10 Most Common Birth Control Pill Side Effects
The oral contraceptive pill, commonly referred to as “the pill,” is a form of hormonal contraception.
The pill is a highly effective method of birth control when taken correctly (at the same time daily), with only 0.1% of women experiencing an unintended pregnancy, according to the Association of Reproductive Health Professionals (AHRP); around 1 in 100 women taking the pill experience an unintended pregnancy in the first year of pill use.
However, pregnancy rates increase dramatically in women who miss a pill (rates rise 30-80 times, according to the AHRP).
There are two types of contraceptive pills, both of which contain synthetic hormones estrogen and progesterone. Combination pills contain both hormones estrogen and progesterone whereas the “mini pill” known as the progestin-only pill contains only the hormone progestin.
The pill may also be taken for non-contraceptive medical purposes to address issues such as:2
“The pill” is a type of hormonal contraception that is taken by around 12 million women per year in the US to prevent pregnancy and for other medical reasons.
- Regulation of menstrual periods
- Irregular periods
- Menorrhagia (heavy periods)
- Dysmenorrhea (painful periods)
- Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD)
- Acne, hirsutism (excess hair growth) and alopecia (hair loss)
- Decreasing the risk of breast cysts, ovarian cysts,pelvic inflammatory disease (PID) and pregnancies in the fallopian tubes.
Oral contraceptives are also used as a method to prevent ovarian and endometrial cancers. Birth control pills do not prevent sexually transmitted diseases.
Common birth control side effects
The 10 most common side effects of oral contraceptives are:
- Intermenstrual spotting: approximately 50% of people using the pill experience vaginal bleeding between expected periods, most commonly within the first 3 months of starting to take the pill. Generally, this resolves in over 90% of cases by the third pill pack. During spotting, the pill is still effective as long as the pill has been taken correctly and none were missed. People who experience 5 or more days of bleeding while on active pills or heavy bleeding for 3 or more days should contact a health care professional for advice.
- Nausea: some people experience mild nausea when first taking the pill, but symptoms usually subside after a short period of time. Taking the pill with food or at bedtime can help lower the likelihood of nausea. Anyone experiencing persistent or severe nausea should seek medical guidance.
- Breast tenderness: birth control pills may cause breast enlargement or tenderness. This tends to improve a few weeks after starting the pill, but anyone who finds a lump in the breast or who has persistent pain/tenderness or severe breast pain should seek medical help. Reducing caffeine and salt intake can decrease breast tenderness, as can wearing a supportive bra.
- Headaches: anyone who experiences new onset of headaches when taking the pill should seek medical attention.3
- Weight gain: clinical studies have found no consistent association between the use of birth control pills and weight fluctuations. However, many people taking the pill report experiencing some fluid retention, especially in the breast and hip areas.
- Mood changes: people with a history of depression are recommended to discuss this with their medical provider as some people do experience depression or other emotional changes while taking the pill. Anyone experiencing mood changes during pill use should contact their medical provider.
- Missed periods: there are times when despite proper pill use, a period may be skipped or missed. Several factors can influence this, such as stress, illness, travel, and hormonal or thyroid abnormalities. If a period is missed or is very light while on the pill, a pregnancy test is recommended prior to taking the next pack of pills; if further periods are missed or are very light, seek medical advice.
- Decreased libido: the hormone(s) in the contraceptive pill can affect sex drive (libido) in some people. However, many other factors can contribute to a decrease in libido. If decreased libido persists and is bothersome, this should be discussed with a medical provider.
- Vaginal discharge: some people experience changes in vaginal discharge when taking the pill. This can range from an increase to a decrease in vaginal lubrication, an alteration in the nature of the discharge, and changes which can affect sexual intercourse. Anyone who is concerned about such changes, including those who suspect an infection, should speak with their medical provider.
- Visual changes with contact lenses: contact lens wearers should consult their ophthalmologist if they experience any changes in vision or lens tolerance during pill use.
Some women experience side effects with “the pill” such as irregular periods, nausea, headaches, or weight change.
It is important that anyone who experiences any of the following side effects while taking the pill contacts their medical provider or visits an emergency room immediately as they may signify a serious condition.
- A: Abdominal/stomach pain
- C: Chest pain (as well as shortness of breath)
- H: Headaches, which are severe
- E: Eye problems such as blurred vision/loss of vision
- S: Swelling/aching in the legs and thighs (also redness, swelling or pain in the calf or thighs).
These symptoms can be remembered using the acronym ACHES.
Birth control pills have also been associated with an increase in blood pressure, benign liver tumors, and a slight increase in the risk of developing cervical cancer.
Precautions and risks while taking the pill
Combination pills do pose a slightly increased risk of cardiovascular side effects such as heart attack, stroke and blood clots, which can be fatal. Blood clots are rare, but anyone with a history of blood clots, heart attacks or stroke is advised not to take the combination birth control pill and to speak with their medical provider about using an alternative method. It is also important to note that an unintended pregnancy has its own side effects.
The US Food and Drug Administration (FDA) advises against the use of combination pills in women aged 35 years or older that smoke. Additional factors that increase the risk of blood clots include obesity or a family history of heart disease.
It is not recommended to take hormonal contraceptives if there is a personal history of liver or heart disease, uterine or breast cancer, uncontrolled blood pressure or migraines with an aura.
Combination pills with the form of synthetic progesterone called drospirenonone may have a higher risk of blood clots including deep vein thrombosis and pulmonary embolism.1,4
A qualified health care provider should be consulted for individual guidance on the most appropriate method of birth control.
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