PrEP (pre-exposure prophylaxis) is highly effective at preventing HIV infection, but it’s only natural to wonder how it may affect your body. You may want to know if PrEP can cause weight gain or other unwanted side effects.
With more people starting PrEP through telehealth services like MISTR, it’s essential to separate fact from speculation. Let’s walk through how PrEP works and what—if any—possible reactions you can expect.
Understanding How PrEP Works in the Body
What Happens When You Start Taking PrEP?
PrEP works by keeping medication in your bloodstream to prevent HIV from establishing infection. After you start a daily pill, you will typically reach protective levels within seven days for anal sex and 21 days for vaginal sex. Common early side effects are usually mild and may include nausea or headache, but they typically subside quickly as your body adjusts.
Does PrEP Cause Weight Gain?
Weight gain is a common and understandable concern. The good news is that research shows any weight change while taking PrEP is usually small and gradual. In fact, some people may even lose weight on PrEP, so it’s important to discuss which medicine is best for you with your provider.
What Research Shows
One long-term PrEP study found that people taking TDF/FTC (tenofovir disoproxil fumarate/ emtricitabine), one of the PrEP options, gained no significant weight within the first year. Other research shows that weight increases among PrEP users tend to be modest, and factors such as diet, age, and activity level still play a significant role.
Can PrEP Affect Your Liver or Kidneys?
This is a common concern that should not be taken lightly when introducing any new medication. TDF has been associated with minor declines in kidney function in a small percentage of users, while TAF (tenofovir alafenamide) tends to have less impact on the kidneys. Serious kidney or liver injury is rare while taking PrEP.
PrEP can affect the metabolism of certain drugs in your body. It’s important to give your doctor a complete list of medications that you take as well as supplements.
How the Body Processes PrEP
PrEP drugs are cleared by the kidneys and, to a lesser extent, the liver. That’s why baseline and follow-up blood tests (including kidney function, creatine, urine testing, and liver enzymes) are standard parts of PrEP care. It’s essential to undergo these tests as required by your doctor.
Does PrEP Affect Blood Pressure, Sperm, or Fertility?
Current evidence does not show any widespread negative effects of daily TDF/FTC PrEP on male fertility or sperm in populations studied to date. Regarding blood pressure, the majority of PrEP research has not shown any significant increases in blood pressure.
Addressing Common Myths About Reproductive Health
- Myth: PrEP lowers sperm count.
- Fact: Studies show PrEP does not impact sperm count, motility, or fertility in men.
- Myth: PrEP changes menstrual cycles.
- Fact: There’s currently no strong evidence that PrEP affects menstrual cycles because it does not cause hormonal changes.
- Myth: PrEP makes it harder to conceive.
- Fact: There is no evidence to suggest that PrEP impacts fertility rates in men and women.
- Myth: PrEP interferes with birth control.
- Fact: PrEP is safe to take with all hormonal contraceptives.
If you plan to conceive or have specific fertility concerns, you should discuss them with your provider.
Can You Drink Alcohol While Taking PrEP?
Alcohol does not reduce the effectiveness of PrEP when you take the medication as prescribed. It’s important to remain on your PrEP schedule, despite alcohol use.
Yes — Safely and Responsibly
Studies of PrEP populations show that many people who drink alcohol still keep up with their dosage schedule. Support and reminders help you stay on track.
How to Monitor Your Health While on PrEP
Although PrEP is generally safe for most people, regular health monitoring is essential to maintain continued protection. It’s important to stay proactive throughout PrEP treatment.
Routine Testing and Check-Ins Keep You Protected
- Take an HIV test every three months while on PrEP.
- Complete kidney function tests before starting PrEP and periodically afterward.
- Stay on top of your STI screenings and routine sexual health check-ins.
These check-ins help identify any small changes early, ensuring PrEP remains safe and effective for you. Ask your provider how often you need screenings.
Stay Informed and Supported With MISTR
MISTR makes it easy to stay smart and maintain PrEP. Stay on schedule and ensure protection throughout treatment with PrEP. Connect with one of our providers today.
Your Health, Your Prevention Plan
- Secure online consults
- At-home lab testing
- Medication delivery to your door