (the most popular ones are probably Tri-Cyclen, Yaz and Yasmin) give you an estrogen-dominant state.

            In my opinion, if you are on a pill that gives you a progesterone-dominant state, it is prudent to avoid super heavy weights (anything you cant lift at least 5 times), and extensive stretching (like yoga), because your risk of injury is higher. However, if youre on a pill that gives you an estrogen-dominant state, do whatever you like.

Nutrition

            Regardless of the kind of pill that a woman is on, the basics are the same:

  • Calories
  • Protein (somewhere between 1.2-2.2 grams/kg/day)

The only difference is the carb-to-fat ratio.

            According to The Womens Book, by Lyle McDonald, if a woman is progesterone-dominant, she should be consuming 35% of her calories from fat (whatever remains after protein and fat requirements are met can be made of carbs). If shes estrogen-dominant, she should be consuming 25% of her calories from fat (yay! More carbs ).

Supplements

            Some women actually report that although their periods are better on oral contraceptives, now, they have depressive symptoms, whereas before, they didnt. Thats because certain birth control pills cause depletions of certain nutrients. One study compared the nutritional profiles of women using oral contraceptives to those of women not using them, and they found different nutrient depletions:

  • Magnesium
  • Vitamins B1, B2, B3, B6, B12
  • Zinc

This study concluded that the possibility to prevent vitamin and mineral deficiencies by taking appropriate dietary supplements should be considered a first-line approach by clinicians.

The symptoms of low magnesium, B6 and B12 often overlap with symptoms of depression, and when nutrient deficiencies are corrected, so are depressive symptoms. So it probably makes sense for women on birth control to supplement with these nutrients. Or, if you want to really be sure youre deficient in them, you can run blood tests for these vitamins and minerals.

If you think that all of this is extremely complicated, boy, are you right. Thats why we make a living at this, because were fitness professionals who work with this stuff every day. We help translate all this complicated physiology into precise, easy-to-follow action steps. These action steps are designed to get you:

  • Leaner
  • Stronger
  • More energetic

 We have a specific program for women with all kinds of hormonal profiles, called Fit and Feminine. If youd like to learn more about this program, and if its something youd like to participate in, just email me with the words Fit and Feminine in the subject line.