Do IUDs cause weight gain? Examine the potential side effects of the Liletta IUD, including weight changes, and learn how this contraceptive option may impact your body.

Exploring the Potential Link Between IUDs and Weight Gain

The potential connection between intrauterine devices (IUDs) and weight gain is a topic of ongoing discussion and research. IUDs, such as the Liletta, are a popular form of long-acting reversible contraception (LARC) that provide effective pregnancy prevention for an extended period. However, some users have reported experiencing weight changes after IUD insertion, leading to concerns about potential side effects.

Understanding the Liletta IUD

Liletta is a hormonal IUD that contains the active ingredient levonorgestrel, a synthetic progestin. It is designed to prevent pregnancy for up to 7 years. The Liletta IUD works by thickening the cervical mucus, thinning the uterine lining, and inhibiting sperm movement, effectively preventing fertilization.

Examining Liletta Side Effects and Weight Gain

While the Liletta IUD is generally well-tolerated, some users have reported experiencing weight changes, including weight gain, as a potential side effect. The available research on this topic, however, presents a mixed picture.

What the Research Says

Studies on the relationship between IUDs and weight gain have yielded varying results. Some research has found no significant association between IUD use and weight changes, while other studies have suggested a small, but statistically significant, increase in weight among IUD users compared to non-users.

It’s important to note that weight fluctuations can be influenced by a variety of factors, including individual metabolism, lifestyle, and overall health. The potential impact of the Liletta IUD on weight may be modest and can vary from person to person.

Factors to Consider

When evaluating the potential for weight gain with the Liletta IUD, it’s essential to consider the following factors:

Hormonal Changes

The Liletta IUD releases a low, continuous dose of the progestin hormone levonorgestrel. While progestin-based contraceptives are not typically associated with significant weight gain, some individuals may be more sensitive to hormonal fluctuations, which could contribute to changes in weight.

Individual Physiology

The way an individual’s body responds to the Liletta IUD can vary greatly. Some users may experience minimal or no weight changes, while others may notice a slight increase or decrease in weight. Factors such as metabolism, overall health, and lifestyle can all play a role in how the body reacts to the IUD.

Existing Conditions

Preexisting medical conditions, such as thyroid disorders or polycystic ovary syndrome (PCOS), may influence an individual’s susceptibility to weight changes with the Liletta IUD. It’s essential to discuss any underlying health concerns with a healthcare provider before considering this contraceptive option.

Managing Potential Weight Gain

If you experience weight changes after the insertion of the Liletta IUD, there are several steps you can take to manage the issue:

Communicate with Your Healthcare Provider

Discuss any weight changes or other side effects you are experiencing with your healthcare provider. They can help you determine if the IUD is the cause and provide guidance on appropriate management strategies.

Monitor Your Weight and Health

Regularly track your weight and overall well-being, noting any significant changes. This information can help you and your healthcare provider make informed decisions about the continued use of the Liletta IUD.

Adopt Healthy Lifestyle Habits

Maintaining a balanced diet and regular exercise routine can help mitigate potential weight fluctuations, regardless of the contraceptive method used. Adopting healthy lifestyle habits can contribute to overall well-being and help manage any weight-related concerns.

Weighing the Pros and Cons

When considering the Liletta IUD, it’s essential to weigh the potential benefits and drawbacks, including the possibility of weight gain. While the research on this topic is inconclusive, it’s important to discuss your concerns with a healthcare provider and make an informed decision that aligns with your individual needs and preferences.

Conclusion

The potential link between the Liletta IUD and weight gain is a complex and nuanced issue. While some users have reported experiencing weight changes, the research on this topic is mixed, and individual responses can vary. By understanding the factors involved and working closely with a healthcare provider, you can make an informed decision about whether the Liletta IUD is the right contraceptive choice for you.

