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Old 05-14-2009, 10:39 AM
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Why do you gain weight on the pill?

This might be a really dumb question, but I really just don't understand. Is it because the hormones MAKE you hold extra weight and is therefor out of your control? Or is it that the hormones make you extra hungry and you eat more and thus gain weight? I'm trying to figure out if I want to go back on the pill, but I'm scared to gain weight. I want to know if anyone knows the science/reason behind it. Whether gaining weight on the pill is the pills direct fault that you can't really do anything about or if you follow the same diet religiously(have self control), you won't have a problem. Does that make sense? I know the pill will effect everyone differently, thats not what this is about, but rather if weight gain can be helped or is out of your control(if it happens). Thanks ladies
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Old 05-14-2009, 10:53 AM
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It's possible that someone other than a lady may also be able to answer your question.

The weight gain caused by bc pills is primarily due to the effects of estrogen in stimulating your kidney's to retain water, therefore increasing your total body water. A lower dose estrogen pill could possibly help with this or I believe there is at least one pill that contains one of the hormones that stimulates the kidney's to excrete water, but I can't remember what the name is.

Most likely there are other mechanism by which estrogen/progesterone acts to increase body weight, but this would be the main one. So to answer your main question, the weight gain is generally out of your control.
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Old 05-14-2009, 10:53 AM
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I believe the weight gain is a result of the amount of estrogen in a pill. Estrogen may cause you to retain water, have an increased appetite, and/or aid in fat storage in your body. However, from most of the reading I've done, the percentage of women who have a more than 5 lb weight gain is rare.

When I first started BC, I was on the patch and gained 15 lbs in 3 months. It freaked me out and I asked my doctor to switch me to a low-estrogen pill instead. The weight came off in about 3 weeks with minimal effort on my part. They do make low-estrogen as well as progestin-only pills, so ask your doctor about those options if you are already pretty hormonally-balanced and don't need the extra estrogen. G'luck.
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Old 05-14-2009, 10:54 AM
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Wow, Vik, I am impressed by your answer You are always super knowledgeable about health and fitness!
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Old 05-14-2009, 11:32 AM
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lol thanks
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Old 05-14-2009, 12:05 PM
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Quote:
Originally Posted by Imhotep View Post
hormones that stimulates the kidney's to excrete water, but I can't remember what the name is.
ADH?
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Old 05-14-2009, 12:35 PM
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Originally Posted by idalis View Post
ADH?
I actually meant that it was the name of the pill brand that I could not remember... possibly yasmin?

But you are probably right, I believe it is synthetic ADH that they add.

Hopefully I am remembering right and not making all of this up.
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Old 05-14-2009, 12:36 PM
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oh haha. yeah i read that totally wrong then.
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Old 05-14-2009, 12:48 PM
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OP -- you might find this link helpful

Birth Control Questions: Deciding on Oral Contraceptive Pills
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Old 05-14-2009, 01:26 PM
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Originally Posted by Imhotep View Post
The weight gain caused by bc pills is primarily due to the effects of estrogen in stimulating your kidney's to retain water, therefore increasing your total body water. A lower dose estrogen pill could possibly help with this or I believe there is at least one pill that contains one of the hormones that stimulates the kidney's to excrete water, but I can't remember what the name is.
How does the estrogen stimulates the kidneys to retain water?
I'm sorry, I fail to see the connection. I thought it influences only the brain (to maintain body temperature constant, prepares it for sexual development, etc), breast, liver (hehe, this is the best part... that's why we have lower cholesterol most of our lives and we're screwed once we rich the menopause), uterus, vagina, and the bones (helps us with bone density, see osteoporosis prevalent in post-menopausal women).

If pills would contain hormones that stimulate the kidneys to excrete water, as you pointed out, then women would not gain the water weight. Are you referring to renin? Or ADH that promotes water excretion?
Anyway, usually pills contain a combination of synthetic hormones. For example, Yasmin (which I'm on) contains drospirenone and ethinyl estradiol, first one mimics the progesterone, second one is an estrogen. I'm pretty sure there are no other hormones in there, otherwise it would be clearly stated on the package.

