Miguel Ángel Jiménez, gynecologist: "The pill can cause increased fluid retention; some patients notice bloating."

The belief that oral contraceptives cause weight gain is still widespread among women. For some, the scale confirms this feeling; for others, it makes no difference. Gynecologist Miguel Ángel Jiménez clarified in a TikTok video that this reaction is possible, but it doesn't occur in all cases or in the same way.

"Like any medication, the pill can have different effects on each patient," explains the specialist. This means that while some women barely notice any changes, others may experience symptoms such as increased fluid retention, increased breast volume, or a feeling of bloating.

Jiménez points out that the effect varies depending on the type of contraceptive and hormonal composition. The type of estrogen or progestin included in the pill influences how the body reacts. "It can cause greater fluid retention or even an increase in breast tenderness and volume," she explains.

These variations don't necessarily imply an increase in body fat, but they can create the perception of weight gain. "What the patient notices is a sensation of having gained weight, although sometimes it's just a matter of accumulated fluids," the gynecologist points out.

According to the specialist, this change most often occurs at the beginning of treatment and is temporary. "In most cases, it's an initial effect and is usually temporary and reversible," he says.

This point is key to reassuring women who fear a permanent physical change. In most cases, the body adapts to the medication, and symptoms disappear without the need for treatment changes.

However, Jiménez warns that not all patients have the same tolerance. There are cases in which fluid retention or bloating is so severe that it interferes with well-being. "You come across that patient who has to stop taking contraception because she has severe fluid retention, a lot of breast tension, and feels unwell," she adds.

In these situations, the gynecologist explains that the solution may involve adjusting the dose, changing the formulation, or simply opting for another contraceptive method. "If the discomfort is significant, the treatment should be modified or permanently discontinued," he emphasizes.

The variability in response to oral contraceptives is one of the reasons why the doctor emphasizes the importance of professional supervision. "Like everything in medicine, it varies greatly from patient to patient," he recalls.

Therefore, before abandoning the pill for fear of gaining weight, the specialist recommends analyzing the real cause of the feeling of weight gain. Sometimes, he points out, the change coincides with other circumstances—such as changes in diet, stress, or lack of exercise—that can also cause changes in the body.