Effectiveness, Ease of Use, and Satisfaction

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Most voted positive review

10 People found this comment helpful

Had it inserted one week ago. I recommend taking max Aleve dosage prior. I only took tylenol (which I think does a poor job). I was incredibly anxious so I held a nurses hand during procedure. Was not comfortable but wasn’t the worst I’ve felt. Measuring the cervix was worse than insertuon for me. Focus on breathing to help your muscles relax.After a minute or two I was able sit up, walk and drive…

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3 People found this comment helpful

I got the Liletta inserted about a month and a half ago. I am seriously considering having it removed. I was on the pill for 2 years and never had a problem except when my provider changed or if I would miss a day. The liletta was the most painful experience I have ever felt physically ( I have lots of piercings and several tattoos) I had always thought I had a high pain tolerance so I went into t…

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Overall rating 2.0

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Where to begin .. started looking around at IUD options because I am extremely fertile and have gotten pregnant multiple times from forgetting to take a pill every now and then. I was leaning towards the Paraguard but was worried bc I am anemic from blood loss from a miscarriage that I had a few months back and heard that one can cause heavy bleeding, so the doctors at the clinic convinced me to get this. Worst decision of my life. I told them that I get migraines and have EXTREME sensitivity to hormone changes a week before my period, but they assured me this IUD would help. Let me tell you, it absolutely did not help. I have only had it for a month and have felt like I’m having a panic attack every day for about 7 days now. My mood swings were horrific. I can’t leave the house or function without taking Xanax. I’m so dizzy, and I have chest pains. Now, I will say that I already have anxiety that I take medication for daily, but it is NOTHING like how I have been feeling. I also have been getting horrible shooting pains from my hip down my thigh to a little passed my knee since insertion. I literally Googled how to remove it at home and pulled it out myself two days ago because I couldn’t get in to the doctor soon enough. I still feel terrible, but the pain in my leg is gone for now. I hope the panic attacks and dizziness subside soon. If you have any slight bit of anxiety, don’t get this. I’d literally rather stop having sex than deal with this horrible IUD! Read More Read Less

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Overall rating 1.0

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So it’s only been 4 days since I got the liletta and I can say since the 1st day it’s been horrible. The insertion wasn’t that bad but 20mins after leaving the clinic I had very bad cramps. The 2nd day cramps and a bad headache. 3rd dizziness and horrible back pain. Now day 4 horrible back pain with intense cramps. I will be calling my doctor 1st thing in the am to get this removed.

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Overall rating 3.7

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I had this inserted in February 2021, and first off VERY PAINFUL, so much so that I was extremely nauseous it was so hard to drive because of it. I have noticed that I randomly get cramps or pain. My periods haven’t been regular since the death of my mom and boyfriend in 2017, I do occasionally spot or bleed a little. Over the last year my acne has gotten so bad, I’m breaking out in places I’ve never broken out before. One thing tho is during sex when my boyfriend hits my wall or whatever,, it really hurts and can feel it.My weight hasn’t been affected and haven’t really noticed a difference or changes with anything else. I know everyones bodies react differently. I’ve never had an iud before and reading these reviews I’m really surprised there have been so many women who have had so many negative side effects. I have been on the patch, shot, and the pill. Overall it’s not the worst birth control but I am definitely never getting another iud again I am definitely going back to the pill once it’s time to take this out. Read More Read Less

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Overall rating 3.7

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After having my firstborn, I had the Mirena for in for 4yrs but removed it to have our 2nd baby. After my 2nd I had the Mirena again. I loved it. After years with it, it was time to get it replaced but my insurance stopped covering it so I was given Liletta. It has been almost 2.5 yrs & I hate the side effects. I haven’t had a period in 1.5 yrs but I still get the horrible cramps every month. I have gained over 30lbs & have the worse mood swings. My sex drive decreased tremendously. I have had headaches that last for days & won’t go away with meds. It does prevent pregnancy but side effects are ridiculous. I have scheduled my appt for removal. Do your research before choosing LILETTA.Read More Read Less

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Overall rating 5.0

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I got the liletta inserted at 19 after not really liking the pill or the DEPO shot. (Didn’t have bad side effects just wasn’t convenient) I was nervous about it because the nurse told me that it would hurt since I hadn’t had children. The insertion went just fine. The measuring hurt more that the insertion but all together it felt like a bad cramp. I helped to just breathe through it. Afterwards I felt a little weird but didn’t really have much cramping. After that day I didn’t have any issues with it. I loved it simply because I didn’t have to worry about going to the pharmacy or the doctor. I had it for a little over a year and had to have the strings trimmed once. Overall it was fantastic for me but everyone is different. I recently had it removed to try for a baby.Read More Read Less

