Birth Control Side Effects: the Bad, the Myths, and the Good

Medically reviewed by Sophia Yen, MD, MPH – Written by Pandia Health Editorial Team

The birth control pill, the birth control patch, the birth control ring: they all contain the hormones estrogen and progesterone. These are steroid hormones that can cause side effects. Some not so great. But some actually very good!

Let’s start with the bad news.

The Bad Side Effects: increased risk of blood clots if you are already at risk

Birth control does not create blood clots. But the hormone estrogen increases the risk of blood clots in case you tick at least one of these boxes:

• You have a family history of blood clotting disorder,
• You personally had a blood clot,
• You are 35 and over AND a smoker.

Make sure you share this information with your doctor who will give you the best advice on this side effect based on your personal situation.

If you don’t tick any of the boxes above, then the risk of a blood clot is very small. But if this side effect is a worry, we explained more about birth control and blood clots in a dedicated article.

The Not So Great Side Effects: your body will need a bit of time to adjust

Most side effects will improve, and even often go away, after 2-3 months on the medication. This is the time your body needs to adjust to it. The most common negative side effects are:

• Nausea: when it happens, taking the medication right before you go to bed or taking it with your LARGEST meal of the day will decrease nauseous feelings.
  
• Irregular Bleeding: To ameliorate this side effect, Dr. Yen recommends starting the birth control pill, patch, or ring on the last days of your period. It is a time when the uterus is cleaned out. As you will be building on the clean slate, you should have less breakthrough bleeding a.k.a. spotting. If it’s just a little spotting, taking 600 mg of ibuprofen up to 3 times a day WITH FOOD for up to 5 days might be enough to stop it. If it’s more than spotting, you should talk to your provider.

The Myth Side Effects: ill-founded beliefs about weight and fertility

Lots of people think the following are side effects of the birth control but there is actually NO supporting evidence:

• Weight Gain: research has actually shown that women on the birth control pill lose 1 pound compared to those NOT on the birth control pill. Not a pound a week, a pound a month, but just 1 pound. Women NOT on the birth control pill are bloating up and down, triggering weight fluctuations. A monophasic pill stabilizes your hormone levels so your cycle won’t impact your weight.
  
• Infertility: birth control methods do not cause infertility. Polycystic Ovary Syndrom – or PCOS for short – is a common cause of infertility, It affects 10% of women and makes it difficult for these women to get pregnant. The birth control pill can actually be recommended to alleviate the symptoms as estrogen and progestin will contribute to rebalancing the hormones. To dig the topic of PCOS and birth control, read our dedicated article.

Now, on to the good news.

The Good Side Effects: better skins, better periods

The birth control hormones create positive side effects too. These are the birth control side effects we love.

• Acne: bye pimples, hello neater skin! Most of the progestins in the pill, patch, ring, increase the sex hormone-binding globulin (SHBG) which decreases circulating testosterone, the hormone is responsible for acne and hairiness. To understand how it works in detail, read our blog post on how birth control treats and prevents acne breakouts.
  
• Regular Periods: no more bad surprise because now you should get them usually on day 2 or 3 off the active pills! If you have a 4-week pack, the inactive a.k.a. placebo a.k.a. sugar pills a.k.a pills when you bleed, are the last week of pills.
  
• Lighter Periods: this is not magic, it happens because you don’t have to build your lining to support an embryo, so the lining of your uterus doesn’t build as much as if you were NOT on these methods. And when you bleed, you bleed less. For example, if you usually bleed for 5 days, 3 should become the new normal. If you usually use 5 pads a day, you will go down to 3.

Did you know you can even skip your periods altogether with birth control? And that it is actually better for you? This is what we call Periods Optional and it is backed up by science!

Feeling relieved? Get in touch to get the best birth control method for you now!

The above information is for general informational purposes only and is NOT a substitute for professional medical advice. Always seek the advice of your doctor/primary care provider before starting or changing treatment.