STD Home > Oral Contraceptive Side Effects
Breakthrough bleeding, nausea, and bloating are some of the more commonly reported side effects of oral contraceptives. While most side effects are minor, some are potentially serious and require immediate medical attention, such as depression, migraines, or hypertension. Several factors play a role in determining which side effects will occur, including the strength and type of hormone in the pill.
As with any medicine, side effects are possible with oral contraceptives (birth control pills); however, not everyone who uses oral contraceptives will experience side effects. In fact, most women tolerate them quite well. If side effects do occur, in most cases, they are minor and either require no treatment or can easily be treated by you or your healthcare provider. Some types of oral contraceptives may be more or less likely to cause certain side effects than others.
(This article covers many, but not all, of the possible side effects with oral contraceptives. Your healthcare provider can discuss a more complete list with you.)
In clinical studies for most medications, one group of people is given the actual medication, while another group is given a placebo (a "sugar pill" with no active ingredients). The side effects in both groups are carefully documented and compared. This way, it is possible to see what side effects occur, how often they appear, and how they compare to the group not taking the medicine. However, it is not possible to use a placebo in clinical trials for oral contraceptives, as this would lead to many unintentional pregnancies.
Since it is difficult to obtain much information about side effects from studies that do not use a placebo, because there is no way of knowing if any particular problem is actually a side effect of the medication, only vague information is available about oral contraceptive side effects. The prescribing information for all oral contraceptives simply lists side effects seen with oral contraceptives in general, instead of a specific product. Specific information, such as how frequently side effects occur, is not provided.
Some side effects with oral contraceptives, while occurring infrequently, are potentially serious and should be reported immediately to your healthcare provider. These include but are not limited to:
- Depression or other emotional changes
- Breast lumps
- Heavy vaginal bleeding between periods (light bleeding or spotting is normal)
- High blood pressure (hypertension)
- High cholesterol
- Signs of a blood clot in the leg, such as:
- Pain in the calf
- Leg cramps
- Leg or foot swelling
- Signs of a blood clot in the lung, such as:
- Shortness of breath
- Sharp chest pain
- Coughing up blood
- Chest pain or heaviness, which may be signs of a heart attack
- Sudden loss of vision or vision changes, which can be a sign of a blood clot in the eye
- Signs of a stroke, such as:
- Vision or speech changes
- Weakness or numbness in an arm or leg
- Severe headache
- Signs of liver damage, such as:
- Yellow eyes or skin (jaundice)
- Dark urine
- Upper-right abdominal pain
- Signs of an allergic reaction, such as:
- Unexplained rash
- Unexplained swelling
- Difficulty breathing or swallowing.
Many of these serious side effects can be attributed to the estrogen content of oral contraceptives. Progestin-only pills, such as Ortho Micronor®, are less likely to cause these types of side effects (see Ortho Micronor Side Effects for more information).