Side effects of the combined pill
Every pill affects each person differently. Some people experience side effects and others do not. If you’re using the pill, keep a record of any side effects that you’re worried about.
Side effects do not cause problems with your health, but they can be hard to live with.
Common side effects
Nausea
A study from the United States found that about 4% of people using the pill reported feeling sick (nausea).
Breast tenderness
A study from the United States found that about 10% of people using the pill said they experienced breast tenderness.
Lower sex drive
Some people on the combined pill say they’re less interested in sex, but most people don’t report any change.
As many things can affect your libido, there’s no evidence to show it’s directly caused by the pill and there’s very little research on this. As there’s no research to support our guidance here, we’ve shared the experience of people who have both positive and negative effects on their sex drive from the pill.
Real contraception experiences
I'm on the combined pill. I think I was more emotional for the first few months and my periods got worse. I used to have an incredibly light flow and no pain, now I have moderate flow and pain. The bonus is that my breasts grew almost 2 cup sizes.
I have a very low sex drive on the pill, but the positive is that I rarely experience negative emotions. I have gone years without crying. It really evens out your emotions, I think the difference is that I don’t suffer from PMS on the pill.
Mood changes
While many people report mood changes – positive and negative – on the combined pill, there’s no consistent evidence that the pill is the cause.
If you experience mood changes on the pill then keep a record of how you feel. This helps you to understand if there’s any link between your mood, the pill or anything else in your life. You may wish to try a pill with a different progestogen type, which may have a different effect on your mood.
Can the pill cause depression?
Some people have reported feeling depressed while taking the combined pill but there’s conflicting evidence about whether the pill can cause depression.
Evidence for it:
A very large Danish study found that people using the combined pill had a higher risk of being prescribed antidepressants by their doctor than those who didn’t use the pill.
Evidence against it:
Studies in Australia, Finland and the US compared self-reported depression scores between users and non-users of the combined pill but found no consistent difference.
Real contraception experiences
My emotional state is completely normal – I get a bit irritated before my period, but otherwise I feel totally stable. I've been on a few types of contraceptive pills with no problems really. But there was one that I was on, a few years back and it made me feel so emotional – so I switched and the new one was fine.
I'm on the combined pill. I think I was more emotional for the first few months and my periods got worse – I used to have incredibly light flow and no pain, now I have moderate flow and pain – the bonus is that my breasts grew almost 2 cup sizes.
The patch made me moody. Luckily, I switched to pills, and after changing around for other reasons, like acne, I found one that left me feeling completely normal. But the patch did not suit me at all. I was weepy, irritable and depressed.
I'm on the pill and I never experienced breakouts, weight gain, mood swings, or anything like that. In fact, it has made my periods lighter, shorter, and more manageable.
Less common side effects
While the oestrogen in the pill can make hair thicker, progestogen may reduce hair thickness.
Some people may experience a skin blemish called chloasma. Chloasma is a mark that appears over the cheek and nose as a response to changes in the hormones. It’s usually mild, but it may not go away even after stopping the pill.
Weight gain
Some people find they put on weight, but there’s no medical evidence to show it’s directly caused by the combined pill.
As with mood changes, lots of things can cause people to put on weight.
Real contraception experiences
I've been on the combined pill for about a year and find it pretty much OK. I do have mood swings but I'm pretty sure I had those before. Sadly enough I haven't put on any weight yet – I could use some.
I definitely have gained weight since I started birth control, but it’s hard to tell if that’s the reason. I’m not willing to get off the birth control to check, because it’s the only thing keeping my pre-menstrual symptoms in check.
I didn't actually realise how it affected my weight until I stopped taking the pill and the weight dropped off.
What to do if you experience side effects
Everyone experiences different types of hormonal contraception differently. If you're getting side effects that you do not like, keep a record of how you feel on it, then try a different method to see whether it’s any better.
Sometimes it can be hard to know if any symptoms you have are because of your contraception or something else.
We recommend that you:
keep a record of any side effects to see how they change over time
discuss it with your clinician, particularly if it carries on after using the contraception for 3 months
stop if you have unpleasant side effects over a longer period of time, and try an alternative method of contraception
Sometimes it takes a lot of trial and error before finding the right method of contraception for you. And what’s right for you may change over time. So just because one method suited you in the past, doesn’t mean it will suit you now.
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