Birth Control Side Effects: A Guide

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A variety of methods of birth control are available today. Some of these contain hormones; others do not. Regardless of which type of birth control you choose, you may experience side effects. Your choice of birth control method should take into account not only the effectiveness of the method, but how well it integrates into your life. This is why it is very important to learn about all possible side effects.

It is also important to note that not all birth control side effects are horrible or a reason to stop a medication. Some side effects may actually fade with continued use of the medication. Other side effects might be treated with other medications or therapies. Very rarely are there life-threatening side effects from birth control methods, but it is possible with some methods and in people with various histories.

Hormonal contraception side effects

Hormonal contraceptives can contain one hormone or a combination of hormones — typically estrogen and/or progesterone. Because these methods use hormones, they may be more prone to causing side effects.

The pill (oral contraception)

The birth control pill is a common form of contraception. It uses one or more hormones to suppress ovulation, while thinning the uterine lining and thickening your cervical mucus, according to the American College of Obstetricians and Gynecologists (ACOG). Typically, birth control pills contain some combination of estrogen and progestin. With these pills, about nine out of 100 women will get pregnant in a year of typical use, but if the pill is used perfectly, that risk would be about 1 in 100. There is also a type of birth control pill known as the mini-pill that contains only progestin.

Below, the general side effects for oral contraceptives are listed, according to ACOG. However, you should always talk to your doctor, midwife, or nurse practitioner about what side effects your specific prescription might carry.

Common side effects of the pill

  • Headache
  • Breast tenderness
  • Headache
  • Breakthrough bleeding

Serious or potentially serious side effects of the pill

Most of these side effects are higher in women over 35 and those who have a history of smoking. Talk to your doctor to learn whether you are more at risk of these:

  • Deep vein thrombosis (DVT)
  • Heart attack
  • Stroke

The patch

This small patch is adhesive and is worn for 21 days on the body (upper back, arms, chest, buttocks, abdomen, not breasts). The hormones are released into the skin. No patch is worn for the next seven days, and then a new patch is used.

Common side effects of the patch

  • Skin irritation
  • Breast tenderness
  • Headache
  • Breakthrough bleeding

The vaginal ring

The vaginal ring (NuvaRing) is an estrogen- and progestin-laden plastic ring that is placed in the vagina for 21 days and removed for seven days, after which a new ring is placed.

Common side effects of the ring

  • Headache
  • Nausea
  • Breast tenderness
  • Vaginal discharge
  • Vaginal irritation
  • Breakthrough bleeding

Long-acting reversible contraceptives: The IUD and implant

Long-acting reversible contraceptives (LARCs) include the birth control implant and the hormonal and non-hormonal intrauterine devices (IUDs). These "set-it-and-forget-it" methods are inserted and then are effective for a long time. Because of this, you don't need to think about on a daily basis. However, you can have your doctor remove them at anytime if you want to try to get pregnant.

These devices are some of the most effective options available, with fewer than one in 100 women experiencing pregnancy with a year of use, according to the Centers for Disease Control and Prevention (CDC). However, it's important to remmeber that neither of these types of birth control protect against human immunodeficiency virus (HIV) or other sexually transmitted infections (STIs).

The implant

The implant (such as Nexplanon or Implanon) is a small, matchstick-sized rod that is placed into the skin of your upper arm. This is done using a local anesthetic and a special tool. It only takes a few minutes to insert and lasts several years.

Common side effects of the implant

  • Unpredictable menstrual bleeding (may become less frequent and stop altogether)
  • Breast tenderness
  • Headaches

Less common side effects of the implant

  • Digestive difficulties
  • Weight gain
  • Acne

Serious or potentially serious side effects of the implant

  • Problems with the insertion or removal (rare)
  • If pregnancy occurs, higher risk of ectopic pregnancy

Hormonal IUDs

The hormonal IUD is placed inside the uterus and stays there for 3 – 5 five years, depending on the type. It slowly releases progestin to help prevent pregnancy by thinning the uterine lining and thickening the cervical mucus.

