Side Effects of the Contraceptive Pill

Although there are common side effects you can get when you take contraceptive pills, they are generally mild and typically improve after a few months as your body adjusts to hormonal changes. Side effects are not generally a cause for concern if they are mild and do not last very long.

Nausea (feeling sick)

Nausea often happens when you first start taking the pill. You can try taking it with food or before you go to bed to see if that helps, but make sure you don’t miss a pill.

Headaches

Headaches can be mild but are sometimes stronger. Also, if you already struggle with headaches or migraines, the pill can make them worse. Make sure you stay hydrated and consider what else might be triggering headaches. If your headaches are severe, consult your GP.

Breast tenderness

You may find your breasts are tender, sore, or achy when you begin taking the pill, but this usually improves over time. You can treat breast tenderness with over-the-counter painkillers and making sure you’re using a supportive bra may also help with any discomfort.

Spotting

In the first few months after you start the pill, it’s common to see a small amount of vaginal bleeding as a result of the change to your hormones levels. There’s no need to treat spotting and it usually goes away on its own, although you should see a doctor if bleeding is heavy or long-term. Making sure you take the pill at the same time each day can help keep your hormone levels stable to minimise spotting.

Changes in your mood

These can be a side effect of the pill due to the hormonal changes it causes. Exercising regularly and taking steps to manage stress, like meditation, may help. Symptoms are generally not long-term, but if they don’t go away you should speak to your GP.

Decreased libido

You may notice you have a lower sex drive while taking the pill. Changing to another pill can sometimes help if this doesn’t go away, and it may help to talk to a doctor to rule out any other possible causes.

Vaginal discharge

The pill works by thickening your cervical mucus to stop sperm entering your uterus. As a result, you may notice your vaginal discharge is whiter or thicker when on the pill. These are normal changes, but if you get any of the following, speak to your doctor as soon as possible:

• cottage cheese-like texture
• pink, green, brown, or yellow coloured discharge
• more discharge than usual
• an odour that’s like fish or rotten meat

Check out our guide for more information on what the colour, texture or smell of your vaginal discharge may mean.

Other potential side effects

When taking the contraceptive pill, you may also experience:

• temporary changes in your weight
• changes in your appetite
• bloating

These side effects will normally clear up over time. Weight changes and bloating can be the result of your body retaining fluid in response to your pill.

For more information on weight gain and the pill, check out our guide: Losing weight on the pill

Remember, if any side effects last a long time or are severe, you should contact your doctor for advice.

Getting serious side effects from taking a contraceptive pill is rare, but it can happen. If you think you might be experiencing any of the following serious side effects, it’s important that you seek medical attention.

Blood clots

Contraceptive pills, particularly the combined pill, can increase the risk of blood clots, including pulmonary embolisms and deep vein thrombosis (usually in your leg).

The risks are low, but can be increased by:

• smoking
• long periods of not moving around much
• obesity
• having a personal or family history of blood clots

Symptoms of a pulmonary embolism include:

• having sudden difficulty breathing
• chest pain that gets worse when you breathe in
• coughing up blood

Symptoms of deep vein thrombosis in your leg include:

• a throbbing pain in one of your legs when walking or standing, typically in your thigh or calf
• swollen veins which are painful or hard if you touch them
• swelling in one (or rarely both) of your legs
• darker or redder skin where it’s painful – this may appear differently or be less visible on darker skin
• warmer skin in the area that’s painful

Deep vein thrombosis can also occur in your stomach or arms.

If you think you could have either of these, seek medical help immediately.

High blood pressure

Taking the combined pill has been linked to increased risk of high blood pressure, due to the rise in oestrogen levels. If you have high blood pressure already or you are at risk, taking the pill may increase your risk of high blood pressure, and as a result also increase your risk of a stroke or heart attack. High blood pressure that is not genetic doesn’t usually cause any symptoms, but you can have your blood pressure checked by your GP surgery

Cancer

The risks relating to cancer depend on whether you take the combined pill or the mini pill.

Using the combined pill slightly increases the chance of breast and cervical cancers, including for up to 10 years after you stop taking it, but it can also lower the chance of ovarian and endometrial (womb) cancers, including after you stop taking it.

Using the mini pill also slightly increases the chance of breast and cervical cancers. Some small studies have also reported that it can provide slight protection from endometrial cancers.

We recommend getting regular check ups like smear tests and mammograms whether you take the combined or the mini pill.

Eye changes

Some people have reported getting changes or disturbances in their vision whilst taking the pill. This could be because of blood clots affecting the blood vessels to the eye. If you get sudden vision changes, you should seek medical attention immediately.

Long-term effects

There is currently no evidence that contraceptive pills impact future fertility. However, it has been suggested that taking the pill can affect bone mineral density in adolescents.

Other serious side effects

According to research, you may be more likely to get gallbladder disease if you take oral contraceptive pills compared to people who don’t. Both the mini pill and the combined pill increase the chances of getting gallstones.

You can lower your chance of getting side effects from taking the contraceptive pill:

• adjusting how you take your pill
• changing your other medications, if you’re taking any
• making changes to your lifestyle

Maintaining a healthy lifestyle can also help to support you to feel well generally.

