The side effects of hormonal contraceptives, such as the birth control pill, are something most women are concerned about, and is often why some are dissuaded from using hormonal contraceptives as a method of birth control. Obstetrician and Gynaecologist Dr. Christopher Ng commented in a Straits Times interview that many women in Singapore shy away from using hormonal contraceptives because of the misconception that taking hormones is bad for them or that it could lead to infertility later on in life - even though hormonal contraceptives are the most effective preventative measure for pregnancy as compared to non-hormonal methods such as condoms.
While side effects vary across different hormonal contraceptives, not all users will experience them. In fact, side effects tend to disappear on their own after 2-3 months of continued use as the body adjusts to the hormonal changes. Educating people about the common side effects of hormonal contraceptives can help to establish realistic expectations and remove the misconceptions many still have about hormonal contraceptives today.
Here is a guide comparing the different hormonal contraceptive methods and their side effects.
What are the different hormonal contraceptive methods?
Hormonal contraceptives are, as the name suggests, birth control methods that contain synthetic versions of female hormones. Combination hormonal contraceptives like birth control pills, the patch, and the ring contain a combination of these female hormones — estrogen and progestin. On the other hand, progestin-only contraceptives like the injection or the intrauterine device (IUD) contain just progestin, and in a lower hormonal dose.
These hormones work to prevent the ovaries from releasing an egg and slows its progress through the fallopian tube by thickening the cervical mucus and thinning the lining of the uterus to keep the sperm from joining with the egg.
While both contraceptive methods work similarly in preventing pregnancy, the different dosages of hormones in each method lead to a different range of side effects..
There is a large body of research to support the lower risk of acne with combination birth control pills and has shown their effectiveness in treating acne caused by hormonal fluctuations. On the other hand, a questionnaire-based study has found that the use of progestin-only pills can cause acne to develop or worsen on the skin, and that switching to combination contraceptives is recommended if the acne worsens.
Some might find the irregular bleeding or spotting while on birth control to be daunting, and some even discontinue the use of contraceptives because of this. The estrogen in combination contraceptives like combination birth control pills, the patch and the ring help stabilize the lining of the uterus, which can prevent irregular bleeding and spotting, making them preferable to progestin-only contraceptives. However, there are some who experience spotting the entire time they’re on birth control, with decreasing severity after 2-3 months of continued use. In most cases, this spotting is completely harmless. However, if your spotting is particularly severe or lasts for a long period of time, please reach out to our customer care team.
Spotting could also be a result of skipping doses of the pill, which causes the hormones to fluctuate. This is worth paying attention to, especially if you’re having unprotected sex, as it means that you may not be fully protected.
The use of combination birth control pills and the ring is shown in a study done by UCLA’s School of Medicine to have decreased effects on breast tenderness after about 18 months of continued use, while breast tenderness is more common in those who use the patch.
Headaches are a common side effect of all contraceptive methods, whether combination or progestin-only, and are usually experienced during the first 2-3 months of use or among those who are more mature in age. It is not recommended to take additional vitamins or switch to an alternative combination contraceptive pill to treat the headache unless the headaches become unbearable.
Some people might experience nausea due to the estrogen in combination contraceptives like birth control pills and the patch, which have a larger dosage of this hormone as compared to the ring. This side effect is especially prevalent in emergency contraceptive pills. Some simple ways to counteract this is to take the contraceptive with or after food, or to alter your diet slightly to avoid strong flavors.
Often mistaken as weight gain, the combination contraceptive method of injection is more likely to cause fluid retention in the body. However, there is insufficient evidence to suggest that birth control pills, the IUD, and progestin-only pills can cause bloating.
There is no “right” contraceptive method. In fact, it all depends on the body! Keeping in mind that the side effects listed above often resolve themselves after 2-3 months of continued contraceptive use and that everyone reacts differently to the different contraceptive methods. To learn more, you can reach out to our customer care team or schedule a teleconsultation with one of our doctors to discuss your medical history and find what works best for you.
Gan, E. and Chia, E., 2017. Birth control methods that work. The Straits Times.
Grossman Barr, N., 2010. Managing Adverse Effects of Hormonal Contraceptives. American Family Physician, 15(82), pp.1499-1506.