Common side effects of the IUD

  • Frequent spotting (decreases with time, and bleeding may stop completely)
  • Pain during periods (decreases with time)

Less common side effects of the IUD

  • Headaches
  • Breast tenderness
  • Mood changes
  • Nausea

Serious or potentially serious side effects of the IUD

  • May become dislodged, including through the uterus (extremely rare)
  • Can cause ectopic pregnancy, if placed when a woman is pregnant (extremely rare)
  • Pelvic inflammatory disease if insertion is done with an undiagnosed STI (extremely rare)
  • If pregnancy occurs and the IUD is left in place, there is an increased risk of miscarriage

Non-hormonal contraception side effects

Some people do not tolerate or want hormonal methods of birth control. The following methods do not contain hormones.

Non-hormonal IUD

The copper IUD (ParaGard) works by altering how sperm moves, making it less effective at reaching the egg or fertilizing the egg. Again, it is not a method of birth control that provides any protection against STIs. After insertion, it lasts up to 10 years and is highly effective.

Common side effects of the non-hormonal IUD

  • Frequent spotting (can be treated with medication)
  • Pain during periods (can be treated with medication)

Serious or potentially serious side effects of the non-hormonal IUD

  • May come dislodged, including through the uterus (extremely rare)
  • Can cause ectopic pregnancy, if placed when a woman is pregnant (extremely rare)
  • Pelvic inflammatory disease if insertion is done with an undiagnosed STI (extremely rare)
  • If pregnancy occurs and the IUD is left in place, there is an increased risk of miscarriage

Barrier methods of birth control

The following are considered barrier methods of birth control. This means that they form a barrier between the egg and the sperm, either physically or chemically. In general, barrier methods are less effective than other methods of birth control, according to ACOG, with as many as 18 – 28 women becoming pregnant every year out of 100 women using these methods. Some barrier methods may also help reduce the risk of STIs.

Condoms

There are both male and female condoms, though male condoms are the most common. These can be made out of many materials, with latex considered the most effective, followed by polyurethane. You may also find other materials used.

Common side effects of condoms

  • User error
  • Must be used at every act of intercourse

Serious or potentially serious side effects of condoms

  • Allergy to the materials

Spermicide

Spermicide may be used alone or with methods like the condom, diaphragm, cervical cap, or sponge. It is a chemical (and there are many types of chemicals used) that kills sperm.

Less common side effects of spermicide

  • Can cause burning
  • Can cause itching

Serious or potentially serious side effects of spermicide

  • Either partner may have an allergy to the ingredients
  • The use of nonoxynol-9 as the active ingredient in the spermicide will cancel out any reduction in risk of STIs

Diaphragm

This is specially fitted and given as a prescription. It is refitted and replaced at least every year. It can be used alone or, for added pregnancy protection, it can be used with spermicide.

Less common side effects of the diaphragm

  • Vaginal irritation with the spermicide
  • May increase the risk of urinary tract infections (UTI)

Serious or potentially serious side effects of the diaphragm

  • Potential allergy to the material in the diaphragm
  • Potential allergy to the spermicide (if used)
  • Potential for toxic shock syndrome (TSS) if not used correctly
  • Potential more risk for contracting HIV

The bottom line

After everything is said and done, it is important to remember that even though side effects are listed for every birth control method, you may not experience any of them. Your personal experience may trump what is noted on a piece of paper. You should also speak to your provider about any side effects that you experience. Some rare side effects have severe consequences and need immediate emergent treatment, while others are more common and merely annoying.

Working with your practitioner, you can usually find a method of birth control that works for your lifestyle and that may include workarounds for a variety of different side effects. You may also have different needs as you age or as your medical history changes. Remember: The best method of birth control is the method you use correctly every single time you have sex.