When the birth control pill came out in 1960, nearly one-third of American women were using it—mainly as an alternative to condoms and diaphragms, according to the American Journal of Public Health. Today, the classique Pill remains the most common method, according to a survey by the Guttmacher Institute.
From Cybelle, Althea, Yaz, Seasonique, to like *counts fingers* so many more different brands and formulations, the Pill is truly a contraceptive superstar. Besides its obvious intent (to prevent an unwanted pregnancy), the Pill actually offers lots of other benefits, like regulating your period, combating hormonal acne, alleviating painful periods, and so much more.
In fact, when the Ortho Tri-Cyclen pill was approved as an acne treatment, researchers saw an overall increase in the number of young people taking contraceptives, explains ob-gyn Tia Jackson-Bey, MD, a reproductive endocrinologist and infertility specialist at Reproductive Medicine Associates of New York. "I recommend the Pill to patients with polycystic ovary syndrome or patients who want help controlling their hormonal acne in general."
But, like all good things, some might also experience not-so-great side effects. "The trick is to find the right pill formulation with the help of your doctor and to allow about three months for your body to adjust," says ob-gyn Sherry Ross, MD, women's health expert at Providence Saint John's Health Center in Santa Monica, California. So remember: "If the first pill you try doesn’t work out for you, there are always other options," says New York City-based ob-gyn Heather Irobunda, MD.
Below, gynecologists explain the 24 known side effects of the Pill and what causes them, so you can find your perfect birth control match.
1. Lighter periods. "Many women who use oral contraceptive pills notice that their periods become lighter on the Pill," says Dr. Irobunda. "This happens because the medication's hormones make the lining of the uterus thinner, making your periods lighter." But if you find yourself not menstruating at all, you should definitely talk to your doctor.
2. More regular periods. We're keepin' the good news coming. "More people who use the Pill find that their periods are more regular, and that's what we want. It's your body responding to the pills on a set 26-to-28 day cycle," says Dr. Jackson-Bey. She also says that having a regular period also decreases your risk of endometrial and ovarian cancer, but more on that later!
3. Vaginal dryness. Some pills containing estrogen can cause people to have a lower amount of estrogen circulating in their bodies, which can then cause dryness, says Dr. Irobunda. "The pills don't cause women to produce estrogen, it actually takes over and causes one steady amount of hormone instead of fluctuating levels of estrogen," she adds. Typically, if you're experiencing vaginal dryness, it's because you're on a pill that has a lower dose of estrogen. But if this happens to you, NBD. There are plenty of great lubes out there that you should already be using for your sexy-time fun anyway.
4. Weird spotting. While this is a v common (but painfully annoying) side effect of the Pill, know that it "typically resolves within the first three months of use," says Dr. Irobunda. The reason this happens in the first place: "It's caused by the changes in hormone levels in the body while taking the Pill, which then affects your uterine lining, making it more prone to spotting," she adds. According to Dr. Jackson-Bey, continued spotting may also be a sign to up the dosage of estrogen that you're currently taking.
5. Nausea. Some people feel queasy when they start taking the Pill, says Dr. Jackson-Bey. Though it shouldn't last more than three months after your body adjusts, according to Planned Parenthood Federation of America, taking it with a meal can help reduce how icky you feel as your body adjusts to new levels of estrogen and progesterone. Another tip: "Taking the Pill before you go to sleep can help decrease symptoms of nausea," says Dr. Irobunda.
6. Breast tenderness. Yeah, this one isn't fun. But Dr. Jackson-Bey suggests that this side effect tends to go away after a few months.
7. More Headaches. A 2005 study published in the American Journal of Obstetrics and Gynecology found that approximately 10 percent of users feel headachy within a month of starting the Pill. Once the body acclimates to a new oral contraceptive, most reports of headaches go away, the study's authors conclude. Still, some people are sensitive to the amount of estrogen that's in the Pill and may notice a headache towards the beginning of the pack. In that case, Dr. Jackson-Bey suggests talking to your doctor about lowering your estrogen dose or switching to another contraceptive.
8. Less Headaches. Yup! Dr. Jackson-Bey explained that certain people who experienced menstrual migraines before going on the Pill may notice a decrease after starting it.
