Is Your Oral Contraceptive The Problem?

Discussion in 'Useful info on weight loss' started by Dr James, Aug 31, 2018.

?

Does you oral contraceptive contain cytoproterone, drospirenone or dienogest

  1. Yes

    50.0%
  2. No

    50.0%
  1. Dr James

    Dr James New Member
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    What if it was something you're currently taking (your oral contraceptive) rather than something you're not taking (Duromine) that was causing your weight control issues?

    When it comes to weight loss, we all know there is a balance between energy in, and energy out and to lose weight we need to tip the balance. The routine advice is diet (eat less food for less energy in) and exercise (use more energy). If that simple advice worked well, nobody would be overweight.

    So what comprises the "energy out"? There are 2 things.
    1. Basal Metabolic Rate (BMR)
    2. Exercise
    By far the largest contributor to energy out for most people is BMR rather than exercise. So let's consider what it is. While some of your BMR is the energy required to keep your heart beating, lungs breathing, and brain thinking, most of it goes to your muscles, but not to move you. It goes to your muscles to heat you - that's why we are warm-blooded and don't have to hibernate in winter.

    So if our muscles are using most of the energy we need to heat us, what happens if we lose muscle?

    You'd be right in thinking our BMR falls, and any difference between energy in and out is reduced, so our rate of weight loss is reduced. There is a separate thread called "Protein is vital" that explains this in more detail but let's now look at the impact of certain contraceptives namely Dianne, Yaz, Yasmine, Angeliq and Valette.

    Dianne was a "miracle pill" when it came out because it provided not only contraception but also fixed pimples. It did this because rather than being a standard estrogen/progesterone blend it contained estrogen and cyproterone.

    What cyproterone does is block testosterone. Now you've probably heard of testosterone. It's your body's natural anabolic steroid. Bodybuilders (and some athletes) take it to increase muscle mass. It can cause "roid rage" and "backne". Men usually have more than women (which is why men are on average stronger and more muscular). We all have a surge of it during puberty, thus the pimples and the rapid muscle growth.

    So, if you accept that muscle mass is important to BMR and weight loss, deliberately taking a drug that blocks the key hormone that drives muscle production suddenly looks like a very bad idea for weight control.

    Yaz, Yasmine and Angeliq are similar but contain drospirenone instead of cyproterone. Valette is also similar but contains dienogest.

    Many women are put on these pills in their teens for acne, but stay on them into their 20s and 30s when they are no longer required.

    So, here is a hint. If you are on one of these pills and well past the teenage acne years, maybe you should consider moving to a standard oral contraceptive. The reasons are:
    1. Standard contraceptives (that usually contain 30 ug ethinyl estradiol and 150 ug levonorgestrel) and come in dozens of brand names are substantially cheaper
    2. Standard contraceptives are suggested to have lower rates of Deep Venous Thrombosis (particularly important in smokers)
    3. You will almost certainly find it easier to lose weight because you will rebuild some of the muscle lost to the testosterone blockade.
    If you are on one of these pills consider talking to your doctor about changing it.

    I find a disproportionate number of ladies wanting to lose weight are on these particular contraceptives, and we get much better weight loss results when they come off them.

    YMMV
     
    April likes this.
  2. April

    April Staff member
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    Thank you very much Dr. James for this valuable information!!! I really appreciate the time and effort, and I am sure that many users will be grateful to you for the insight. I edited your message and added a link to your previous article about the protein, if you don't mind, so that it's easier for the users to find it. Thanks again, hats off
     
    Bonnie13 likes this.
  3. Starlet85

    Starlet85 New Member
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    Dr James, I’m currently on Zoely, should I consider switching pills? Thank you
     
  4. Dr James

    Dr James New Member
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    Zoely does have some testosterone blocking effects, so if these are not required, and weight is a problem, it would be worth discussing a change with your doctor.

    Zoely is relatively new is relatively new, and as mentioned here (I can't place a link so Google "nps nomegestrol") https:// www. nps. org. au/australian-prescriber/articles/nomegestrol-oestradiol

    It is unclear if it (Zoely) will have any advantages over currently approved contraceptive pills, however, periods may be shorter and lighter.

    While I prefer to steer my patients to tried and tested solutions, rather than the latest thing on the market, the old adage "if it ain't broke, don't fix it" applies, so if you are on a medication, and it's working well why change?

    All medications have side effects. If you start a medication and something happens you should always ask "Is it this medication".
     
    #4 Dr James, Sep 3, 2018
    Last edited: Sep 3, 2018
    April likes this.
  5. Starlet85

    Starlet85 New Member
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    Thank you for that! I was on Levlen for many years then took a break from the pill, when I went back to the doctor they suggested this one as it was more ‘natural’ then other pills however weight is an issue for me so I’d prefer to take a pill that won’t hinder that, maybe I should stop the pill while on Duromine
     
  6. Dr James

    Dr James New Member
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    Levlen is considered 1st line and the standard one I use.

    Femme-Tab, Levlen, Microgynon, Monofemme, Nordette, Evelyn, Eleanor, Mocronelle all contain Ethinyloestradiol and Levonorgestrel and the 30/150 is the routine dose.

    This link needs the spaces removed...

    https:// www. nps. org. au /australian-prescriber/articles/choosing-a-combined-oral-contraceptive-pill
     
  7. Starlet85

    Starlet85 New Member
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    Thank you for information good to know, will staying on the pill hinder my weight loss while on duromine? Should I think about taking another break from it while I’m focused on losing weight? (I’m only on the pill to avoid pregnancy so can use alternatives)
     
    #7 Starlet85, Sep 3, 2018
    Last edited: Sep 3, 2018
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