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HomeHealth ConditionsBirth Control

What are the Risks and Side Effects of Birth Control Pills?

Christina Aungst, PharmDStacia Woodcock, PharmD
Updated on April 12, 2023

Key takeaways:

  • Birth control pills are the most commonly used form of reversible contraception in the U.S. But there are several side effects of the pill that you should know about.

  • Common side effects of birth control pills include breakthrough bleeding, nausea, and breast tenderness. Most side effects start during the first 3 to 6 months of taking the pill and get better over time.

  • Serious side effects of the pill include a higher risk of blood clots, breast cancer, and cervical cancer. But, for most people, the overall risk of these complications while taking the pill is still very low. 

A male pharmacist looking at the ingredients at the back of a box of medication while a female customer looks on.
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From 2017 to 2019, over 65% of women between the ages of 15 and 49 used some form of birth control. Among these women, the most commonly used method of reversible contraception was an oral birth control tablet (commonly called “the pill”).

Because birth control pills contain hormones, they can cause side effects for many of the people who take them. There are also some long-term risks with the pill that are important to know about.

What are the side effects of birth control pills?

Birth control pills contain hormones like estrogen and/or progestin, which can cause side effects. These side effects are typically mild and most common when you first start taking the pill. But they can still be frustrating.

When side effects are ongoing, some women may switch birth controls or stop taking the pill altogether. Below, we discuss the potential side effects of birth control pills.

Common side effects of birth control pills

The rate of specific side effects varies between individual products. But the following are common side effects of all birth control pills:

  • Changes to your menstrual cycle, including heavier, lighter, or skipped periods

  • Spotting or breakthrough bleeding

  • Sore or tender breasts

  • Nausea

  • Stomach pain

  • Headaches

Less common side effects

While less common than the side effects listed above, you could also experience the following when taking birth control pills:

  • Changes to vaginal discharge

  • Hair loss

  • Low or no sex drive

  • Dry eye

  • Discomfort with contact lenses

These side effects don’t always get better with time. If they become too bothersome, let your healthcare provider know. Your provider may suggest switching to a different birth control method.

Serious side effects

More serious side effects can also occur with birth control pills, but they are rare. Be sure to discuss these with your healthcare provider before taking the pill:

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When do you start to experience birth control pill side effects?

The most common side effects of birth control pills tend to lessen or resolve after the first few months of taking them. If the side effects don’t become more manageable, or they worsen after initially getting better, contact your healthcare provider.

Below, we outline the typical time frames for common and less common birth control side effects.

Changes to your menstrual cycle

Changes to your menstrual cycle can appear within the first month of taking birth control. Spotting or breakthrough bleeding is very common with birth control pills that only contain progestin (the “mini-pill”). But this can occur with all birth control pills. Typically, this side effect will resolve after the first 3 to 6 months of taking the pill.

Physical pain and discomfort

Side effects like sore breasts, nausea, and headaches can also happen during the first month of taking birth control pills. These side effects should get better or go away after about 2 to 3 months of taking the pill.

In the meantime, there are things you can do to help lessen your discomfort. Taking the pill with food or at bedtime can help combat nausea. Wearing loose-fitting bras and shirts may help with breast tenderness. And over-the-counter (OTC) pain relievers, such as ibuprofen (Advil, Motrin), can help relieve headaches and breast soreness.

If these side effects don’t go away after a few months, or they become severe, reach out to your healthcare provider. Your provider may have you try a different type of birth control.

Hair loss

Hair loss is a less common side effect of birth control pills. When it does occur, it’s usually in the form of hair thinning, not balding or losing clumps of hair. Hair thinning may start about 3 months after beginning a hormonal contraceptive.

Certain types of progestins, called androgenic progestins, may be more likely to cause hair loss. This side effect may also be more common with birth control pills that only contain progestin.

In some cases, hair thinning lessens or stops after about 6 months of taking the pill. If you notice severe hair loss, or hair loss that continues after 6 months, contact your healthcare provider. Your provider may suggest that you try a different birth control pill.

Dry eye and contact lens problems

Dry eye and contact lens problems are uncommon side effects of birth control pills. Because of that, the relationship between the pill and these side effects is not very well studied. The hormones in many birth control pills may lower natural tear production, causing dry eye. And wearing contact lenses can worsen dry eye symptoms.

Experts don’t know when these side effects are more likely to occur or who’s at greater risk for them. So these side effects could potentially happen at any time while taking the pill.

OTC artificial tears may help relieve occasional dryness. But speak with your healthcare provider before using them regularly. Long-term use of artificial tears has risks of its own.

