What Are the Side Effects of Birth Control?
Medically reviewed by Lindsay Cook, PharmD
There are various ways to prevent pregnancy, such as condoms, diaphragms, and hormonal birth control. Hormonal birth control is a type of birth control that contains either the hormones estrogen and progestin or progestin alone.
There are several types of hormonal birth control, including oral contraceptives (commonly known as birth control pills), injections, intrauterine devices (IUDs), vaginal rings, implants, and skin patches. As with any medication, there are potential side effects associated with hormonal birth control, such as headache, nausea, breast soreness, vaginal yeast infections, mood swings, and spotting between periods.
Of note, hormonal birth control is very effective in preventing pregnancy, but it does not prevent sexually transmitted infections (STIs), such as chlamydia, gonorrhea, HIV/AIDS, and others.
This article discusses the side effects of the various types of hormonal birth control.
Getty Images | Peter Dazeley
What Are the Side Effects of Hormonal Birth Control?
People who take hormonal birth control may experience some side effects. Side effects can vary from person to person and based on the type of birth control. General side effects may include:
Headache
Nausea
Breast tenderness
Mood swings
Decreased interest in sex
There is a small risk of blood clots. People who are over 40 years old, who smoke, are very overweight, or have a family history of clotting may have a higher risk of blood clots.
Birth Control Pills
Birth control pills are 99% effective with perfect use, which means that you take your pill every day around the same time each day and do not skip pills. Given that people generally do not take their pills perfectly, the actual effectiveness tends to be around 93%. So, about 7 out of 100 people who take birth control pills get pregnant each year. Birth control pills contain estrogen and progestin hormones (combination birth control pills) or a progestin hormone alone (often referred to as the minipill).
Common side effects of birth control pills include:
Changes in bleeding (unpredictable bleeding, spotting, or shorter cycles; some people experience no bleeding at all)
Headaches
Nausea
Breast tenderness
Side effects tend to start when you start taking birth control and tend to go away after a few months.
Injectable Birth Control
Depo Provera is an injectable birth control. It contains a progestin hormone. A healthcare provider administers this birth control every three months. It is more than 99% effective with perfect use or when a person gets the shot on time. With actual use, it is about 96% effective. Common side effects of Depo Provera, which tend to go away after a few months, include:
Changes in your periods, especially in the first year (bleeding more, spotting, or not getting your period)
Nausea
Weight gain
Headaches
Breast soreness
Depression
Slight bruising at the injection site
Implant
Nexplanon is a birth control implant, a tiny rod that releases a progestin hormone into your body. It protects against pregnancy for up to five years. It is over 99% effective as a method of birth control. The most common side effects include:
Changes in bleeding
Headache
Weight gain
Breast pain
Stomach pain
Intrauterine Device (IUD)
An intrauterine device (IUD) is inserted by a healthcare provider and is over 99% effective. There are several types of IUDs available. The copper IUD is a nonhormonal type of birth control, but the other types of IUDs are hormonal, including:
Mirena: prevents pregnancy for up to eight years
Liletta: prevents pregnancy for up to eight years
Kyleena: prevents pregnancy for up to five years
Skyla: prevents pregnancy for up to three years
Common side effects of IUDs generally last three to six months and may include:
Lighter periods (some people stop getting their periods)
Spotting
Irregular periods
Pain when the IUD is inserted, along with back pain and/or cramping for several days after the procedure
Vaginal Rings
A vaginal ring, such as Nuvaring or Annovera, is a flexible plastic ring that is inserted into the vagina. Estrogen and progestin hormones are slowly absorbed into the body to prevent pregnancy. Used perfectly, a vaginal ring is about 99% effective, but real-life use makes it about 93% effective. Common side effects, which generally last up to three months, include:
Headache
Nausea
Sore breasts
Changes in periods (early, late, or stopping)
Spotting
Increased vaginal wetness
Skin Patches
Birth control skin patches, such as Xulane or Twirla, contain both estrogen and progestin hormones. They are similar to the pill in terms of how effective they are in pregnancy prevention. Common side effects, which tend to go away after a few months, include:
Headache
Nausea
Breast soreness
Changes in periods (early, late, or stopping)
Spotting
Skin reactions where the patch is applied, such as itching, dry skin, pain, swelling, or rash)
Are There Risks Associated With Hormonal Birth Control?