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Overall rating 2.0

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I had the Mirena IUD for 8 years. Insertion was so painful I put off getting my IUD replaced. My doctor had to put me under to switch (Mirena to Liletta) and I still experienced intense pain (I have a high pain tolerance – covered in tattoos/piercings). I’m 31, no kids. I’ve had Liletta for 2 mo, & I REALLY want to go back to Mirena. My sex drive has decreased. My husband has to work extra hard to get me in the mood, and I can enjoy it sometimes, but in general sex feels like a chore. I’ve gained around 15 pounds (112 to 127ish), with the majority of that coming within the first couple weeks. I’m bloated, don’t fit into my clothes, and struggle to get stretchy exercise clothes on. My fingers and feet swell. The BIGGEST/WORST side effect(s) are the MOOD SWINGS. I’ve always struggled w anxiety, but now there’s so many ups/downs, I don’t recognize myself. Crying all the time & emotional. LOW ENERGY. Acne is about the same (mild adult acne). One positive: prevents pregnancy.Read More Read Less

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Overall rating 3.3

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I switched to this IUD due to concern over the pill not being as effective since I have digestive issues. My OB/GYN also recommended it to help with random spotting. The insertion was very painful and made me nauseous. I’ve had no children. The good thing is it wasn’t long-lasting pain, for me. I stopped getting regular periods, but, I get a lot of spotting at random, at times, heavier than others. It did not help with my bleeding between periods, it actually made it worse. This is after the time it is supposed to stop. I’d rather have one week of bleeding and cramps every month than have more days than not of spotting. There are also random days of cramps/pain. My insurance covered the insertion free of charge, but, they want you to get an ultrasound to check it afterwards, which I was not told beforehand, and that was not fully covered, of course. I would not get this again. It might work well for others, but, it doesn’t work for me. And, hearing about women still getting pregnant despite the claim it’s basically impossible also puts me off. Wasn’t worth it.Read More Read Less

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Overall rating 1.0

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So liletta has been an absolute nightmare. After having two children I picked an iud for my first birth control ever. The insertion was terrible, I bled for about a month after. Now a year and a half later it’s horrible. The cramps are awful without even being on my period, I’ve gained almost 30 pounds within a few months, my acne is so bad, and I can’t have sexual intercourse without being in pain during and bleeding after. After intercourse the cramps are the most intense and most painful. My mood swings are absolutely terrible, makes you feel bipolar when you’re not. I’m definitely getting mine removed, also DO NOT RECOMMEND!!!Read More Read Less

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Overall rating 2.3

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Been 2 years with it and taking it OUT! I have gained more than 20 pounds, have anxiety that started as intense panic attacks, now I’m just anxious. Acne, hair, hormonal changes.
I had Mirena previously, I got pregnant with it so I thought to give something else a shot but oh boy, this is bad.
I will give the NuvaRing a shot if not back to Myrena.

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Overall rating 2.7

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I got Liletta in May of this year, mainly to stop having periods, which my experience has been quite the opposite. This is my first IUD. The insertion was interesting. Not a sharp pain, but a strong weird sensation, I ended up holding a nurses hand to get through it, but after I felt fine.
I bled for a few weeks straight after and since then my periods have been irregular and last at least 10 days. The last couple of months I’ve only had a week of no bleeding between these periods… and its getting to be super annoying. Not why I got it in the first place.
I’m committed to giving it a year, but if my periods don’t go away by then, I will look into something else. I was on a pill form of progesterone for a couple years and never had a period, may go back to that if this keeps up. Read More Read Less

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Overall rating 3.7

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Okay so, I’ve only had liletta in for a few days so I can’t guarantee any of these side effects will stick, but so far it’s been a little “meh.” Although the insertion itself was not terrible, it was uncomfortable, and almost 10 minutes after the insertion I almost fainted. So far I have not had any unusual mood swings, weight gain, or acne related to this (then again, it’s only been about 4 days. ) Cramps weren’t so bad, a little uncomfortable, but barely there. My biggest issue with this is nausea. I do not want to eat; I have to force feed myself or else I probably wouldn’t eat anything at all. I’m hoping this nausea goes away in time, but for right now it’s a bit intolerable. The other side effect I’ve been having is insomnia, I can’t sleep right for the life of me (but maybe that’s just my anxiety kicking in.) Regardless, this isn’t such a bad IUD, and everyone works differently, so if you’re willing, give it a try. Liletta has one of the higher dosages of progestin, so hopefully my body gets used to this. Read More Read Less