Casssean,
It could be a combination of factors. The hormones do influence how we deposit the fat. As Anna said, the number of women who gain more than 5lbs is pretty low.... I would also suggest talking to you doctor and/or trying a lower dose-combo of hormones.
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Old 05-14-2009, 02:58 PM
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Thankyou everyone for the replys
Anna, I'll definately check out that link, it looks like it might breakdown the pills for me to see the real differece.
I've been wanting to go back on the pill to hopefully help with my skin. I didn't even think about a lower dose or a pill without the hormones. Shows you how much I know. I'll definatly be asking my doctor about which would be best since I'm worried about gaining weight. I know 5lbs isn't much, but I've been working out a lot and eating so well, I would hate all that to be ruined by a stupid pill(since it sounds like there's not much I can do to control that if my pill makes me) Plus, I'm also petite, so any weight looks like a lot, unfortunately.
Is Yasmin the one that is without hormones? I have heard good things about that one. Although, that doesn't really mean anything, LOL.
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Old 05-14-2009, 03:42 PM
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All birth control pills contain synthetic hormones (both, progesterone and estrogen) but in different doses.
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Old 05-14-2009, 04:11 PM
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^^^
Ah yes I see...Different levels of Estrogen are what determines how much you may get in water retention(reading DarlinAnna's site). Progesterone is resposible for some women being hungrier. So you can get it with both. But at least the progesterone is somewhat in my control. I think I'll be going with something lower in Estrogen, like YAZ or Yasmin(and of course I'll talk with the doctor). I hate that pills are so scary. It's just crap all round!
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Old 05-14-2009, 04:31 PM
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Originally Posted by aluhall View Post
How does the estrogen stimulates the kidneys to retain water?
I'm sorry, I fail to see the connection. I thought it influences only the brain (to maintain body temperature constant, prepares it for sexual development, etc), breast, liver (hehe, this is the best part... that's why we have lower cholesterol most of our lives and we're screwed once we rich the menopause), uterus, vagina, and the bones (helps us with bone density, see osteoporosis prevalent in post-menopausal women).

If pills would contain hormones that stimulate the kidneys to excrete water, as you pointed out, then women would not gain the water weight. Are you referring to renin? Or ADH that promotes water excretion?
Anyway, usually pills contain a combination of synthetic hormones. For example, Yasmin (which I'm on) contains drospirenone and ethinyl estradiol, first one mimics the progesterone, second one is an estrogen. I'm pretty sure there are no other hormones in there, otherwise it would be clearly stated on the package.

Casssean,
It could be a combination of factors. The hormones do influence how we deposit the fat. As Anna said, the number of women who gain more than 5lbs is pretty low.... I would also suggest talking to you doctor and/or trying a lower dose-combo of hormones.
You're not aware of all the known effects of estrogen, which is not a terrible thing, because there are many. One of which is its effect on the renin-angiotensin system. I see you are a graduate student in the nutrition sciences, so for interest you can see PMID: 16203652.

Regarding Yasmin, it may have been the synthetic form of progesterone in it that I was thinking of. That drospirenone has antialdosterone activity, unlike other synthetic progesterone.
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Old 05-14-2009, 05:25 PM
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Wow, Vik, I am impressed by your answer You are always super knowledgeable about health and fitness!
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Old 05-14-2009, 07:30 PM
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I want to quit my birth control pills as I believe that they are the main cause of my weight gain over the past 7+ years and I suspect it links in somehow with cellulite. I mentioned it to the gyno at my last visit and she didn't advise I come off of them b/c she said the health benefits supercede all the side effects. I was consistently around 105 lbs until the beginning of Mircette and today I am at 126 lbs. The only concern that I have with quitting birth control is gaining weight b/c I accidentally got preggers!!
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Old 05-14-2009, 07:56 PM
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Originally Posted by Imhotep View Post
You're not aware of all the known effects of estrogen, which is not a terrible thing, because there are many. One of which is its effect on the renin-angiotensin system. I see you are a graduate student in the nutrition sciences, so for interest you can see PMID: 16203652.

Regarding Yasmin, it may have been the synthetic form of progesterone in it that I was thinking of. That drospirenone has antialdosterone activity, unlike other synthetic progesterone.
That's actually one of my favorite mechanisms. Lol, I know I'm weird...
Now, seriously, let me know if I'm missing something here.

