What are the side effects of birth control?

Every body is different. That’s why every body can react differently to medications, including different formulations of birth control. It’s important to know the possible side effects of birth control, whether you’re thinking about switching to a new type of birth control or wondering if how you’re currently feeling is a side effect.

It can be tricky to know for sure if something you’re experiencing is a birth control symptom or not. The possible side effects of birth control are extremely variable and can be triggered by plenty of other things. But knowing the likelihood of side effects on different birth control formulations can be a big tip-off, as well as key information that can help you decide whether it’s time to switch methods.

Birth control side effects

Birth control, just like any medication, can have unintended side effects. Human bodies are so complicated that it’s nearly impossible to guarantee a drug will only affect the specific thing you want it to.

For example, many contraceptives contain hormones as active ingredients, since they’re a super effective way to prevent pregnancy (by preventing ovulation). But hormones play a ton of roles in the body, so avoiding so-called “off-target effects” – aka side effects – can be tough. And even though there are a number of non-hormonal forms of birth control, these can have side effects, too.

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Birth control side effects can range from annoying (e.g. acne) to life-threatening (e.g. blood clots). That means it’s important to take stock of what you might be susceptible to when you’re considering the risks associated with different methods. For example, if you know your family has a history of blood clots, you should take that potential side effect more seriously, perhaps limiting your options to those that are not associated with clots.

That said, a risk of side effects is just that: a risk. A list of potential side effects is not a list of experiences you should expect to have while on birth control! Some side effects may be more or less likely than others, and some may not happen to you at all.

Some side effects might even be desirable, like not having a period.

If your current birth control seems to be giving you side effects that you don’t want, or you’d like to start on a new form of birth control but are concerned about certain side effects, talk to your doctor.

Common side effects of birth control

Somewhere between 65 and 70 percent of people who stop using their hormonal birth control do so because they experienced side effects.¹ And although many bad side effects of contraceptives are common, that still doesn’t necessarily mean you should expect or tolerate them. What matters most is finding a birth control that works for your own biology.

Some side effects are more common than others. This infographic shows the most commonly reported side effects across birth control options.

Birth control side effects list

Here are some of the most common side effects of birth control² reported:

• Acne
• Weight gain
• Breast tenderness
• Vaginal discharge
• Breakthrough bleeding
• Nausea
• Mood changes
• Sexual effects (e.g. decreased libido)
• Headaches
• Heavy periods
• Irregular periods
• Hirsutism
• Oily skin
• Absence of periods

Infertility is a birth control side effect that’s often asked about, but there’s actually no evidence that birth control can cause infertility.

How soon do birth control side effects start?

How quickly birth control side effects show up can vary greatly – it depends on the type and the side effect. For instance, some people experience nausea right away when they first start taking birth control pills. Other side effects, like breakthrough bleeding, may take longer to show up.

And, when you first start on birth control, or switch to a new method, you might even experience side effects that are expected to resolve on their own. In other words, they may go away if you wait it out. This is because there’s a so-called “adjustment period” that lasts for three to five months after you start a new birth control.³ If you do experience some of these temporary side effects after starting a new birth control, it’s up to you whether you’re comfortable waiting it out – don’t feel pressured to suffer for five months. That’s a long time!

Some side effects from starting birth control that may resolve in a few weeks or months include:

• Breakthrough bleeding
• Nausea
• Breast tenderness

When side effects don’t improve

If you think you’re experiencing birth control side effects that haven’t improved after the first few weeks or months – or gotten worse over time – you should consider switching methods. The evidence for which formulations cause which side effects is variable, but here’s a run-down of what the evidence does show. This list may help you recognize whether an unwanted symptom you’re feeling may be a result of your current birth control method.

9 of the most common birth control side effects

Breakthrough bleeding

Breakthrough bleeding is spotting or bleeding between periods (or between withdrawal bleeds, if you’re using hormonal forms of birth control). If you’re experiencing problematic bleeding on hormonal birth control, there’s some evidence that taking a three-day break from your contraceptives can help.⁴ If the problem persists, you might consider switching to a formulation with more ethinyl estradiol (estrogen)⁵ or switch to a different form of progestins.⁶

Breast tenderness

Some people report feeling tenderness in their breasts when they start taking birth control. This often resolves on its own for those taking the pill,⁷ but is slightly more likely to persist on norelgestromin-containing patches (like Ortho Evra).⁸

Acne

The relationship between birth control and acne is one of the most complicated, since some people taking some forms of birth control report that their acne actually gets better, while for others it can get worse. Generally, acne is more common in people taking older formulations of progestin-only contraceptives,⁹ and less common (or improved) in formulations that contain estrogen (estradiol), like combined oral contraceptive pills.¹⁰

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Decreased libido

Some people report that they feel less sexual drive, or libido, on birth control. This birth control side effect has occasionally been reported for those on low-dose pills or the implant,¹¹ but in general evidence is inconsistent across all forms of birth control. There is some evidence that libido can actually increase for some people while using a levonorgestrel-releasing IUD!¹²

Depressed mood

Research suggests that all forms of hormonal birth control have some association with increased risk of depression, and some forms have a stronger link than others. Progestin-only contraceptives (like the minipill) and hormonal IUDs are more associated with depression, and this relationship is stronger in adolescents.^13-14

Headaches

Headaches can be triggered by changes in estrogen levels in the body, and so are more likely to occur in people who are already prone to getting headaches with their cycle. When taking cyclical formulations, like combined oral contraceptives, estrogen drops during the scheduled withdrawal period, which can give some people a headache or migraine. Some might experience these symptoms from the change in hormone levels that occur when first starting a new birth control. For the same reasons, some people who have migraines find that their symptoms actually improve when they take birth control that keeps their hormones consistent, like hormonal IUDs.¹⁵

Hirsutism

Hirsute is just a fancy way of saying hairy, and it’s true that some forms of birth control can increase hairiness in places that, for some people, is unwanted – like the upper lip, chin, arms, or even back. This side effect is most common in progestin-only forms of birth control.¹⁶ There’s no medical reason to be concerned about body hair, but if this concerns you, don’t fret – other birth control options are available.

Weight gain

Weight gain is one of the most commonly asked about side effects of birth control, but there’s actually no conclusive evidence that most forms of birth control could cause it.¹⁷ The one exception is the birth control shot, which has a confirmed slight risk of weight gain for some people.¹⁸

Don’t suffer in silence

If you’re experiencing any unwanted symptoms that you think might be side effects from your birth control, talk to your doctor! There are so many different birth control formulations out there, you may not have found the best fit for your body yet. Find one that works for you – without side effects.

Here at adyn, we use your biology to help you do just that.