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Overall rating 1.0

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In August 3rd I got liletta put in. My doctor did a excellent job putting it in it pinch for 1 second. when I got up I felt a little light headed but went away after a few min when I left the clinic started to feel my boobs tender and cramps. But as the days went by man been having bad mood swings, headache that don’t go away even taking Advil gane 2 pound I feel swollen and a little depressed what gets to me is that many years ago I tried different pills and had bad side effects and I told him why I had to stop he recommended liletta and now when I see him in a few days going to ask to get it removed asap! Not worth it please do your research on it Read More Read Less

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Overall rating 2.0

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As I know everyone is different, I tried not to let the reviews deter me. First, my doctor said it was the exact same as Mirena, and oh was that farrrr from the truth. Within a month of insertion, I gained 15 pounds very rapidly- so fast that I have stretch marks on my back from it. While continuing to gain weight no matter how much I worked out and how well I ate, I began very very horrible spouts of bloating and gas – did not matter what I ate. The bloating would be so painful I could not walk, and made me look 5 months pregnant and would follow with terrible gas. The breast pain was 1000/10 painful, they also grew so much that they were constantly throbbing and swollen to the touch. I have also never had acne in my life, and found myself with terrible cystic acne after a few months. Mentally, I was now ridden with anxiety, and felt so depressed that I could not bring myself to do much of anything anymore. Since I had Mirena for 5 years (made my period go away) and instantly got this inserted after it was out, I never got a period- but these side effects sent me over the edge to get it removed after 7 months (ultimately gained 20 pounds) I have since switched to the pill, and after being off this IUD, I have had no bloating, weight has already decreased, breasts are smaller, and I am feeling like myself again!!Read More Read Less

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I got this and getting it out only after a month. … it’s not for everyone.

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Overall rating 3.0

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I got my Liletta iud inserted in 02/2021. The insertion was extremely painful, and I felt really lightheaded for about 10 mins afterward. The cramps afterwards were manageable with OTC medicines and were gone by the next day. For the next 8-9 months straight, I had period bleeding. Here and there I would have one day without spotting for some reason. I couldn’t even tell when I was having my actual period anymore which was concerning. Around month 10, the bleeding started to lessen. However I still have a little spotting every day, and it’s a little easier to tell when I’m on my period. I also now experience worse cramps before my periods. Liletta worked with not getting me pregnant but I’m getting it removed in a few months because the side effects were extreme. Read More Read Less

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Overall rating 4.0

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After insertion, I had severe cramping and bleeding for over 2 months. Debated on removal but was scared to go through the pain again after the painful insertion. Had no issues with it since except when having intercourse I can feel it when my partner hits it and it is uncomfortable. My hormonal acne has been better since having it inserted.

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I suffered from severe allergic reactions for 2 years after getting this iud after I gave birth to my first born. It took along time to pin point it to my iud. I now suffer from severe allergic reactions from everything. The iud has permanently damaged my body. It gave me anaphylaxis, anjiodimia, and drug reactions on my skin and after the removal of the iud i still suffer from allergic reactions to my own progesterone now

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Overall rating 2.3

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I won’t lie…I hate Liletta. The insertion literally had me in tears! The cramps after had me in tears! I bled for what felt like forever after the insertion. My period is finally beginning to regulate, but leading up to it I feel crappy. I’ve always gotten headaches, but now my back hurts, I’m nauseous and my poor nipples are tender as hell! Don’t get me started on the BV! AND the strings poke my partner but the doctor claims that’s fine??. 10/10 would not recommend! This is ghetto!