Sex drive

Changes to sex drive are an often overlooked birth control side effect. But these changes can cause considerable stress and strain on people’s daily lives and relationships. 

A change to your sex drive can happen at any time while you’re taking the pill and can last the entire time you’re taking it. These changes are thought to be the body’s unique response to hormones, so it makes sense that everyone’s experience with this side effect is different.

If you notice you have a very low sex drive or no sex drive, and that wasn’t the case before you started taking birth control, it’s worth discussing it with your healthcare provider. You may not experience this side effect with all birth control pills. And your provider can help you explore other options.

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What are the long-term side effects of taking birth control pills?

All birth control pills carry the risk of causing long-term problems. The risk of these side effects is very small, but they can be life-threatening if they occur.

Higher risk of breast cancer

One of the most serious warnings about birth control pills is that they raise the risk of developing breast cancer. The link between hormones and breast cancer is a well-known one. And this risk is similar for all hormonal birth control, regardless of which hormones are included. Because of this, it’s recommended that women with a history of breast cancer avoid hormonal birth control.

A large study from 2017 reported that the risk of breast cancer associated with birth control pills is actually very small for most women. And the risk lowers once a person stops taking birth control pills. About 5 years after someone stops taking the pill, their risk for breast cancer returns to normal.

Higher risk of cervical cancer

Cervical cancer is another rare, long-term side effect of birth control pills. The longer you take birth control pills, the greater the risk. But, like the risk of breast cancer, the risk of cervical cancer goes back down after you stop taking the pill.

Higher risk of blood clots

A concerning risk with estrogen-containing birth control pills is blood clots. A blood clot can lead to a heart attack, stroke, or pulmonary embolism (a blood clot in the lungs). 

The risk of blood clots for most people is fairly low with hormonal birth control. This risk is actually higher for pregnant people than for those taking birth control. But there are certain people who have a greater risk of blood clots with birth control, including those who:

  • Are over 35 years old and smoke

  • Have clotting disorders

  • Have a history of blood clots, heart attack, or stroke

  • Have a health condition that raises the risk of blood clots, such as heart disease or diabetes

  • Have obesity

  • Are currently immobile, such as after surgery

The bottom line

Birth control pills can cause a number of side effects. Common side effects of the pill include breakthrough bleeding, nausea, and tender breasts. These typically occur during the first 3 to 6 months of taking birth control pills and resolve over time. Less common birth control pill side effects include low sex drive, hair thinning, and dry eye.

Serious side effects of birth control pills include a higher risk of blood clots, breast cancer, and cervical cancer. For most people, the likelihood of these complications happening is low. But be sure to discuss birth control pill side effects with your healthcare provider before you start taking oral contraception.

References

American College of Obstetricians and Gynecologists. (2023). Progestin-only hormonal birth control: Pill and injection.

Casado-Espada, N. M., et al. (2019). Hormonal contraceptives, female sexual dysfunction, and managing strategies: A review. Journal of Clinical Medicine.

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Chen, S. P., et al. (2014). Tear osmolarity and dry eye symptoms in women using oral contraception and contact lenses. Cornea. 

Cooper, D. B., et al. (2022). Oral contraceptive pills. StatPearls.

Daniels, K., et al. (2020). Current contraceptive status among women aged 15-49: United States, 2017-2019. Centers for Disease Control and Prevention.

Fitzpatrick, D., et al. (2023). Combined and progestagen-only hormonal contraceptives and breast cancer risk: A UK nested case–control study and meta-analysis. PLoS Med.

Graves, K. Y., et al. (2018). Alopecia due to high androgen index contraceptives. JAAPA.

Hughes, L. D., et al. (2018). Hormonal contraception and suicide: A new dimension of risk. British Journal of General Practice.

LiverTox. (2020). Estrogens and oral contraceptives.

Mørch, L. S., et al. (2017). Contemporary hormonal contraception and the risk of breast cancer. The New England Journal of Medicine.

Mu, E., et al. (2022). Hormonal contraception and mood disorders. Australian Prescriber.

National Cancer Institute. (2018). Oral contraceptives and cancer risk.

Planned Parenthood. (n.d.). What are the disadvantages of the pill?

Planned Parenthood. (n.d.). What are the side effects of the birth control pill?

Practice Committee of the American Society for Reproductive Medicine. (2016). Combined hormonal contraception and the risk of venous thromboembolism: A guideline. Fertility and Sterility.

Villavicencio, J., et al. (2016). Unscheduled bleeding and contraceptive choice: Increasing satisfaction and continuation rates. Open Access Journal of Contraception.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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