9. Bloating. The ups and downs of your body's sex hormones from taking the Pill can lead to water retention and bloating, according to a study by the American Journal of Physiology. These effects may be particularly strong for people suffering from irritable bowel syndrome and other gastrointestinal tract disorders. That said, many users feel better six months into a new pill regimen, per the American Journal of Obstetrics and Gynecology.
10. Reduced risk of certain cancers. A 2011 review of studies by a German medical journal examined the link between birth control and cancer risk and found that incidences of endometrial and ovarian cancers dropped by 30 to 50 percent among users without a history of HIV or HPV who took the Pill.
11. Fewer cramps. Since the Pill regulates how much estrogen and progesterone enter your body, your periods follow a more predictable schedule. Once you get adjusted to the Pill, your periods may become lighter, which can mean less painful menstrual cramping, says Dr. Ross.
12. Clearer skin. Acne is largely influenced by high levels of androgens, like testosterone and androstenedione, so taking a pill that contains estrogen and progesterone can help scale back the prevalence of pimples on your face, per the Journal of Drugs and Dermatology.
13. Increased appetite. Perhaps you recall from ever having PMS that hormones can make you super hungry. The same goes when you alter your estrogen and progesterone levels via the Pill. "Sometimes the progesterone component of the Pill can stimulate your appetite," says Dr. Jackson-Bey.
14. Yeast infections and/or bacterial vaginosis. The Pill impacts hormones that can affect vaginal tissue, in some cases making it more susceptible to infection. And if getting a new 'script leads to a switch-up in how often you use tampons or your bleeding patterns, that can make you susceptible too, says Dr. Irobunda.
15. Mood swings and other emotional issues. This issue is complicated. While some people with a history of mood issues—depression, anxiety, even insomnia—tend to see an increase in their symptoms' severity once they go on some birth control pills, others report that going on the Pill improves their mood, according to Dr. Jackson-Bey.
16. Blood clots. These are more likely to form in your legs or lungs if you are on a birth control pill that contains estrogen, says Dr. Irobunda. "The hormone estrogen can cause your blood to clot more easily," she confirms. This can be concerning and become life-threatening, so it's worth telling your doctor ahead of time if you have any family history (or previous history individually) regarding blood clots before starting the Pill.
17. Fewer complications from anemia. Studies suggest a link between oral contraceptive use and fewer incidences of anemia—a condition in which you have lower levels of red blood cells that carry oxygen to all your organs. "The Pill helps boost these iron levels because there is less blood lost during your period while on an oral contraceptive," says Dr. Irobunda. "The Pill keeps not only the red blood cell count higher, but also keeps hemoglobin and iron levels higher."
18. Less pain during sex. According to a study published in Elsevier, going on the Pill can increase a woman's vaginal lubrication and, as a result, make intercourse a heck of a lot less painful—especially if she experienced it as such prior to going on the Pill.
19. Greatly reduced chance of pregnancy. Remember that one? It's kind of why birth control was created. In case you needed a reminder.
20. Brown spots on your face. According to a study in the British Journal of Dermatology, oral contraceptives can increase the risk of a skin condition called melasma, which can make your face break out in some brown-colored splotches. Research shows that this is more likely to occur in people who have a family history of the skin issue. Switching from the Pill to an IUD may resolve this, several case studies suggest.
21. Lower sex drive. Some patients report decreases in their libido once they begin the Pill, Dr. Jackson-Bey says. But it's tricky. "It makes sense because you're not having your normal fluctuation of hormones that you would without the Pill." But she points out that much of this may be due to birth control's other side effects like vaginal dryness and breast pain. That said, many people report that their sex drive picks back up again — or even gets stronger than pre-Pill levels — about nine months into taking the Pill, according to a study published in the journal Contraception.
22. Mood improvements. Yes, some people with a history of emotional issues have found the Pill worsens their symptoms. But others claim it's offered a boost to their psychological well-being. Evidence suggests the Pill can, for many, decrease depression.
23. Stronger ligaments (maybe). Apparently, birth control pills are linked with lower incidences of knee injuries, according to the National Library of Medicine. The researchers who found this correlation peg it to birth control's regulation of estrogen, which — if too high — may weaken younger user's ligaments.
24. Changes in mate preference. Studies have also found a fascinating link between the use of oral contraceptives and user's preference for certain traits in their partners. Going on birth control can, according to some evidence, make people more inclined to choose nurturing partners over sexually exciting ones.
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