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Overall rating 2.7

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I hate Liletta!!! I have never written a review like this ever, but I had the Mirena for years with no problems. I got a new OBGYN and she suggested getting a Liletta and it has been legit the worst!!!! With the Mirena, my periods still came like clockwork, but very light periods—maybe 3-4 days max. With Liletta, I have had it in for two years now and my periods usually last about 11 or 12 days and my cycle varies anywhere from 18 to 40 days. It is a nightmare!! I hate it so much. If you’ve had success with Mirena, stick with it. Liletta is the worst!!!!!Read More Read Less

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Overall rating 4.3

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I went on this IUD to treat my heavy flow and for contraceptive purposes. It does its job, but I get nauseous really easily on this IUD. To be fair, the minipill gave me the same side effect, so I think that’s just how my body reacts to progestin. Despite the nausea, this IUD doesn’t give me any mood swings, so I can tolerate it.

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Do IUDs Cause Weight Gain?

IUDs have not been shown to cause weight gain. Learn why your weight may change with an IUD.

Like all medications, birth control can have side effects. They’re important to consider when choosing the method that’s right for you. Birth control side effects may include acne, breakthrough bleeding, mood changes, and more. Weight gain is a concern among women choosing birth control, but it’s a common misconception that IUDs cause weight gain. To answer some frequently asked questions about IUD weight gain, we talked to Christina Madison, PharmD, FCCP, BCACP, AAHIVP, founder of The Public Health Pharmacist and clinical researcher of women’s health.

What is an IUD?

An IUD, or intrauterine device, is a small, T-shaped plastic device placed in the uterus to prevent pregnancy. With less than a 1% risk of pregnancy each year, IUDs are the most effective form of birth control available. IUDs are a great choice for those who often forget to take their daily birth control pills. After insertion, an IUD lasts anywhere from three to 12 years. It can be used by women of all ages, according to the CDC. They are also a reversible contraception option, allowing you to go back to regular fertility once your IUD is removed.

There are two types of IUD products: copper and hormonal. While both are effective in preventing pregnancy, there are some key differences to keep in mind. 

RELATED: How does IUD birth control work?

Copper IUDs

Copper IUDs are hormone-free. They use plastic and copper coils instead of levonorgestrel. Copper is a natural spermicide, killing sperm before it can reach an egg. Copper IUDs, like ParaGard, can be used for up to 12 years.

Hormonal IUDs

Sometimes referred to as intrauterine systems, hormonal IUDs release small amounts of a progestin hormone called levonorgestrel into the uterus, which prevents sperm from reaching and fertilizing an egg. These IUDs can last anywhere from three to eight years. 

One of the most common hormonal IUD brands is Mirena, manufactured by Bayer. Mirena prevents pregnancy for up to five years but may remain effective for up to eight years. 

The cost of Mirena varies, but Bayer recently reported that 95% of women are covered with little to no out-of-pocket costs. The list price of Mirena is $1,410, which comes out to about $15 per month over eight years. If your insurance doesn’t cover it, there are Mirena coupons available. 

Other common brands include Skyla, Liletta, and Kyleena. Each hormonal IUD brand is different, so be sure to consult with your OB-GYN on which is right for you.

RELATED: What is Mirena? | What is Skyla? | What is Liletta? | What is Kyleena?

What are the side effects of an IUD?

Both hormonal and copper IUDs do much more than just preventing pregnancy. For example, Mirena treats heavy bleeding, which benefits those who experience endometriosis-related pain. ParaGard, the copper IUD, is also used as an emergency contraceptive since it begins working immediately.

Side effects of intrauterine dosage forms, like the Mirena IUD, are typically less severe than those seen with oral contraceptives, according to Dr. Madison.

While IUDs are 99% effective, there are some common side effects that include:

• Cramping and back pain after placement
• Irregular bleeding and spotting
• Irregular periods, which may become lighter or even stop
• Ovarian cysts, which usually disappear
• Heavy menstrual bleeding or longer periods with copper IUDs

Rare, but serious, side effects of IUDs include:

• Potential risk of pelvic infection within 20 days after insertion
• The IUD slipping or moving, which will need to be taken out by a professional
• Expulsion of the device from the uterus

Mirena side effects

Possible side effects of IUDs vary from patient to patient. Side effects may also depend on the type of IUD used. The Mirena IUD may have additional, hormone-based side effects, such as:

• Headaches
• Acne
• Breast tenderness
• Mood swings
• Nausea
• Fatigue

Since Mirena and other hormonal IUDs use the progestin hormone instead of estrogen, some patients may experience weight gain or hair loss due to lower estrogen levels. However, these side effects are uncommon and may be related to a number of other health issues, such as stress or other illnesses.

