Side Effects of Hormonal Birth Control: The Good, the Bad, and the Ugly

Hormonal birth control includes medicines or devices that contain hormones that are intended to prevent you from becoming pregnant. Some types of birth control contain a combination of hormones (estrogen and progestin), including birth-control pills, a patch that is applied to the skin, and a ring that is placed in the vagina. Some types contain only progestin, including pills, (called the “mini-pill”), shots, implants that are placed under the skin, and intrauterine devices (IUDs).

All medications can cause side effects, and hormonal birth control is no exception. Since the pills or devices contain hormones, many of the side effects are related to changes in your hormone levels. While there are some serious risks associated with hormonal birth control, many women use it with no problems at all. Even if you do experience unwanted side effects, most of them are mild and go away after a few months. If you feel sick or extremely uncomfortable while using hormonal birth control, talk to your doctor about a different type of birth control method that may be better for you.

Over time, your periods may get lighter and may even stop completely while you are using hormonal birth control. Hormonal birth control can also be used to reduce the appearance of acne, prevent bone thinning, reduce symptoms of PMS, and prevent iron deficiency anemia.

Sore breasts, nausea, headaches, bloating, weight gain, mood changes, vaginal discharge, changes in your eyesight (especially if you wear contact lenses), and acne are common side effects of hormonal birth control. Your level of sexual desire may also change. Progestin-only pills can cause spotting between periods. Most of these side effects go away in 2 to 3 months.

If you are taking pills that contain estrogen, you are more likely to have serious side effects, including heart attack, stroke, blood clots, liver tumors, and gallbladder disease. These are very rare, but they can be serious and life-threatening.

If you smoke or are older than 35, you should not take pills containing estrogen. Combination pills may not be the right choice for you if you have a history of blood clots, breast cancer, heart problems, migraines, high blood pressure, diabetes, or liver disease. The birth control patch increases the level of estrogen in your body more than birth control pills do, so you may have a higher risk of blood clots while using the patch.

Estrogen-containing pills were once thought to increase your risk for cancers, such as breast cancer, cervical cancer, and liver cancer, but the risk disappeared within 5 years after women stopped taking the pills. Many factors, including age, how long you take the pill, whether or not you have ever been pregnant, and other diseases you may have, affect your risk of cancer. It is now believed that hormonal birth control may actually decrease your risk of certain types of cancer.

If you are breastfeeding, estrogen can decrease the amount and quality of your milk in the first few weeks after you give birth. Progestin-only birth control methods are usually safe to use while you are breastfeeding. Any hormones that get into your breastmilk should not harm the baby.

Most people will never have any problems with their hormonal birth control, but you should know the signs of a serious issue: sudden back/jaw pain; chest pain; sore, achy legs; trouble breathing; severe stomach pain; sudden, extreme headache or a headache that is different than a normal headache; seeing flashing or zigzag lines that are not there or loss of vision; yellow skin and/or eyes; a breast lump; depression; fainting; seizures; and severe mood swings. If you experience any of these symptoms, you should see a doctor right away.

In addition to the hormone-related side effects caused by birth control, some devices can cause problems that aren’t related to hormones. For instance, the patch may cause skin irritation where you apply it. Birth control implants that are placed under your skin can cause pain or bruising, as well as infection, at the insertion site. Similarly, the birth control shot can cause pain or bruising, and even a small, permanent dent where the shot is given. IUDs can cause pain, cramping, and backaches, and the vaginal ring may cause vaginal discomfort and irritation, vaginal bleeding, and yeast infections. Most women use all of these forms of birth control with few to no problems, but if any of these occur, last a long time, or make you uncomfortable, talk to your doctor about other birth control methods.

Always tell your doctor about your personal and family history. He or she can help assess your risks and personal preferences and choose a birth control method that is right for you. Luckily, there are lots of options!

If you ever have questions about your birth control or the side effects you are experiencing, read the package insert that comes with your prescription or talk to your pharmacist or your doctor.

Jennifer Gibson
Dr. Jennifer Gibson earned a Bachelor of Science degree in Biochemistry from Clemson University and a Doctor of Pharmacy degree from the Medical College of Virginia School of Pharmacy at Virginia Commonwealth University. She trained as a hospital pharmacist and is the author of clinical textbooks, peer-reviewed journal articles, and continuing education programs for the medical community, as well as a contributor to award-winning healthcare blogs and websites. In her free time, she enjoys running, reading, traveling, and spending time with her family.

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