Side Effects of Birth Control Pills

Differences in Birth Control Pill Side Effects

Most birth control pills contain an estrogen and a progestin. Those that contain estrogen use the same kind of estrogen (ethinyl estradiol), but the dose can vary. Several different types of progestin hormones are used in birth control pills. The strength of the estrogen, the type of progestin, and the dose of progestin all play a role in determining which side effects a particular birth control pill is likely (or unlikely) to cause.
Some progestins have androgenic activity (testosterone-like activity). These progestins are often thought to carry a higher risk for acne and excessive hair growth (a condition known as hirsutism). Other progestins have anti-androgenic (anti-testosterone) effects and are thought to be useful for treating acne or excessive hair growth. Some progestins may worsen water retention, while others may help relieve this problem. Differences in the estrogen content may affect menstrual bleeding tendencies, and many high-estrogen pills can increase the risk of blood clots.
When you and your healthcare provider choose a birth control pill that is right for you, be sure to discuss any of these side effects that may concern you. For instance, if you have a problem with acne, your healthcare provider may choose a birth control pill that is likely to improve it rather than making it worse.

Side Effects of Birth Control Pills to Report

Some birth control pill side effects, while occurring infrequently, are potentially serious and should be reported immediately to your healthcare provider. These include but are not limited to:
    • Pain in the calf
    • Leg cramps
    • Leg or foot swelling
  • Signs of a blood clot in the lung, such as:
    • Shortness of breath
    • Sharp chest pain
    • Coughing up blood
  • Chest pain or heaviness, which may be signs of a heart attack
  • Sudden loss of vision or vision changes, which can be a sign of a blood clot in the eye
  • Signs of a stroke, such as:
    • Vision or speech changes
    • Weakness or numbness in an arm or leg
    • Severe headache
  • Signs of liver damage, such as:
    • Yellow eyes or skin (jaundice)
    • Dark urine
    • Upper-right abdominal pain
  • Signs of an allergic reaction, such as:
    • Unexplained rash
    • Hives
    • Itching
    • Unexplained swelling
    • Wheezing
    • Difficulty breathing or swallowing.
Many of these serious side effects can be attributed to the estrogen content of birth control pills. Progestin-only pills, such as Ortho Micronor®, are less likely to cause some of these side effects (see Ortho Micronor Side Effects).
Last reviewed by: Kristi Monson, PharmD
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