 “Benefits of using these highly effective and long-acting products outweigh the risk of potential side effects,” says Dr. Madison, but make sure to consult with your doctor to determine if an IUD is the right option for you.

RELATED: Mirena alternatives

IUD weight gain

The majority of IUD users do not experience weight gain. Copper, non-hormonal IUDs do not cause weight gain, whereas about 5% of patients using hormonal IUDs report weight gain. Since Mirena is a hormonal IUD, Mirena weight gain is possible, but unlikely.

“The perception of weight gain from these products is widely thought of, but has not been substantiated,” says Dr. Madison. “There was no difference in body weight or composition seen among [IUD] products after 12 months of continuous use.” While you may have some weight gain after getting your IUD, it should subside.

Weight gain can happen with hormonal IUDs due to the hormone, progestin. Any IUD weight gain is likely not an increase in body fat, but instead an increase in water retention. The hormone progestin may increase water retention that causes bloating, typically adding about five pounds. The amount of weight gained will vary from patient to patient, but any water retention will likely go down three months post-insertion.

It’s important to know that gaining any weight post-insertion is likely due to the patient’s lifestyle as opposed to the IUD itself. Many American women naturally gain two pounds each year, entirely unrelated to any hormonal contraceptives, according to Yale Medicine.

Consider making some lifestyle changes to avoid weight gain after getting an IUD. Exercising regularly, eating a balanced diet, and other common healthy habits should minimize the chances of any weight change after getting an IUD.

Should bloating not subside three months after IUD insertion, consider speaking with a healthcare professional about other options. Copper IUDs, like Paragard, have not been linked to weight gain, making them a great alternative.

What birth control doesn’t cause weight gain?

Should an IUD prove to be not the best birth control method for you, there are plenty of other contraceptive options to consider. Consult your healthcare provider about what would work best for you. Some common birth control options include:

• Birth control pills
• Xulane patches
• Birth control injections, like Depo-Provera
• Contraceptive implants, like Nexplanon 
• Vaginal rings, like NuvaRing

Hormonal birth control gets a bad reputation for causing weight gain. However, weight gain is not a side effect of most birth control methods. Any weight gain reported while taking birth control is likely natural, like aging or your metabolism slowing down.

Only one form of birth control has been linked to weight gain, and that’s the injection Depo-Provera. If you’re looking to avoid weight gain, stay away from injectable contraceptives. These injectables have been shown to activate signals that control hunger, resulting in weight gain in some patients.

As you consider other birth control options, keep in mind that some, like the pill, injections, patches, and vaginal rings, have 10% yearly failure rates due to human error. 

“Choosing the best contraceptive product is very individualized,” says Dr. Madison, so make sure to speak openly and honestly with your gynecologist about which birth control method is right for you.

IUD weight gain FAQs

Does Mirena cause weight gain?

Mirena has not been shown to cause weight gain. Less than 10% of Mirena users experienced weight gain in its manufacturer clinical trials. There was not enough evidence to show that these participants’ weight gain was caused by Mirena. However, it is possible to initially gain a few pounds due to an increase in water retention, which should subside after a few months. 

What should I do if I gain weight on Kyleena?

If you experience weight gain with Kyleena, try to find the cause of the weight gain. Was there a recent change in your life that may be causing it? There is a multitude of reasons that someone can gain weight. Kyleena does not have evidence of weight gain by itself, but an initial weight gain of a few pounds due to water retention should not be alarming. Practicing a healthy lifestyle with a balanced diet and regular exercise can help prevent weight gain. However, if you experience unexplained weight gain, talk to your healthcare provider because it could be caused by another medical condition.

Why do people gain weight with IUDs?

People can gain weight with IUDs due to water retention. This usually goes away within a few months of getting an IUD inserted. Generally, IUDs do not show an increase in actual weight or body fat. 

Can a copper IUD make you gain weight?

Studies have shown that Copper IUDs do not cause weight gain. This is because they do not have progestin, the hormone present in hormonal IUDs that causes water retention. If you gain weight unexplainably with a copper IUD, speak to a healthcare provider. It could be caused by an underlying condition. 

Lithium for BAR. Weight change.

