What are the common side effects of hormonal contraceptives?

Some users of hormonal contraceptives report headaches, nausea, mood swings, weight gain, breast tenderness, and acne; however, there is not enough evidence to prove that the hormonal method is the cause of all these symptoms. Some women may also notice changes in their menstrual cycle patterns, such as irregular bleeding or absence of periods (amenorrhea). These effects are often mild and usually improve within about 3 months of starting use [4].

Side Effects of Combined Hormonal Contraceptives

Some hormonal contraceptives contain two hormones: progestin and estrogen. These include combined oral contraceptive pills, the contraceptive patch, and the vaginal ring [4]. Common side effects associated with these methods may include headaches, nausea, breast tenderness, and bleeding or spotting between menstrual cycles [2]. In rare cases, these methods may increase the risk of high blood pressure, blood clots, heart attacks, or strokes [2]. It is important to seek urgent medical attention if you experience symptoms of a blood clot, such as a throbbing pain in one leg (usually in the calf or thigh), swelling in one leg, or skin that is red or bluish around the painful area [6]. If these symptoms occur along with shortness of breath or chest pain, you must contact emergency services immediately, as the clot may have traveled to the lungs [6].

Side Effects of Progestin-Only Contraceptives

Some contraceptives contain only progestin. These include progestin-only pills (mini-pills), the hormonal intrauterine device (IUD), the contraceptive implant, and contraceptive injections [4]. Progestin-only pills may affect the menstrual cycle in different ways; periods may become lighter, more frequent, or stop completely. Some bleeding (spotting) between menstrual cycles may also occur [5]. Other side effects that some may notice include acne, mood swings, weight gain, or changes in sex drive, but there is not enough evidence to prove that these effects are caused by progestin-only pills [5]. For the hormonal IUD, side effects may include abdominal/pelvic pain, irregular bleeding, or absence of periods, and fluid-filled ovarian cysts may form [2][5]. Subcutaneous implants may cause acne, changes in bleeding patterns, headaches, mood swings, and weight gain [2]. Contraceptive injections may lead to a delayed return of fertility, headaches, irregular bleeding or absence of periods, and loss of bone density [2]. In rare cases, blood clots may occur with contraceptive injections [2].

When Should You Consult a Doctor?

If the side effects of hormonal contraceptives are bothersome or do not improve after about 3 months, you should contact the doctor or health clinic that provided the contraceptive. Another type of contraceptive might be more suitable for you [4]. It is also essential to consult a doctor if you are a smoker, have liver disease, have a history of blood clots, heart attacks, or strokes, or suffer from migraines [2]. You must also seek urgent medical help if any symptoms appear that may indicate a blood clot, such as severe pain or swelling in the leg, or chest pain with shortness of breath [6].

Choosing the Right Contraceptive

Choosing the most suitable contraceptive depends on several personal factors, including your overall health, age, frequency of sexual activity, desire for future pregnancy, and family medical history [3]. It is important to discuss all available options with your healthcare provider to evaluate the potential risks and benefits of each method. A healthcare provider can help you make an informed decision that considers your needs and health circumstances. For more information on choosing contraceptives, you can visit Choosing Contraception: Effectiveness and Risks (Arabic).

Medical references

• Side effects and risks of hormonal contraception - NHS
• Birth Control
• Side effects and risks of the progestogen-only pill - NHS
• About Contraception and Birth Control
• DVT (deep vein thrombosis) - NHS