Birth Control Pills Side Effects & Alternatives

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How This Helps

Hormonal birth control is the most commonly prescribed form of contraceptive being used today to prevent any unwanted pregnancy. The most commonly preferred type of hormonal birth control is the oral contraceptive pill, commonly referred to only as ‘the pill.’ While there are many other hormone-based methods of birth control, the fact that remains the same across all of these various methods is that there are many side effects associated with these. Hormonal birth control can also be prescribed for resolving irregular menstruation, heavy or painful periods, acne, endometriosis, and premenstrual syndrome (PMS) as well. There is no doubt that the pill is highly effective, but at the same time, there are many side effects of taking hormonal birth control. Let us take a look at some of the most common side effects of taking hormonal birth control.

Common birth control pills side effects

Birth Control Side Effects

Birth control side effects are a reality. Since hormonal birth control is a common form of contraceptive used by people worldwide, there are many side effects that stem from the use of birth control pills as well. Some of the most common birth control side effects are:


● Nausea

● Intermenstrual spotting

● Breast tenderness

● Migraine and headaches

● Weight gain

● Mood changes

● Yeast infections

● Gum disease and Crohn’s disease

● Blood clots

● Nutritional deficiencies

● Reduced libido

● Gallstones

Let us look at these birth control side effects and the long term side effects of birth control pills in detail.


– Nausea

Many women end up experiencing mild nausea when they first start taking the birth control pill. However, symptoms do tend to subside after a few months. Nausea gets better if you take the pill at bedtime or with food. If nausea is severe while taking the birth control pill, or it tends to persist for longer than three months, then you should consult your doctor and seek a change in contraceptive.[1] Nausea is seldom one of the long term effects of birth control.


Intermenstrual Spotting

Intermenstrual spotting, usually known as breakthrough vaginal bleeding, is commonly observed in women taking hormonal birth control. This side effect also tends to resolve itself within three months of starting the birth control pill.

During intermenstrual spotting, the pill still remains effective, but only as long as you are taking it correctly, and you do not miss any doses. Anyone who is experiencing five or more days of such type of breakthrough bleeding while being on the pill, or heavier than usual bleeding for three days or longer, should consult their doctor immediately. 

This bleeding usually happens because the uterus adjusts itself to having a thinner than usual endometrial lining. It may also occur because the body is adjusting itself to having varying levels of hormones. 

Some studies have found that women who experience intermenstrual spotting are at a higher risk of getting chlamydia. [2]


– Breast Tenderness

Hormonal birth control can also cause breast tenderness or breast enlargement. This also tends to resolve itself within a few weeks of starting a new form of hormonal contraceptive. However, if you find a lump in the breast or if you have persistent tenderness or pain in the breasts, or even severe breast pain, then it is absolutely critical to consult a physician and get a thorough check-up done. 

Some tips for alleviating breast tenderness include reducing your salt and caffeine intake and wearing a supportive bra that lifts up the breasts.  Otherwise, also, there have been many studies that have shown that the appearance of the breast changes based on what type of hormonal birth control you are taking. [3]

Some studies have also linked the use of oral hormonal contraceptives such as the pill to a higher incidence of breast cancer in women. [4] 


Headaches and Migraine

The hormones present in birth control pills are known to increase the likelihood of getting a migraine and headaches in general. Different types of birth control pills have varying doses of the hormone, which are known to trigger different kinds of side effects and symptoms. 

According to The Migraine Trust, migraine headaches are more common in women who are on hormonal contraceptives as compared to women who are not using the birth control pill.[5] This is believed to be due to the widespread effect of the varying doses of estrogen and progesterone that can be found in the birth control pill. Some women are also more sensitive to the fluctuations of hormones during the entire menstrual cycle than others. 

Even though headaches are a common side effect of taking oral hormonal contraceptives, it is also known to improve over time. Many women find their headaches and migraine improving when they start the pill, while others find their migraine and headaches getting worse. 