Each form of hormonal birth control may have some slight variations in benefits and risks. You should always consult your healthcare provider for professional medical advice regarding your medical conditions and treatment, as they can weigh the benefits vs risks of any type of birth control for your specific medical history. Although there are some benefits of combination hormonal birth control, such as lower risk of ovarian, endometrial (uterine), and colorectal cancer, some examples of general risks associated with combination hormonal birth control include:
There is a slightly increased risk of blood clots in those who take a combination estrogen and progestin birth control;however, other factors can contribute to risk, such as age, weight, and family history. Progestin-only types of birth control do not increase the risk of blood clots.
Possible increased risk of breast cancer. Studies have found that progestin-only birth control may also increase breast cancer risk.
Possible increased risk of cervical cancer.
Consult your healthcare provider for more information about the benefits and risks of hormonal birth control.
Who Should Not Use Hormonal Birth Control?
Hormonal birth control is not safe for everyone. You should always consult your healthcare provider for medical advice regarding the safety of hormonal birth control for you. Some examples of people who should not take birth control pills include those who:
Are 35 years or older and smoke cigarettes
May be pregnant
Have a history of blood clots or stroke
Have a history of an estrogen-dependent tumor, such as breast cancer or uterine cancer
Have abnormal or unexplained menstrual bleeding
Have liver problems
Experience migraine associated with visual or neurologic symptoms like aura
People with other conditions, such as high blood pressure, epilepsy (seizures), or diabetes, should check with their healthcare provider for medical advice.
Other Methods of Birth Control
The following lists some additional types of birth control that are not hormonal. You should always discuss the pros and cons of each type of birth control with your healthcare provider.
Condoms: Condoms are very effective in preventing certain sexually transmitted infections (STIs) like HIV, gonorrhea, and chlamydia. They are less effective in preventing STIs that can be transmitted through cuts or sores, such as human papillomavirus (HPV), genital herpes, and syphilis. External condoms are worn over the penis. Latex condoms provide the best protection. Note that lambskin condoms contain small holes and do not protect against STIs. An internal condom, sometimes called the female condom, can be inserted into the vagina or anus during intercourse.
Copper IUD (Paragard): A healthcare professional must insert the copper IUD. It can prevent pregnancy for up to 10 years, but it does not protect against STIs.
Diaphragm: A silicone device that covers the cervix. It can be inserted up to two hours before sex and must stay in place for at least six hours (but no longer than 24 hours) after sex. It does not protect against STIs.
Cervical cap: A small silicone cup covering the cervix. It can be inserted several hours before sex and must stay in place at least six hours after sex but no longer than 24 hours after sex or for more than 48 hours total. The cervical cap does not prevent STIs.
Spermicides: Contain chemicals to prevent pregnancy. They must be used along with another type of birth control, such as condoms. Spermicides are not effective enough on their own to prevent pregnancy. They do not prevent STIs.
Phexxi: A vaginal gel that prevents pregnancy. A prefilled single-dose applicator must be inserted vaginally just before (or up to one hour before) each episode of vaginal intercourse. Phexxi does not prevent STIs.
Abstinence: This means not having sex. This is the most effective way of preventing pregnancy and STIs.
Withdrawal: Often referred to as "pulling out," this is when the penis is removed from the vagina before ejaculation. It is not an effective way to prevent pregnancy, and it does not prevent STIs.
Tubal ligation: This surgical procedure, which can be done in women, is often referred to as "getting your tubes tied" and is a permanent form of birth control. It does not prevent STIs.
Vasectomy: A surgical procedure that can be done in men and is a permanent form of birth control in men. It does not prevent STIs.
Summary
Hormonal birth control contains estrogen and progestin hormones or progestin alone. Common side effects may include changes in bleeding, spotting, headache, nausea, and breast tenderness. Often, these side effects lessen or go away as you continue with your treatment. Consult your healthcare provider for more information about hormonal birth control.
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