The oral contraceptive pill, commonly referred to as “the pill,” is a form of hormonal contraception taken by approximately 12 million women in the United States per year to prevent pregnancy.1
The pill is a highly effective method of birth control when taken correctly.1
Each year, 8% of women experience an unintended pregnancy while taking the pill – most commonly because they forgot to take it.
However, when taken daily at the same time, only one in 100 women will experience an unintended pregnancy within the first year of pill use.1
There are two types of contraceptive pills, both of which contain synthetic hormones estrogen and progesterone.2 Combination pills contain both hormones estrogen and progesterone whereas the “mini pill” known as the progestin-only pill contains only the hormone progestin.1
The pill can also be taken for non-contraceptive protection to treat medical conditions such as:2,3
Regulation of menstrual 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.1-3
10 most common side effects of the pill
Intermenstrual spotting: vaginal bleeding between your expected periods is experienced by approximately 50% of women using the pill, most commonly within the first 3 months of initiating the pill.
Generally, this resolves in over 90% of women by their third pill pack. During this time of spotting, the pill is still effective as long as the pill has been taken correctly and none were missed.
It is recommended that you contact your medical provider if you experience 5 or more days of bleeding while on your active pills or heavy bleeding for 3 or more days.3
Nausea: mild nausea when initially starting the pill can occur. However, nausea symptoms usually resolve over a short period of time.
One solution is to try taking your pill with food or at bedtime. Seek medical help if the nausea is severe or persistent.3
Breast tenderness: birth control pills may cause your breasts to enlarge or become tender, which tends to improve after the first few weeks of starting the pill.
However, if there is a presence of a lump or the pain is not going away, seek medical help. Reducing caffeine and salt intake can decrease breast tenderness, as can wearing a supportive bra.3
Headaches: the onset of new headaches should be brought to the attention of your medical provider.3
Weight gain: despite the failure of clinical studies to reveal that birth control pills cause weight fluctuations, some women do experience some fluid retention, especially in the breast and hip areas.3
Mood changes: if you are someone who has a history of depression, it is important that this is discussed with your medical provider – some women do experience depression or other emotional changes while taking the pill. It is important to contact your medical provider if you are experiencing mood changes during pill use.3
Missed periods: there are times when despite proper pill use, a period may be skipped or missed.
Several factors can influence this such as outside stress, illness, travel or at times hormonal and or thyroid abnormalities. If a period is missed or is very light while on the pill, take a pregnancy test prior to taking your next pack of pills and call your medical provider if this continues.3
Decreased libido: the pill can affect your sex drive because of the hormones found in them. However, other outside factors may also cause a decrease in your libido. If this is persistent or bothersome, inform your medical provider.3
Vaginal discharge: some women may notice changes in vaginal discharge ranging from an overall increase to a decrease in vaginal lubrication with intercourse. Speak with your medical provider if you are concerned that there is the presence of an infection.
Visual changes with contact lenses: you should see your ophthalmologist if you are a contact lens wearer and notice some changes in vision or with lens tolerance during pill use.3
If you experience the side effects with the acronym “ACHES” (see below), contact your medical provider or visit an emergency room immediately as they may signify a serious condition.3,4
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).
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.3
Precautions and risks while taking the pill
Combination pills do come with a particular risk for cardiovascular side effects such as heart attack, stroke and blood clots – which at times can be fatal. While blood clots are rare, they can occur. For women with a history of blood clots, heart attacks or stroke, it is advised that they do not take the combination birth control pill and speak with their medical provider about using an alternative method.1
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 your risk of blood clots include obesity or a family history of heart disease.1
It is not recommended to take hormonal contraceptives if you have a personal history of liver or heart disease, uterine or breast cancer, uncontrolled blood pressure or migraines with an aura.4
It is important to note that 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
You should speak with your medical provider to see what type of birth control option is best for you.