Studies indicate that headaches are less likely to occur if you take the lowest hormone dose pills, which contain newer types of progestogens. [6]  While symptoms of migraine and headaches improve over time, but if you experience severe headaches that start when you begin a new cycle of the pill, then you should seek medical help as it may be a warning sign of some other underlying condition. [7]


Weight gain

Weight gain while having birth control pills is normal due to fluid retention. A review by the Oregon Health & Science University found that there was an average weight gain of just under 4.4 pounds (or 2 kilograms) in women taking progestin-only birth control for 6 to 12 months. Studies of other types of birth control methods have also shown the same weight gain.[8]


–  Mood Changes

Studies have found that oral contraceptives have an effect on the user’s mood. It also increases the risk of depression, along with other emotional changes. [9] Anyone who is experiencing severe mood changes while using the pill should consult their doctor.

– Yeast infections

Research has proven that yeast infections are more prevalent among women on birth control. While birth control pills do not directly lead to yeast infections, they can disrupt the human body’s natural hormonal equilibrium -especially the balance between progesterone and estrogen -which can sometimes cause yeast overgrowth and subsequent vaginal infection.

– Gum disease and Crohn’s disease

Gum disease is a more common complication of birth control pills, and this might be because the Candida and Prevotella bacterial species which contribute to it are more plentiful in the mouth when taking birth control.

Another type of inflammatory bowel disease, Crohn’s disease, also happens more frequently in women on birth control, maybe almost three times as frequently. This might be a consequence of the change in gut microbes and estrogen’s negative effect on gut permeability.

– Blood clots

Venous thrombosis (blood clots) is among the more serious unwanted side effects of most birth control pills. Birth control pills dramatically increase the risk of heart attack or stroke risk by 60 percent in the lowest estrogen dose, and more so as the estrogen dosage increases.

– Nutritional deficiencies

Various nutrients such as vitamins and minerals are depleted in birth control pill takers. Studies have noted lower levels of numerous vitamins and minerals in women taking birth control pills. One research focused solely on vitamin B12 and discovered women who had taken the birth control pill had consistently lower vitamin B12 concentrations compared to non-users, independent of the dietary intake.

– Reduced libido

Another recorded side effect of birth control pills is that for a small fraction of women, it may significantly reduce libido. A probable explanation is that birth control pills reduce the amount of testosterone circulating in your body. Research affirmed this when comparing the sex drive of participants with a contraceptive ring, implant, or birth control pill to people with a non-hormonal birth control alternative, like a copper IUD, discovering that participants with a hormonal birth control alternative experienced a diminished sexual drive.

– Gallstones

Gallstones are residues of digestive juices inside the gut that can result in symptoms such as pain, indigestion, nausea, and vomiting. The probability of developing gallstones is 35-50% higher for women who take birth control pills when compared with women who do not. Gallstones can be painful and lead to operation to remove the gallbladder. Ultimately this has a lifelong and negative effect on digestion and your microbiome.

Benefits of birth control pills

Apart from being an effective means for birth control, studies indicate that birth control pill users have a decreased risk for ovarian, endometrial, and colorectal cancer compared to non-users. The pill has also been viewed as a helpful way of chemoprevention across women with varying degrees of cancer risk. Other potential benefits of birth control pills contain lighter, less painful periods, more regular intervals, and less acne (with some types of birth control pills).

Birth control alternatives

For people who decide they do not want to deal with possible side effects of birth control pills, you will find other birth control options, such as condoms, non-hormonal copper IUDs, diaphragms, and various kinds of fertility trackers. 

Non-hormonal IUDs: A non-hormonal IUD is typically made from copper and operates by altering how in which the sperm swims, preventing it from filling an egg and, for that reason preventing pregnancy. They can last up to 12 years or be eliminated at any time. We see that patients find non-hormonal IUDs best for when they do not foresee getting pregnant anytime soon or are done with kids. 


Apart from the many side effects noted above, there are also many other ways in which hormonal birth control can impact the body. Some of the other side effects of using oral hormonal contraceptives may include missed periods, decreased libido, vaginal discharge, and can even cause changes to eyesight in people who use contact lenses. 

Birth control pills are also known to be associated with an increase in blood pressure levels, benign liver tumors, and even some types of cancer. Additionally, the use of hormonal birth control also increases the risk of many long term health problems such as heart disease and cancer. For those who wish to discontinue hormonal birth control, there are many other options available. These include condoms, diaphragm, the vaginal ring, intrauterine devices, and others. You should consult your doctor about which type of birth control would be the right one for you.