Feeling sick and headaches

If you are worried about getting nausea, try taking the pill at the same time each day, with food, and before bed. Taking the pill at the same time each day can also help you avoid headaches. You should also stay hydrated and consider a low-oestrogen pill for a lower chance of headaches.

Mood changes

To avoid changes to your mood, practicing mindfulness techniques or meditation may help. It is also a good idea to consider switching to a pill that contains drospirenone, since these will be less likely to cause mood swings. If you already have trouble managing your mood, you may consider speaking to your GP about starting antidepressants. Just make sure to mention you’re on the pill as some antidepressants can make the pill less effective.

Healthy lifestyle

Making improvements to your lifestyle can help reduce your chances of getting a number of different contraceptive pill side effects.. Following a healthy diet, getting enough sleep, and doing regular exercise can help lower your chance of side effects and help you deal with any side effects more easily.

Alternative pills or other contraception

Depending on which side effects you most want to avoid, you could consider taking different kinds of contraceptive pills, for example:

• low-oestrogen pills or mini pills that contain no oestrogen have a lower chance of oestrogen-related side effects, like headaches or breast tenderness
• pills containing third and fourth generation progesterones like desogestrel and norgestimate have a lower chances of causing progesterone related side effects, such as acne or spotting

There are also alternative methods of contraception you could consider which have a lower chance of side effects than the pill.

When you stop taking the contraceptive pill, you may get temporary side effects as your body readjusts to its natural hormonal balance. There are several common side effects that you might get when you come off the pill. They typically go away within a few months. However, not everyone gets these side effects, and they will vary from person to person.

Changes in menstrual cycle

Your periods might become heavier, more painful, or irregular as your body adjusts. You can manage this by taking over-the-counter painkillers like paracetamol and applying a warm compress to your lower abdomen or back when you experience period pain.

Mood swings

Shifts in your hormone levels can cause irritability, anxiety, or mood swings, or make them worse if you experience them already. You may be able to manage these through stress management techniques like mindfulness meditation. Reach out to a doctor if these side effects become severe

Acne or skin changes

Changes in your hormone levels can alter the production of oil in your skin, leading to acne. If your acne improved while you were taking the pill, it can often get worse again after you stop. A regular skincare routine may help and you can get specific acne treatment as well.

Temporary changes in libido

You might get increased or decreased sex drive as your hormone levels readjust. If you get any side effects from coming off the pill, and they are severe or long-lasting, you should contact your GP or healthcare provider for advice and support.

The contraceptive pill is a safe and effective contraceptive method, if approved by a healthcare provider and taken as instructed. However, like all medications, there are some risks of serious side effects, which vary between people.

The overall health risks are generally very low. It is important that you discuss your medical history with your doctor or GP before starting or stopping the pill to make sure the pill is a safe option for you.

There is no pill that is “better” than others for everyone when it comes to side effects. Side effects will vary depending on the individual taking the pill and the pill type. You may find that a particular pill gives you less or no side effects compared to other options.

However, different types of pills have different chances of causing specific side effects.

See our guide on different brands of the contraceptive pill for more information.

The mini pill

Since the mini pill doesn’t contain oestrogen, it has a lower risk of oestrogen-related side effects like headaches and breast tenderness. However, the mini pill can be more likely to cause progesterone-related side effects which can be offset by the oestrogen in combined pills, including acne or spotting.

Lower-oestrogen combined pills

If you are worried about oestrogen-related side effects on the combined pill, like headaches and breast tenderness, taking a pill with a lower dose of oestrogen can lower your chance of side effects.

Third and fourth generation progesterones

Using a contraceptive pill that contains later-generation progesterones like desogestrel or norgestimate can reduce your chance of some progesterone-related side effects like acne and spotting as well.

There are many other contraceptive methods available other than the pill you’re taking, so if you’re experiencing unpleasant side effects, you may want to consider alternative types of contraceptive methods like:

• an intrauterine device (IUD) or copper coil, which is fitted to your uterus
• an intrauterine system (IUS) or hormonal coil fitted to your uterus, which releases hormones
• a contraceptive implant inserted into your arm, which releases hormones
• a contraceptive injection of hormones
• a contraceptive patch worn on your skin, which releases hormones
• a vaginal ring, which is put into your vagina and releases hormones
• condoms, worn on the penis to stop sperm entering the vagina and prevent the spread of sexually transmitted infections (STIs)

These options also have potential side effects, but you may find them more tolerable. This will vary from individual to individual, so try and find what’s right for you.

Non-hormonal methods

Methods that don’t contain hormones, like the IUD or condoms, won’t have the same risk of hormonal side effects. Examples of non-hormonal methods of contraceptives include:

• contraceptive diaphragm – a reusable barrier which you can insert in your vagina
• barrier methods – like condoms (both male and female)
• cervical caps – a small reusable cup that fits over the cervix to prevent pregnancy
• copper IUD (intrauterine device) – a T shaped device that can be placed in the uterus by a healthcare professional

Localised treatments

The vaginal ring and IUS (intrauterine system) are both placed inside the vagina and so the effect of their hormones are localised. This means they may not have the same full-body effects that methods like the pill or patches have. This can mean you have less chance of some side effects.

For more detailed guidance on contraceptives, check out our Ultimate Guide to Different Types of Contraceptive Methods.