-baroreceptors in the blood vessels are stimulated by the decreased blood volume
- renin is released from the kidneys, this stimulates the conversion of angiotensinogen to angiotensin I
- then angiotensin I is converted to angiotensin II which stimulates the release of aldosterone (from the adrenal cortex)
- aldosterone influences the kidney to retain sodium
- antidiuretic hormone (now it's called AVP or arginine vasopressin) is stimulated by the osmolality in the extracellular fluid and the hydrostatic pressure.

I just looked at the abstract you mentioned. They assessed the post-menopausal women, though. I'm not surprised they got low blood pressure since it's a.... sort of hormone replacement therapy and women after menopause don't produce any estrogen... therefore they're blessed with hypertension. So, of course the hormone pills are going to mimic the ones produced by the body. I hope my logic makes sense.
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Old 05-14-2009, 09:05 PM
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I want to quit my birth control pills as I believe that they are the main cause of my weight gain over the past 7+ years and I suspect it links in somehow with cellulite. I mentioned it to the gyno at my last visit and she didn't advise I come off of them b/c she said the health benefits supercede all the side effects. I was consistently around 105 lbs until the beginning of Mircette and today I am at 126 lbs. The only concern that I have with quitting birth control is gaining weight b/c I accidentally got preggers!!
^^^
Hahaha, right huh? I weigh 103lb, so i can relate. What kind or hormonal pill are you on? Is it a low does of estrogen, like 20mcgm or 30-50mcgm? Also how did it do for you skin? Why can't they have a pill where you LOSE weight.
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Old 05-14-2009, 09:12 PM
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That's actually one of my favorite mechanisms. Lol, I know I'm weird...
Now, seriously, let me know if I'm missing something here.

-baroreceptors in the blood vessels are stimulated by the decreased blood volume
- renin is released from the kidneys, this stimulates the conversion of angiotensinogen to angiotensin I
- then angiotensin I is converted to angiotensin II which stimulates the release of aldosterone (from the adrenal cortex)
- aldosterone influences the kidney to retain sodium
- antidiuretic hormone (now it's called AVP or arginine vasopressin) is stimulated by the osmolality in the extracellular fluid and the hydrostatic pressure.

I just looked at the abstract you mentioned. They assessed the post-menopausal women, though. I'm not surprised they got low blood pressure since it's a.... sort of hormone replacement therapy and women after menopause don't produce any estrogen... therefore they're blessed with hypertension. So, of course the hormone pills are going to mimic the ones produced by the body. I hope my logic makes sense.
You only really needed to read the first couple sentences of the abstract:

Progesterone has a high affinity for the mineralocorticoid receptor and is an antagonist of aldosterone. Almost all synthetic progestogens are devoid of an antimineralocorticoid effect, and are unable to antagonize the salt-retaining effect of estrogens. This property could be one cause of the weight gain and increase in blood pressure associated with the use of combined oral contraceptives and, in some susceptible women, with postmenopausal hormone replacement therapy (HRT).

I picked that abstract because it clearly states both what it terms the "salt-retaining" effect of estrogens, and also the antagonizing effect of the synthetic progresterone in yasmin, in general. I wasn't trying to show you the specific research conduced by the study.

I'm not sure why you posted that general mechanism, but all i can tell you is mechanism from textbooks arent inclusive of everything. there are almost always other factors involved that can only be known of by studying the literature. in this case, as far as i know, the mechanism isn't fully understood.


here is another abstract that may further answer your questions:

Drospirenone is a novel progestogen that possesses antimineralocorticoid activity. This activity is seen clinically in its effects on physiological parameters, body weight, general well-being and fluid-related symptoms. Clinical studies with an oral contraceptive containing 30 microg ethinylestradiol and 3 mg drospirenone (Yasmin, Schering AG, Berlin, Germany) and a new continuous combined oral hormone replacement therapy (HRT) containing 1 mg 17beta-estradiol and 2 mg drospirenone (Angeliq, Schering AG) were all designed specifically to evaluate treatment effects on body weight and cardiovascular function, both of which can be influenced by aldosterone receptor antagonism. Weight gain during traditional oral contraceptive and HRT use has been one of the main reasons for poor compliance and discontinuation. Women receiving hormone therapy with 1 mg 17beta-estradiol/2 mg drospirenone had either no weight change or a small decrease, while those receiving estradiol alone tended to increase in weight. Mean body weight after 1 year of treatment with 1 mg 17beta-estradiol/2 mg drospirenone decreased by 1.2 kg (p < 0.001). Studies using different drospirenone doses in combination with estradiol indicate that the effect on body weight is dependent on the dose of drospirenone, and that this is due to drospirenone's antimineralocorticoid activity. These data are in agreement with previous studies that compared the changes in body weight in young women receiving for 13 or 26 cycles the oral contraceptives 30 microg ethinylestradiol/3 mg drospirenone or 30 microg ethinylestradiol/150 microg desogestrel (Marvelon, Organon International); 30 microg ethinylestradiol/3 mg drospirenone had a more favorable effect on body weight, with the mean body weight remaining lower than baseline for the majority of women. A variety of physical and emotional changes have been linked to hormonal fluctuations during the menstrual cycle. Fluid retention-related symptoms, such as breast tenderness, swelling, abdominal bloating and skin changes, may affect well-being and quality of life. Improvements in these cycle-dependent disorders, together with some psychological symptoms, such as fatigue and depressive mood, are well documented with the use of 30 microg ethinylestradiol/3 mg drospirenone. Therefore, the effects of hormone therapy with 1 mg 17beta-estradiol/2 mg drospirenone on quality of life were assessed in the Women's Health Questionnaire. Significant improvements were observed in quality of life during treatment with 1 mg 17beta-estradiol/2 mg drospirenone, which also resulted in higher mean scores than estradiol alone. Improvements were mainly seen in somatic symptoms, anxiety/fears and cognitive difficulties.1 mg 17beta-estradiol/2 mg drospirenone has unique antimineralocorticoid properties, which can be attributed to drospirenone. This combination prevents salt and water retention elicited by estrogens, and thereby prevents increases in blood pressure and maintains a stable body weight. Its additional beneficial impact on premenstrual symptomatology and health-related quality of life may improve well-being and clinical tolerance.

Climacteric. 2005 Oct;8 Suppl 3:28-34.
Added benefits of drospirenone for compliance.
Foidart JM.
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Old 05-15-2009, 05:48 AM
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You only really needed to read the first couple sentences of the abstract:

Progesterone has a high affinity for the mineralocorticoid receptor and is an antagonist of aldosterone. Almost all synthetic progestogens are devoid of an antimineralocorticoid effect, and are unable to antagonize the salt-retaining effect of estrogens. This property could be one cause of the weight gain and increase in blood pressure associated with the use of combined oral contraceptives and, in some susceptible women, with postmenopausal hormone replacement therapy (HRT).

I picked that abstract because it clearly states both what it terms the "salt-retaining" effect of estrogens, and also the antagonizing effect of the synthetic progresterone in yasmin, in general. I wasn't trying to show you the specific research conduced by the study.
Got ya! Thanks for clearing that up. You're pointing out the background although I think it's important to point out if they're referring to post-menopausal, pre-menopausal, etc. women. And, if I'm not mistaken, the effects is generally minimal and don't take in consideration already present conditions and treatments.
Sorry I was taught to keep my "skeptic" hat on at all times.
Well, I'm not actually apologizing for this but I just wanted to mention that I'm not trying to be difficult here.


Quote:
I'm not sure why you posted that general mechanism, but all i can tell you is mechanism from textbooks arent inclusive of everything. there are almost always other factors involved that can only be known of by studying the literature. in this case, as far as i know, the mechanism isn't fully understood.
Agreed, I posted it because you mentioned that estrogen is involved in the mechanism and I just wanted to find out where in the mechanism it is involved exactly.


Quote:
here is another abstract that may further answer your questions:

Drospirenone is a novel progestogen that possesses antimineralocorticoid activity. This activity is seen clinically in its effects on physiological parameters, body weight, general well-being and fluid-related symptoms. Clinical studies with an oral contraceptive containing 30 microg ethinylestradiol and 3 mg drospirenone (Yasmin, Schering AG, Berlin, Germany) and a new continuous combined oral hormone replacement therapy (HRT) containing 1 mg 17beta-estradiol and 2 mg drospirenone (Angeliq, Schering AG) were all designed specifically to evaluate treatment effects on body weight and cardiovascular function, both of which can be influenced by aldosterone receptor antagonism. Weight gain during traditional oral contraceptive and HRT use has been one of the main reasons for poor compliance and discontinuation. Women receiving hormone therapy with 1 mg 17beta-estradiol/2 mg drospirenone had either no weight change or a small decrease, while those receiving estradiol alone tended to increase in weight. Mean body weight after 1 year of treatment with 1 mg 17beta-estradiol/2 mg drospirenone decreased by 1.2 kg (p < 0.001). Studies using different drospirenone doses in combination with estradiol indicate that the effect on body weight is dependent on the dose of drospirenone, and that this is due to drospirenone's antimineralocorticoid activity. These data are in agreement with previous studies that compared the changes in body weight in young women receiving for 13 or 26 cycles the oral contraceptives 30 microg ethinylestradiol/3 mg drospirenone or 30 microg ethinylestradiol/150 microg desogestrel (Marvelon, Organon International); 30 microg ethinylestradiol/3 mg drospirenone had a more favorable effect on body weight, with the mean body weight remaining lower than baseline for the majority of women. A variety of physical and emotional changes have been linked to hormonal fluctuations during the menstrual cycle. Fluid retention-related symptoms, such as breast tenderness, swelling, abdominal bloating and skin changes, may affect well-being and quality of life. Improvements in these cycle-dependent disorders, together with some psychological symptoms, such as fatigue and depressive mood, are well documented with the use of 30 microg ethinylestradiol/3 mg drospirenone. Therefore, the effects of hormone therapy with 1 mg 17beta-estradiol/2 mg drospirenone on quality of life were assessed in the Women's Health Questionnaire. Significant improvements were observed in quality of life during treatment with 1 mg 17beta-estradiol/2 mg drospirenone, which also resulted in higher mean scores than estradiol alone. Improvements were mainly seen in somatic symptoms, anxiety/fears and cognitive difficulties.1 mg 17beta-estradiol/2 mg drospirenone has unique antimineralocorticoid properties, which can be attributed to drospirenone. This combination prevents salt and water retention elicited by estrogens, and thereby prevents increases in blood pressure and maintains a stable body weight. Its additional beneficial impact on premenstrual symptomatology and health-related quality of life may improve well-being and clinical tolerance.

Climacteric. 2005 Oct;8 Suppl 3:28-34.
Added benefits of drospirenone for compliance.
Foidart JM.
I highlighted some areas as well.
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Old 05-15-2009, 09:40 AM
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^ the areas you highlighted indicate that estrogen in oral contraceptives promotes water retention, and the form of progesterone in yasmin is able to significantly negate this water retention (similar to natural progesterone)? This is what I am also trying to explain to you, no?

About the relative effect of estrogen/water retention versus other ways in which estrogen may increase body weight, i don't think there is any 100% consensus. So your skepticism is not unwarranted. There isn't a 100% consensus that oral contraceptives even increase body weight at all. But most discussion of possible mechanisms involved in this process will propose estrogen mediated water retention to be at the top of the list, this is all I am trying to say.
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Old 05-15-2009, 06:33 PM
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Correct! I do agree with you and thank you for taking me off vacation mode.

At some point I thought maybe you were aware of the mechanisms estrogen is involved in the gain weight and water retention. I was just curious where it happens and how since it never showed in my readings. But again, my studies are related only to nutrition and mostly at the molecular level.

By the way, the only birth control I ever had issues with was the patch. It wasn't because of the weight but because for a week it transformed me into this monster, my brain was way under too much estrogen-ic pressure.
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Old 05-15-2009, 08:40 PM
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Originally Posted by michelle View Post
I want to quit my birth control pills as I believe that they are the main cause of my weight gain over the past 7+ years and I suspect it links in somehow with cellulite. I mentioned it to the gyno at my last visit and she didn't advise I come off of them b/c she said the health benefits supercede all the side effects. I was consistently around 105 lbs until the beginning of Mircette and today I am at 126 lbs. The only concern that I have with quitting birth control is gaining weight b/c I accidentally got preggers!!
What did she say the health benefits of BC pills were?
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Old 05-15-2009, 11:23 PM
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What did she say the health benefits of BC pills were?
If you have endometriosis, bad pms, acne, or irregular periods those are some things the pills can help. They also help regulate your hormones if you have PCOS, but the pill causes insulin resistance which leads to worsening PCOS if you go off of them.
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Old 05-16-2009, 09:03 AM
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