Lithium is the gold standard for the treatment of bipolar affective disorder (BAD). For a long time it was believed that one of its side effects is weight gain due to metabolic changes. However, the results of Susana Gomes-da-Costa et al. A meta-analysis published in the journal Neuroscience and Biobehavioral Reviews reported little effect of lithium therapy on weight. At the same time, a shorter duration of therapy was associated with a more pronounced change in weight.

Bipolar disorder is a chronic disorder characterized by recurrent mood swings. Long-term lithium therapy remains most effective in preventing both depressive and manic episodes; in addition, it reduces the risk of suicide, dementia and overall mortality. Lithium is the first line in most recommendations. Despite the effectiveness of this group of drugs, the issue of their safety is relevant. Along with a narrow therapeutic window, the need for monitoring and various side effects, weight gain is a concern for patients. Nevertheless, this effect remains one of the least studied.

The analysis was constructed according to PRISMA criteria. MEDLINE/PubMed, Scopus, and Web of Science databases were used to search for studies published up to August 1, 2019. Inclusion criteria were based on longitudinal studies evaluating the effect of lithium therapy on weight.

No single mechanism of weight gain has been identified with lithium therapy. Weight gain at the start of treatment may be due to previous inadvertent weight loss. Due to the thirst that arose during therapy, the consumption of high-calorie drinks may increase. In addition, lithium preparations can retain sodium and water, which also leads to weight gain. Some authors claim that during therapy with lithium preparations, the amount of adipose tissue increases. The most common mechanism for weight gain seems to be the effect of lithium preparations on carbohydrate metabolism, due to their possible insulin-like action. Increased uptake of glucose by cells stimulates hexokinase, pyruvate kinase and inhibits muscle protein kinase. A direct appetite-stimulating effect in the hypothalamus is also possible. Recent studies also look at the effects of lithium on the leptin system.

Meta-analysis by Susana Gomes-da-Costa et al. it was found that weight gain during therapy with lithium preparations is insignificant and does not exceed 0.5 kg. There were also no significant differences in weight change compared to placebo. At the same time, patients with bipolar disorder are more prone to gaining excess weight and the risk of developing obesity due to genetic and behavioral factors. Thus, weight gain may be promoted by comorbid binge eating, more depressive episodes, excess carbohydrate intake, and physical inactivity.

The association of greater weight gain with shorter treatment times can be explained by initial fluid retention, which stabilizes over time. Also, in the initial stages of therapy, patients may need to take several drugs that affect weight gain to achieve remission. In addition, patients may have uncorrected eating habits that also contribute to weight gain.

This study found that lithium supplementation had less effect on weight in bipolar patients than expected. Nevertheless, the tendency to increase body weight cannot be neglected. It is recommended to assess the weight before and after the appointment of therapy, as well as, if possible, to avoid other drugs that cause weight gain. The lifestyle of the patient, in particular physical activity and eating behavior, also has a significant impact.

Translated by: Gorbunova E. V.

Editing: Yavlyukhina N. N.

Source: Gomes-da-Costa S, Marx W, Corponi F, Anmella G, Murru A, Pons-Cabrera MT, Giménez-Palomo A, Gutiérrez-Arango F, Llach CD, Fico G, Kotzalidis GD, Verdolini N, Valentí M, Berk M, Vieta E, Pacchiarotti I. Lithium therapy and weight change in people with bipolar disorder: A systematic review and meta-analysis. Neurosci Biobehav Rev.

https://pubmed.ncbi.nlm.nih.gov/34265322/

Phenaret Clinic – May 4-7 Basel 2016 hosted the 14th Congress – the 2nd Global Conference of the European Society for Contraception and Reproductive Health

The 14th Congress – 2nd Global Conference of the European Society of Conceptiontraception and Reproductive Health. Basel , Switzerland, 4-7 May, 2016)

Chief Director of the Fenareta Clinic Artymuk N.V. made 2 reports: “The prevalence of human papillomavirus infection among female prisoners in Siberia” and “The specific feature of contraception in women with adenomiosis”.

Congress News:

• More than 50% of women receive information about contraception from the Internet (only 18% are health workers)
• Major misconceptions about hormonal contraception:
 weight gain,
 need a break,
 should not be taken by women over 35 years,
 causes infertility

T. o. COC is a highly effective, reversible method, adequate counseling is necessary, because. many myths and misconceptions that have no evidence.

