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Side Effects and Risks


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Side effects of contraceptive pills

The pill and other forms of hormonal contraceptives are prescription medicines. This means that you need a doctor’s authorization to use them and that permission is subject to some kind of medical check. This is because hormonal contraception can potentially cause side effects in some women. In very rare cases those side effects might be serious.

In fact, approximately 9 out of 10 women will not experience any noticeable side effects at all. The 10% of women who do have unwelcome side effects will generally experience mild ones.

Combined contraceptives side effects

Common side effects of combined hormonal contraceptives may include:

  • Headaches
  • Nausea or vomiting
  • Breast tenderness 
  • High blood pressure
  • Mood swings 
  • Minor vaginal bleeding and spotting

If you are using the NuvaRing you may experience an unwelcome reaction to having the plastic ring in your vagina. This is quite a rare side effect and most women will not be able to feel the ring inside their body. 

Transdermal contraceptive patches (Evra patch) may rarely cause local skin irritation, but this is an unusual side effect.

Mini-pill side effects

The mini-pill (progesterone only pill or POP) may also cause minor side effects in a minority of women. 

  • Acne or skin problems
  • Changes to libido or sex drive 
  • Mood changes 
  • Headaches 
  • Sore, tender, or enlarged breasts
  • Nausea or vomiting 
  • Ovarian cysts

Do hormonal contraceptives cause thrombosis?

If you use some forms of hormonal contraception, you will statistically have a slightly higher risk of thrombosis than women who do not use hormonal contraception. To put this in perspective, the actual risk is low for both groups (approximately 1 in 1,000 adults per year will experience deep vein thrombosis from a variety of causes). If you have a history of thrombosis, cardiovascular problems, or high blood pressure, you may be unable to use combined pills, NuvaRing, or Evra patches. 

It’s possible that you will be able to use an oestrogen-free mini-pill, which has a lower risk. Our online GP will check your medical questionnaire carefully to make sure that your physical condition does not include extra risk factors. Make sure you provide accurate information in the questionnaire. If you notice any signs that may hint to blood clots, high blood pressure etc. while you are using a hormonal contraceptive, immediately consult a GP. Blood clots are rare, but they can be life-threatening.

What are blood clots?

Blood clots are blood that has changed from its normal liquid state to a gel-like or more solid state. Blood clots can occur in veins or arteries and range from fairly harmless to life-threatening. There are many causes of blood clots and in a small number of cases they may be associated with the use of hormonal contraceptives. 

What is deep vein thrombosis? 

Deep vein thrombosis (DVT) is a medical condition where a blood clot forms in a deep vein (usually in the legs). Often there may be no symptoms, but if a clot breaks free and travels to vulnerable parts of the body serious complications may occur. There are approximately 10 deaths in the UK each year that might be a result of DVT caused by hormonal contraceptives, although there is no scientific proof that this is the case. Some consequences of deep vein thrombosis may include pulmonary embolism when a blood clot is carried to the lungs.

Breast cancer and the pill

If you use the combined pill, NuvaRing, or Evra patch, you statistically have a slightly higher risk of developing breast cancer than a woman who doesn’t use these forms of hormonal contraception. This risk is higher among older women who use the pill. 

Recent research suggests that out of a group of 10,0000 women who use the combined pill throughout their 30s, approximately 54 will develop breast cancer before the age of 40. A similar group of 10,000 women who don’t use the pill might produce 40 cases of breast cancer. 

The combined pill may actually reduce the risk of non-cancerous breast disease.

Will the pill affect my emotional state?

There is a possibility that any hormonal contraceptive may affect your emotional state, but this is not necessarily bad news. If you suffer from PMS (premenstrual syndrome) symptoms may include moodiness, irritability, emotional instability, or dysphoria. Hormonal contraceptives may help to ease these symptoms, and to regulate and lighten periods and reduce period pains. Some women are prescribed hormonal contraceptives to ease their PMS and menstruation rather than to prevent pregnancy.

Hormonal contraceptives can also produce undesirable side effects in the form of mood swings or low moods. If you experience other side effects, these may in turn cause anxiety or stress, affecting your emotional state. Chances of this happening are slight, however, make sure to consult a GP and stop taking the specific contraceptive, which has this effect on you.

What you need to know about homonal contreception

The combined pill and smoking

It is not recommended to take the pill and smoke in general. If you are over 35 and you smoke (or only gave up during the previous year) the combined pill may be unsuitable for you. Our GPs review each case on an individual basis, according to your medical questionnaire. If you are a smoker and over 35, there is a raised risk of blood clots, deep vein thrombosis and associated complications. The mini-pill may be a safer form of contraception.

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