Contraception side effects: What's normal?

We take a look at some of the common side effects associated with contraception.
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November 28, 2023
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Most women will experience at least one side effect from taking hormone-based contraception [1]. Luckily, a lot of these side effects are normal or expected — but it can still be confusing trying to figure out what “normal” actually is.

Whether we're talking about the combined pill, vaginal ring or hormonal IUD, understanding the effects each birth control method can have on your body helps you make the right decision, making sure that your contraception is working for you, and not against you. Let's dive into it.

Understanding the different types of hormonal contraceptives

While hormone-based contraception options all have the same job to do, they can still be very different when it comes to their ingredients, how to take them, and what side effects to expect.

Hormonal contraception comes in many forms, with different types (and levels) of hormones that can affect women in different ways:

  • Combined hormonal contraceptives like the combined oral contraceptive pill and vaginal ring, which contain both estrogen and progestin.
  • Progestin-only contraceptives, such as the implant, hormonal IUD, Depo-Provera “shot”, or mini pill.

Side effects of the oral contraceptive pill

While all birth control pills contain synthetic versions of female hormones, not all contain the same level, or the same combination, of these hormones.

Most oral contraceptive pills fit into one of 2 categories:

  • Combination pills: These contain both a form of oestrogen and a form of progestin (a man-made form of progesterone) and each pack comes with active and inactive pills.
  • Mini pills: These contain a form of progestin-only and consist solely of active pills, which are taken continuously.

Generally, they both come with the same list of common side effects:

  • Breakthrough bleeding
  • Nausea
  • Breast tenderness
  • Headaches and migraines
  • Mood changes
  • Decreased libido
  • Skin issues
  • Weight gain

Note, however, that these side effects should subside after your body adjusts — usually within 1 month — and for many women, the pros outweigh the cons.

If you want to give the pill a try, consider Kin's pill subscription. All you need to do is complete a digital consult with our Aussie practitioners and they'll create a personalised prescription plan for your individual circumstances.

From there, you get free and fast delivery of your pill to your door 2 weeks before you run out (or earlier if you prefer). Plus, you get personalised ongoing support and have the option to switch your pill anytime you want.

Should you experience uncomfortable side effects that don't seem to go away, a health practitioner will be there to support you at any time and help you decide what your next step should be.

Side effects of the vaginal ring

Some women choose to use the vaginal ring to skip periods, reduce menstrual cramps, and improve acne. However, this can come with a price, with possible side effects like:

  • Increased discharge
  • Nausea and vomiting
  • Tender breasts
  • Headaches
  • Bloating
  • Mood changes
  • Skin changes

Combined studies on women using the vaginal ring say the occurrence of these side effects is low [2].

Side effects of "the shot”

Choosing to go with the shot — a.k.a Depo-Provera or Depo-Ralovera — requires an injection of synthetic progestin into your body every 12 weeks.

This is definitely a stronger dose of hormones than your other typical hormone-based contraceptives. Does that mean more severe side effects, though? Well, it depends.

You can experience:

  • Unpredictable period cycles
  • Spotting
  • Weight gain
  • Moodiness
  • Headaches
  • Acne
  • Bone thinning (if used for a long time).

You may also experience slight bruising (temporary) and notice a small dent (usually permanent) on the area where you got the shot.

Plus, and although evidence is conflicting, new research on women taking Depo-Provera has shown women’s body weight and fat can increase with the use of this contraception [3]. If you're using it and have noticed this yourself, there are also reports of a decrease in body weight and fat when you stop using it [4].

Side effects of the implant

Side effects of the implant include:

  • Headaches
  • Mood swings
  • Sore breasts
  • Acne
  • Irregular bleeding
  • Dizziness
  • Lower libido

Research has shown that implantable contraceptive devices such as Implanon and Mirena are likely to cause an acne flare-up given the active hormone ingredients they contain (etonogestrel in Implanon and levonorgestrel in Mirena) [5].

Side effects of the hormonal IUD

Most commonly, you may experience spotting in the first few months of using a hormonal IUD, as well as longer and heavier periods or missed periods.

Other possible side effects include:

  • Cramping
  • Backaches
  • Nausea
  • Ovarian cysts
  • Mood changes
  • Headaches

Are there any serious side effects?

There are some more severe risks linked with hormonal contraceptives, though they're rarer than the ones we listed before.

The birth control pill, vaginal ring, and Depo-Provera shot can slightly increase your risk of breast cancer, blood clots, and heart attack.

With the hormonal IUD, there is the risk that the device will dislodge and perforate your uterus, causing infection and severe bleeding, although this is rare (like 1 in 1000 type rare).

Also rare, but possible, is pelvic inflammatory disease (PID). This occurs when the IUD insertion procedure introduces bacteria into the uterus. It’s important that you monitor for some of these more extreme side effects:

  • Lower abdominal or uterine pain, or a fever in the first 3 weeks after implementation
  • Pain, or bleeding during intercourse
  • Painful or difficult urination
  • Unusual discharge with a bad odour from the vagina

Choosing between birth control methods

Contraception works by preventing pregnancy (and some protect you from sexually transmitted infections as well) but there is always risk involved with hormone-based contraception [6].

You are, after all, using synthetic (aka fake) hormones to change the way your reproductive system functions every month. Ultimately, it's about weighing the pros and cons and choosing the contraceptive method that better suits you.

If you've started taking the pill or any other type of hormonal contraception and suspect something's not "normal", be sure to speak to your doctor. They'll help you find treatment for your side effects or recommend alternative birth control methods that may be better suited for you.

All of the tools you need to take your reproductive health into your own hands.