• IUD is a highly effective method of contraception
• The method is safe in young and nulliparous women
• Brief counseling increases knowledge, interest and possibilities of using IUD (3 min)

Contraception – the latest

• Injectables
• Progering (10mg\day) ring for nursing
• Jaydess (small Mirena 3 years, smaller dose and size)
• Liletta (LNG-IUD) 52mg, generic, 3 years, 10 lbs for developing countries

Contraception on the horizon for women

• Short acting methods
 COC
 Estetrole (Estelle) – fetal estrogen, inhibits ovulation, reduces hot flashes, antagonist of the mammary gland and vascular endothelium, neutral for the liver, less potential than E2
 EE\nesterone transdermal gel (1-2 phase, less side effects)
 EE\LNG patch (Twirla) 3 phase, once a week (Evra regimen)
• Progestogene
 LNG patch (lower dose, 1 phase, 1 time per week)
• Ulispristal acetate – tablets (2nd phase)\ring (2nd phase), breast protection

Contraception – on the horizon for men

• Implant ment (hormonal subcutaneous androgen implant (4), replacement after 1 year)
• Testosterone/nesterone gel (sperm suppression) daily

9004 8 Wishes for hormonal contraception

• More reversible methods for men
• Cheaper methods so that they can be applied worldwide
• More versatile technological methods
• Fewer side effects
• Prolonged methods

Risks of arterial (ATE) and venous (VTE) thrombosis.

• Risk of VTE is reduced with low dose estrogens and high androgenic progestins
• ATE is more determined by atherosclerosis than by blood stasis
• Insufficient evidence to judge differences in atherosclerosis progression with different COCs
• Antiandrogenic progestins seem to be or drospirenone have benefits for ATE

Risks of VTE

• Risk of VTE is very low with low-dose drugs
• Risk is 50% higher during the first year
• Decreasing coc dose from 40mg to 20mg reduces risk by 18%
• Lower risk in women taking COCs than during pregnancy and childbirth
• The risk of 3rd and 4th generation drugs is slightly higher compared to the 2nd generation

Risks of ATE (stroke).

• ATE (including stroke), the most serious complication of COCs, remains very rare.
• Untreated hypertension – severe restriction of COC use
• Reducing the dose of EE from 50 to 30-20 mcg reduces the risk of ATE
• Similar risk with 2nd and 3rd generation drugs
• Non-oral formulations are not safer
• Progestin-only pills are not associated with an increased risk of stroke

Risks of ATE (heart attack)

• Premenopausal MI very rare
• COCs may increase risk but very rare
• Type of progestogen may influence, with 3rd generator ation – below
• What form of COC reduces the risk is unknown
• Transdermal E2 (gel, patch) + progestogen can solve the problem of thrombosis!!!

Treatment of side effects of progestogens.

• Weight gain
• Mastalgia
• Skin changes
• Mood changes (depression to suicide)!!!!! – take anamnesis, warn the patient about the possibility of mood changes
• Decreased libido
• Ovarian cysts (LNG-IUD)

PCOS

• PCOS is a complex heterogeneous disease that includes reproductive and metabolic disorders (including CV and thrombotic risks – 2 times ATE@VTE)
• Rotterdam criteria do not include CV risks
• The effect of treatment depends on the phenol type
• No evidence of superiority of one COC over the other in women with PCOS!!!

Contraception in carriers of BRCA1,2 mutations.

• The risk of breast cancer is increased by 2 times when starting contraception before 20 years and for more than 5 years
• Method of choice – Cu-IMC

Hormones and the state of the endometrium. Take home message

• LNG-IUD reduces the risk of perimenopausal endometrial hyperplasia
• LNG-IUD is more effective in reducing the incidence of AUB (severe) than oral drugs
• LNG-IUD has more side effects and cost compared to endometrial ablation
• COCs with LNG (2nd generation) are less effective than with norethisterone (1st generation)
• Intermenstrual bleeding is less with COCs with gestodene than with LNG
• Progestins give a higher incidence of irregular bleeding, especially intermenstrual bleeding compared to COCs
• Danazol – a lot of side effects
• Tamoxifen – increases the risk of postmenopausal bleeding, endometrial polyps, cancer.