I recently saw I teenage patient of mine who had been in about a year ago complaining of irregular periods and problems with menstrual cramps as well. Interestingly, due to persistent acne, she had been on Accutane about a year before but she was now interested in starting birth control pills (OCP). She had “heard” from her friends (best source of info for a teen), that OCP would not only regulate her periods, but they might also help her skin (all correct information, I might add).
So, after reviewing the risks and benefits of “the pill” and discussing this with both she and her mother, we all agreed she would try OCP.
She took the pill over the last year with great success. Her periods became more regular, they were shorter and she had little problem with cramps. All was good, until she started complaining of weight gain. When I recently saw her she had gained about 15 lbs and was quite upset about the weight gain (but still liked her regular periods).
The dilemma is that while you may notice a 2-5 lbs weight gain on the pill, it is not “typical” for there to be a 15-20 lbs weight gain due to OCP alone. When I reviewed her history over the last 9 months, it was significant in that she had stopped playing year round competitive volleyball. Despite a change in her athletic schedule, she had not continued any routine exercise.
In discussing her eating habits and diet, it was noted that she had started to drive and she said, “I am not always home for meals, so I eat may pick up something after school or at dinner”. She had been snacking at home this summer as well.
Despite my conversation about her changes in lifestyle with decreased exercise and more snacking, she did not think that the change in her exercise or diet had “anything to do with her weight gain!”. A very common teenage reaction for sure.
So, it was decided that I would try another brand of OCP, and she was encouraged to try to resume a regular exercise program. With school back in session her mother and I also thought that her eating habits would improve as they were getting back to regular family meals.
But, she was most happy that I had listened to her, and so had her mother. Often, just listening to a teenager is the most important thing you do.