What Are the Side Effects of Birth Control?

By Sabina Rebis, MD
Medically reviewed checkmarkMedically reviewed
March 7, 2022

Every drug, whether prescription or over-the-counter, has side effects.

So, when you talk about the side effects of any medicine you take, you’re referring to adverse or unwanted reactions that are possibly related to the medication you’re taking, whether it’s ibuprofen or an antihistamine. 

Side effects may occur in several ways. You may have a relatively minor reaction, such as developing a rash or feeling mildly nauseous.

Or, your reaction could be much more serious. All medications come with potential risks, and birth control pills are no exception.

In this article, I’ll cover the known side effects of birth control pills and explore whether birth control pills can have long-term side effects.

I’ll discuss alternatives to the birth control pill as well. 

Finally, I’ll explain when you should see a doctor due to the side effects you are experiencing while on the birth control pill.

What Are the Side Effects of Birth Control Pills?

Because 14% of people on birth control  (around 8 million in the United States) are taking the pill, it’s not surprising that some will experience side effects at a much higher or more disruptive rate than others, and that variations of the pill will have a different effect on different people.

Estrogen and progestin can significantly impact how a person feels, so birth control pills can alleviate some problems while creating new ones for others.

Birth control pills come in different formats: triphasic, biphasic, and monophasic.

If you’re using a triphasic pill, for 5–7 days you take one strength of estrogen and progestin, then for 5–9 days, you take the following strength, and for the third phase, you take a different strength for 5–9 days.

You then take a placebo (i.e., medicine-free) pill for the remainder of the month.

The biphasic pill works similarly, but with only two changes in dosages.

The monophasic option only has one level of hormones and is the most widely used option.

The hormones in all of these birth control variations will affect some people differently from others. 

In addition to the three types of combination pills, there is also the mini pill, which is a progestin-only pill.

Side effects from birth control pills may include any of the following effects.

Spotting between periods

Sporadic spotting between periods is caused by the introduction of estrogen in birth control and will usually resolve itself in a few months.

Nausea 

Hormones can cause nausea, which may need to be addressed by your doctor. Sometimes, it may help to take your daily pill with food.

However, if you are feeling nauseated for longer than a few weeks, it’s possible that you will need to switch your prescription to another option.

Breast tenderness 

Many experience breast tenderness right before and during their period.

Often, it’s described as a heaviness radiating from the breast to the armpit and arm. Breast tenderness can become more painful when on birth control pills.

Some find that decreasing their salt and caffeine intake, and increasing the water they drink, can reduce this discomfort.

Headaches and migraines 

The pill can have either a positive or negative effect on headaches, particularly migraines.

Some find their headaches get better when they take the pill, while others find that they begin to have headaches when they never have before. 

Weight gain 

While many stop using birth control pills because they believe it causes them to gain weight, some clinical studies have shown this is not the case.

Unfortunately, it’s impossible to do a short-term study of weight gain in those who use the pill versus those who don’t.

Mood changes

Some people on birth control pills experience depression, anxiety, and mood swings.

If you have a history of depression, it’s essential to tell your doctor so that they can determine whether birth control pills are the right choice for you.

In addition, you’ll need to monitor your mental state when you begin taking birth control pills, and let your doctor know if you think they’re affecting your well-being.

Studies have shown that birth control can lead to depression, especially in those who tend to have depressive episodes.

Missed periods 

Most of the time, periods missed while on birth control occur for the following same reasons a woman who isn’t taking the pill will miss a period: stress, dietary changes, or, 9% of the time, pregnancy.

If you continue to miss your periods when on birth control, and aren’t taking the type of pill that would stop your period, talk to your doctor about it.

Decreased libido 

The hormones in birth control pills can sometimes have the side effect of a decrease in your sex drive. However, you shouldn’t have to accept it as a side effect of birth control and should look into trying a different pill to see if it helps.

Vaginal discharge 

You may notice a slight increase in vaginal discharge when they take the pill, while others find that they experience vaginal dryness.

Neither is a serious concern, and those experiencing dryness can use a lubrication product to help the problem. Most of the time, these issues go away after a few months.

Eye changes 

The pill can cause side effects like dry eye, vision changes, and other ocular problems.

If you experience issues like these, or are a contact lens wearer who now can’t use your lenses due to discomfort, ask your ophthalmologist for help. 

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Can Birth Control Pills Have Long-Term Side Effects?

Birth control pills can cause some long-term problems for some people.

For example, studies have shown that those who use the pill have a 7% higher chance of getting breast cancer than those who don’t use it.

There’s also a slightly higher risk for cervical cancer in people on the birth control pill.

However, studies also show that those who use the pill have a lower risk for uterine cancer, endometrial cancer, and ovarian cancer.

People over 35 who smoke are at higher risk for serious health problems like heart attacks, high blood pressure, strokes, and blood clots if they use hormonal-based birth control.

There are also additional medical concerns that would prohibit the use of the pill, including lupus, high blood pressure, and diabetes.

Despite these concerns, for most, it’s safe to take birth control pills indefinitely, as long as they remain healthy, visit their doctor regularly, and take their pills as prescribed.

Birth Control Pill Alternatives

Suppose you’re a woman who can’t use hormonal birth control. In that case, you do have options, including a copper IUD, barrier methods such as a diaphragm or cervical cap (with spermicide), or condoms.

If estrogen is a problem for you, the mini pill would be a good choice to try because it contains only progestin.

If you’re comfortable with hormonal birth control but prefer something longer-lasting, there are several IUDs that last from 5–10 years and require little to no maintenance once a doctor inserts them.

If you are finished having children, or don’t plan to have children, sterilization (known as tubal ligation) is 99% effective.

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When to See a Doctor

You should maintain regular contact with your doctor when you start birth control to ensure your experience is typical, comfortable, and easy.

You should call your doctor if you have any of the side effects I’ve discussed in this article, and if they don’t go away after a few days or weeks. 

Also, contact your doctor if you believe you may be pregnant, because you’ll need to stop taking the pill if you are.

Finally, visit your doctor if you decide you’re ready to stop using the pill, whether because you’re hoping to get pregnant or because you want to try a longer-lasting form of birth control, like an IUD.

Did you know you can get affordable primary care with the K Health app?

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FAQs

Does birth control harm your body?
For most women the pill doesn't harm their bodies. Some women have pre-existing conditions such as diabetes, lupus, or other auto-immune diseases that the pill can exacerbate, so they shouldn't use the pill for birth control.Women who are 35 and over and who smoke tobacco products should not take birth control pills, as it places them at high risk for serious health problems, including strokes and blood clots.
Can you get pregnant on birth control?
The short answer is yes. The pill is 91% effective, meaning 9% of women who are on the pill may get pregnant. However, those odds are small, and overall the pill is an efficient and easy way that millions of women have used (and continue to use) to keep from getting pregnant before they're ready.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Sabina Rebis, MD

Dr. Sabina Rebis is a board certified family medicine physician with over 5 years of primary care and urgent care experience.