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The oral contraceptive pill is a hormonal method of preventing pregnancy. Side effects are common, and they vary from person to person.
The pill is a type of birth control. It works by preventing the body from producing an egg, which means that there is nothing for sperm to fertilize, and pregnancy cannot occur.
The specific side effects vary widely among individuals, and different pills cause different side effects. Some common side effects include spotting, nausea, breast tenderness, and headaches.
There are two main types of birth control bill. Combination pills contain estrogen and progestin, which is a synthetic form of the natural hormone progesterone, while the mini pill contains progestin only.
This article looks at 10 common side effects of the pill, as well as its risks, long-term effects, and alternatives. It also discusses the cost of birth control pills and how to get them.
Birth control pills affect a person’s hormone levels, leading to various side effects. These effects usually resolve within 2–3 months, but they can persist.
In the United States, around 12.6% of females aged 15–49 years take oral contraceptive pills. They are safe for most females to use.
If the side effects last for a long time or are very uncomfortable, it is best to talk to a healthcare provider about trying a different brand or a different method of birth control.
The sections below will look at some common side effects of oral contraceptives.
1. Spotting between periods
Breakthrough bleeding, or spotting, refers to when vaginal bleeding occurs between menstrual cycles. It may look like light bleeding or brown discharge.
Spotting is the most common side effect of birth control pills. It happens because the body is adjusting to changing levels of hormones, and the uterus is adjusting to having a thinner lining.
Taking the pill as prescribed, usually every day and at the same time each day, can help prevent bleeding between periods.
Some people experience mild nausea when first taking the pill, but this usually subsides. Taking the pill with food or at bedtime may help.
Birth control should not make people feel sick all the time. If the nausea is severe or lasts for a few months, it is best to talk to a healthcare provider.
3. Breast tenderness
Taking birth control pills often causes the breasts to feel tender, especially soon after a person starts taking them. Wearing a supportive bra can help reduce breast tenderness.
Along with increased breast sensitivity, the hormones in the pill can make the breasts grow bigger. Learn more here.
4. Headaches and migraine
Changes in the female sex hormones (estrogen and progesterone) can trigger migraine. Symptoms can depend on the dosage and type of pill. For example, low dose pills are less likely to cause this symptom.
On the other hand, if a person’s migraine is associated with PMS, taking the pill may actually reduce their symptoms.
5. Weight gain
Birth control pills often list weight gain as a possible side effect, though research has not yet confirmed this.
In theory, birth control pills could lead to increases in fluid retention or water weight. They could also lead to increases in fat or muscle mass. However, some people may instead report weight loss when taking the pill.
According to a 2017 article, there has not been enough research to confirm whether the hormones in birth control pills lead to weight gain or weight loss.
6. Mood changes
Hormones play an important role in a person’s mood and emotions. Changes in hormone levels, which taking the pill may cause, can affect a person’s mood.
If a person is concerned about mood changes, they can talk to their healthcare provider. If the symptoms are linked to taking the pill, changing pills may help.
7. Missed periods
Taking birth control pills can cause very light periods or missed periods. This is because of the hormones they contain.
Depending on the type of birth control, people can use the pill to safely skip a period. Learn more here.
If a person suspects that they may be pregnant, it is best to take a pregnancy test. The birth control pill is very effective, but pregnancies can occur — especially with improper use.
Many factors can cause a late or missed period, including:
- hormonal problems
- thyroid problems
8. Decreased libido
The pill can affect sex drive, or libido, in some people. This is due to hormonal changes.
Other people might experience an increased libido by, for example, removing any concerns they may have had about pregnancy and easing any symptoms of PMS.
9. Vaginal discharge
Changes in vaginal discharge may occur when taking the pill. This may be an increase or a decrease in vaginal lubrication or a change in the nature of the discharge.
If the pill causes vaginal dryness and a person wants to engage in sexual activity, using lubrication can help make this more comfortable.
These changes are not usually harmful, but alterations in color or odor could point to an infection.
10. Eye changes
Some research has linked hormonal changes due to the pill with a thickening of the cornea in the eyes. This does not suggest a higher risk of eye disease, but it may mean that contact lenses no longer fit comfortably.
People who wear contact lenses can talk to their ophthalmologist if they notice any changes in their vision or lens tolerance.
The pill is safe for most females to use. However, research has linked its use with certain risks. Therefore, before taking birth control pills, it is important to discuss individual risk factors with a healthcare provider.
According to the Office on Women’s Health, there is evidence to suggest that taking birth control pills may raise a person’s risk of blood clots and high blood pressure, or hypertension. This can lead to heart attack or stroke.
If a blood clot enters the lungs, it can cause serious damage or death. These side effects are serious but rare.
Some research suggests that birth control increases the risk of some forms of cancer and decreases the risk of others.
The pill may not be safe for people who:
- have untreated hypertension
- smoke and are over the age of 35 years
- have a history of heart disease
- have migraine with aura
- have a history of breast cancer or endometrial cancer
A person should see a healthcare provider if the following symptoms occur, as these may indicate a serious health concern:
- severe abdominal pain
- chest pain, shortness of breath, or both
- severe headaches
- eye problems, such as blurred vision or a loss of vision
- swelling or aching in the legs and thighs
Birth control pills are safe for most females to use long-term or indefinitely.
