The Impact of Hormonal Contraceptives on Body Weight and Associated Side Effects in Riyadh, Saudi Arabia: A Cross-Sectional Study

Introduction: Public health professionals often use unintended pregnancy as a proxy to understand the community's need for contraception, highlighting its effectiveness in addressing this issue. However, discontinuation rates and transitions between different contraceptive methods are high, largely due to the emergence of side effects. Objective: The objective of this study is to assess the association between hormonal contraceptive use and weight gain, as well as other side effects, and evaluate patient satisfaction across different contraceptive methods. Methods: A cross-sectional observational study was conducted among adult women (≥18 years) attending gynecology clinics in Riyadh in 2023. Women with uncontrolled chronic disease (e.g., diabetes, uncontrolled hypothyroidism, severe polycystic ovary syndrome) were excluded, whereas stable, well-controlled cases under treatment were included. Data were collected using medical records and a structured questionnaire adapted from prior research and piloted locally. Weight change was determined using recorded weights where available, with self-report used in some cases. Results: Of 500 participants, 324 were eligible for analysis. Combined oral contraceptive (COC) users reported significantly higher mean weight gain compared to users of other hormonal methods. Mood changes and weight gain were the most frequent side effects, while satisfaction was highest among vaginal ring and patch users. Conclusions: COC users reported greater weight gain and mood-related side effects compared with users of other methods. Satisfaction varied by method, highlighting the importance of individualized counseling to address patient concerns and guide contraceptive choice.