Table of Contents
Introduction
Birth control offers reliable protection against unplanned pregnancy and, for many women, added benefits like clearer skin or lighter periods. However, it’s not always smooth sailing.
Whether you’re just starting or have been using contraception for years, understanding birth control side effects is key to protecting your overall health.
Many women experience side effects when starting a new method, ranging from mild changes like spotting to more disruptive symptoms like mood swings or cramping.
This guide breaks down what you can expect based on the type of birth control you use, when side effects usually settle, and how to decide whether to switch methods or wait it out.
As a pharmacist, I’ve seen how individualized contraceptive experiences can be. What works well for one woman might trigger difficult symptoms in another. So, get informed and make body-wise choices about your contraceptive care.
Why Birth Control Has Side Effects
Hormonal vs. Non-Hormonal Differences
Most common birth control side effects come from methods that alter hormone levels—namely estrogen and/or progestin. These hormones control your cycle, and changing their levels can affect everything from your mood to your gut and skin.
Hormonal contraceptives include:
- Combined oral contraceptive pills (COCPs)
- Progestin-only pills (POPs)
- Hormonal IUDs (e.g., Mirena, Kyleena)
- Implants (e.g., Nexplanon)
- Injections (Depo-Provera)
- Vaginal rings and patches
Non-hormonal options, like copper IUDs or barrier methods, don’t change your hormone levels but can still cause side effects, especially at the beginning.
Your Body's Adjustment Period
When you start a new birth control, your body typically takes 3 to 6 months to adjust. During this time, you might experience:
- Irregular bleeding
- Nausea or headaches
- Breast tenderness
- Mood fluctuations
- Skin changes (acne or improvement)
These are often temporary, but for some, persist—and that’s when it’s time to re-evaluate your options.
Side Effects by Birth Control Type
1. The Pill
Oral contraceptives are among the most popular methods but can cause a wide range of side effects, especially in the first few months.
- Combined pills (with estrogen and progestin) are more likely to cause nausea, breast tenderness, and headaches. Some women also notice mood changes or lower libido, especially if sensitive to estrogen shifts.
- Progestin-only pills (mini-pills) may cause irregular periods, breakthrough bleeding, and acne flares.
If you’re taking prenatal vitamins alongside birth control, be aware of possible nutrient overlap or GI side effects. This guide on prenatal vitamins and birth control explains more.
2. Intrauterine Devices (IUDs)
There are two main types:
- Hormonal IUDs: Common side effects include spotting, light or missed periods, cramping, and sometimes mood changes. Some women experience ovarian cysts, though they’re usually benign.
- Copper IUDs: These are non-hormonal and can cause heavier, more painful periods—especially in the first 6–12 months. Spotting and pelvic discomfort are common but usually lessen with time.
Despite initial discomfort, IUDs remain one of the most effective long-term options, especially for those avoiding daily pills.
3. Implants
The implant is a small rod inserted under your skin that releases progestin over time. Irregular spotting or bleeding is the most reported side effect—sometimes lasting weeks.
Some users also report weight changes, acne, or mood alterations, though evidence of mood changes remains mixed.
4. Birth Control Shot
Depo-Provera is injected every 3 months. Its most common side effects include irregular bleeding, especially in the first year, weight gain in some users, delayed return to fertility, which can take 9–12 months, and bone density loss with long-term use (a reason it’s often limited to 2 years of use)
5. Patches and Vaginal Rings
These methods deliver estrogen and progestin through the skin (patch) or vaginal lining (ring).
Possible side effects include skin irritation for patch users, vaginal irritation or discharge for ring users, and similar systemic side effects to the pill, including nausea or mood shifts.
6. Non-Hormonal Options
These include:
- Copper IUDs
- Condoms (latex sensitivity may be an issue)
- Diaphragms and cervical caps
- Spermicides, which can cause vaginal irritation)
Though non-hormonal options are typically free from systemic side effects, they can still cause local discomfort.
How to Manage Birth Control Side Effects
When to Wait It Out
Most side effects—especially spotting, cramping, or nausea—subside within 3 to 6 months.
If your symptoms are mild and gradually improving, it’s usually safe to continue your current method while staying in touch with your healthcare provider.
Strategies to ease the adjustment:
- Take the pill with food to reduce nausea.
- Use NSAIDs like ibuprofen to manage IUD-related cramping.
- Track symptoms with a period app to spot patterns.
When to Switch Methods
If side effects persist or affect your quality of life, consider switching. For example:
- Severe mood changes may improve on a low-dose or progestin-only option.
- Persistent spotting with the implant could mean trying a hormonal IUD instead.
- Heavy bleeding on the copper IUD may be resolved by switching to a hormonal option.
There’s no universal “best method”—the best birth control with the least side effects depends entirely on your body, preferences, and health history.
Frequently Asked Questions
Most temporary side effects resolve within 3 to 6 months. If they last beyond this or worsen, consult your provider about alternatives.
This varies by individual, but generally:
- Hormonal IUDs offer low-dose, localized hormone delivery with fewer systemic side effects.
- Non-hormonal options, like the copper IUD, avoid hormone-related symptoms but may increase bleeding.
- Barrier methods have the fewest systemic effects but are less convenient for some.
Long-term side effects are rare but may include bone thinning with prolonged Depo-Provera use, delayed return to fertility (particularly with injections), and mood changes, though the evidence is inconsistent.
There is no evidence linking hormonal birth control to long-term infertility. Most women regain fertility quickly after stopping.
Final Thoughts for You
Birth control and side effects often go hand in hand—especially in the first few months. But side effects aren’t something you have to just “put up with.”
If your current method disrupts your well-being, you have options. Talk with your provider about alternative methods, personalized approaches, and ways to reduce symptoms without compromising contraceptive effectiveness.
Every woman’s experience is different. What matters most is finding a method that fits your lifestyle and supports your long-term health and peace of mind.
Lewis CA, Kimmig ACS, Zsido RG, Jank A, Derntl B, Sacher J. Effects of hormonal contraceptives on mood: a focus on emotion recognition and reactivity, reward processing, and stress response. Current Psychiatry Reports. 2019;21(11):115.
Reed BG, Carr BR. The normal menstrual cycle and the control of ovulation. In: Feingold KR, Ahmed SF, Anawalt B, et al., eds. Endotext. MDText.com, Inc.; 2000.
Loder EW, Buse DC, Golub JR. Headache as a side effect of combination estrogen-progestin oral contraceptives: A systematic review. American Journal of Obstetrics and Gynecology. 2005;193(3):636-649.
NHS. Side effects of medroxyprogesterone contraceptive injections. nhs.uk.
Lopez LM, Grimes DA, Gallo MF, Stockton LL, Schulz KF. Skin patch and vaginal ring versus combined oral contraceptives for contraception. The Cochrane Database of Systematic Reviews. 2013;2013(4):CD003552.
Westhoff CL, Heartwell S, Edwards S, et al. Oral contraceptive discontinuation: do side effects matter? American journal of obstetrics and gynecology. 2007;196(4):412.e1.
