Hormonal contraception is the most commonly used reversible means of birth control in the US and much of the developed world. Since the initial oral contraceptive pills were introduced 1960 the dose of estrogen in the most common combined estrogen and progestin oral contraceptives had decreased by about 2/3 and serious side effects are far less common. Still side effects can occur and this article will discuss the common side effects and their management.
This article is not meant to be comprehensive, or to address the rare more serious hormonal contraceptive complications like deep vein thrombosis, stroke and risk of breast cancer.
Acne is more common with progestion only hormonal contraception like depo-provera and the mini-pill, and is less common with some of the newer low dose combination oral contraceptives.
Amenorrhea is more common and expected with the Mirina IUD, depoprovera, and continuous use OCPs or continuous use Nuvaring.
Breakthrough bleeding is more common with continuous use OCPs, the mini-pill, and Implanon. It is less common but still fairly common with the lowest dose estrogen combination OCPs.
Weight Gain: possibly with depo-provera, not shown to be an issue with other types of hormonal contraception.
Decreased sex drive: Only seen with very low dose estrogen OCPs (15 mcg of estrogen daily)
Increased vaginal discharge: common with Nuvaring, not with outer types.
Headache: can be seen with all of the hormonal contraceptives and is more common in women over age 35.
Oily skin: common with progestin only types like depo-provera and the mini-pill, maybe with Implanon.
Most women who do not have a major contraindication to hormonal contraception use can find a type that will meet their needs and give effective and well tolerated contraception.
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