However, usage can increase the long-term risk of certain health problems. The following sections will look at these potential effects in more detail.
Combination pills can slightly increase the risk of serious cardiovascular problems, such as heart attack, stroke, and blood clots. The risk is higher with certain pills. A healthcare provider can advise on suitable options.
Anyone who has uncontrolled high blood pressure or a personal or family history of cardiovascular problems should ask their healthcare provider about alternative methods of contraception.
The natural female sex hormones (estrogen and progesterone) affect the risk of some types of cancer. Likewise, hormone-based birth control methods can increase or decrease the risk of different cancers.
According to the National Cancer Institute, taking birth control pills can affect a person’s risk of certain cancers in the following ways:
- Breast cancer: The risk of breast cancer is slightly higher in people who use hormonal birth control pills than in people who have never used them.
- Ovarian and endometrial cancer: These cancers seem to be less likely to occur in people who take the pill.
- Cervical cancer: Taking the pill for longer than 5 years is linked with a higher risk of cervical cancer. However, most types of cervical cancer are due to the human papillomavirus.
- Colorectal cancer: Taking the pill is linked to a lower risk of colorectal cancer.
For people who cannot use or do not wish to take the birth control pill, other options are available.
The effectiveness of different methods of birth control vary. With typical use, around 9 out of 100 people using birth control pills will become pregnant within a year.
It is important to note that birth control pills do not prevent sexually transmitted infections (STIs). Only barrier methods of protection, such as condoms and dental dams, can prevent STIs.
The sections below will look at some alternative forms of contraception.
Condoms are barrier methods of birth control. There are many types and brands. Most are made from latex, but people with a latex allergy can find polyurethane or lambskin versions.
With typical use, 18 out of 100 people who rely on male condoms for contraception will become pregnant within a year.
A diaphragm is another barrier method of contraception. This is a shallow, dome shaped cup that, when a person places it in the vagina, can prevent sperm from reaching the cervix. People often use diaphragms with spermicide.
With typical use, around 12 out of 100 people who use diaphragms with spermicide will become pregnant within a year.
Vaginal rings are plastic rings that release hormones into the vagina to suppress ovulation.
To use a vaginal ring, a person can insert it for 21 days, remove it for 7 days to allow menstruation, and then insert a new ring.
As a hormonal method of birth control, the vaginal ring can have similar side effects to those of the pill.
With typical use, around 9 out of 100 people using vaginal rings will become pregnant within a year.
Intrauterine devices (IUDs) are small devices that a healthcare provider can insert into the uterus. IUDs can be hormonal or non-hormonal. Hormonal IUDs can last between 5 and 7 years, while non-hormonal IUDs can last for up to 10 years.
With typical use, fewer than 1 out of 100 people who use an IUD will become pregnant within a year.
Hormonal IUDs can have similar side effects to those of the pill. Non-hormonal or copper IUDs can cause spotting, irregular periods, heavier periods, and worsened cramps.
The contraceptive implant is a small, plastic rod that a healthcare provider can insert into the upper arm. It releases a hormone to prevent pregnancy and can last for 3 years.
With typical use, fewer than 1 out of 100 people with the implant will become pregnant in a year.
As a hormonal method, side effects can be similar to those of the birth control pill.
Birth control injections
Birth control injections, also known as the shot, are hormonal injections that a person can receive every 3 months to prevent pregnancy.
With typical use, around 6 out of 100 people receiving these injections will become pregnant within a year.
The pill and the shot are both hormonal methods of birth control. The main differences are in the method of administration. They might also produce different side effects.
Like the pill, the shot suppresses ovulation and thickens the cervical mucus to reduce the chance of sperm reaching egg cells. It is a progestin-only contraceptive.
The shot is slightly more reliable at preventing pregnancy than the pill. This is because the user does not have to remember to take it every day. However, they must remember to get a shot every 3 months for it to be effective.
Many of the side effects are the same, including:
- breast tenderness
- changes in mood
- missed periods
- possible weight gain
According to Planned Parenthood, for most brands, one pack of birth control pills costs anywhere from $0 to $50. One pack lasts for 1 month.
People might also need to pay for an appointment with a healthcare provider before getting a prescription for birth control pills. This can cost between $35 and $250.
Most insurance companies will cover these appointments under the Affordable Care Act.
Also, most insurance companies will cover all methods of birth control, including the pill. Some plans only cover certain brands or generic forms, however. A person can speak to their insurance provider to find out which types of pill they cover.
People without health insurance may be able to cover the cost of birth control through Medicaid or another governmental program.
In the U.S., a person will need a prescription for birth control pills. Family planning clinics can provide prescriptions.
During an appointment, a healthcare provider will ask about the person’s medical history and physical health to help them work out the most appropriate pill to prescribe.
In some states, a person can get a prescription online or directly from a pharmacist.
Birth control pills contain hormones that affect the body in many ways. Therefore, side effects are common.
Side effects vary widely among individuals and different types of pill. They usually ease within 2–3 months of starting to take the pill.
Each person reacts differently to each pill. A person may need to try a few different types of pill before finding the one that is right for them.
When a person stops taking the pill, their body will return to how it was before they took the pill.
If the side effects are severe, get in the way of daily life, or last for longer than 3 months, it is best to talk to a healthcare provider about trying a different brand or a different method of contraception.