Side effects
Birth control side effects: what is normal and what is not
Quick answer
Most side effects of hormonal birth control (spotting, sore breasts, nausea, headaches, mood changes) show up in the first months and settle by about 3 months. Bleeding changes are the most common effect of every hormonal method. Chest pain, a painful swollen leg, sudden breathlessness, a sudden severe headache or vision changes are emergencies: go to the ER.
Common side effects by method
| Method | Most common | Also possible |
|---|---|---|
| Combined pill | Spotting in the first months, lighter periods | Sore breasts, nausea, headaches, mood changes [src] |
| Progestin-only pill | Irregular bleeding or spotting | Headaches, breast tenderness [src] |
| Injectable (DMPA) | Irregular bleeding, then often no period | Weight gain in some users, slow return of fertility [src] |
| Implant | Unpredictable bleeding, or none | Headaches, acne changes, bruising at the site [src] |
| Copper IUD | Heavier, crampier periods at first | Spotting between periods [src] |
| Hormonal IUD | Spotting at first, then lighter periods | Some people stop bleeding [src] |
Weight gain is the fear Filipinas ask about most. Reviews of trials have not found a large effect of combined pills on weight [src]. The injectable is the exception, with weight gain in some users. Read the full answer in does birth control cause weight gain?
The 3-month rule
Your body needs time to adjust to new hormones. Most common side effects of the pill, like spotting, nausea and sore breasts, settle within the first few months [src]. That is why doctors usually suggest giving a new pill about 3 months before deciding it is not for you, unless a side effect is severe.
- Month 1: spotting, sore breasts or nausea are common. Take the pill with food or at night if nausea bothers you.
- Months 2 to 3: most of this eases. Keep tracking.
- After 3 months: if it still bothers you, a doctor can suggest a different estrogen dose, a different progestin, or another method. See switching pills.
For implants and injectables, bleeding patterns can keep changing for longer. For the copper IUD, heavier periods usually ease after the first few months [src].
Red flags that need urgent care
Go to the nearest emergency room now if you have
- Chest pain, sudden breathlessness or coughing up blood
- A painful, swollen, warm leg (usually one calf)
- A sudden, severe headache unlike your usual ones, or migraine with new flashing lights or zigzags
- Sudden vision changes, weakness or numbness on one side, or trouble speaking
- Severe pain low in your belly, especially with a missed period (on an IUD, implant or POP)
- Thoughts of harming yourself
These can be signs of a blood clot or stroke, which are rare but serious on estrogen-containing pills [src], or of a pregnancy outside the womb. If you smoke and are 35 or older, have migraine with aura, or have had a clot, the combined pill may not be safe for you [src]. See birth control for smokers and people with migraine.
See a doctor within a few days (not the ER) for: bleeding that is very heavy or will not stop, fever after an IUD insertion, a red and painful implant site, or a new high blood pressure reading.
Guides by side effect
- Weight gain (nakakataba ba ang pills?)
- Spotting and breakthrough bleeding
- Mood swings, irritability and low mood
- No period during the pill break
- Fertility after stopping (nakakabaog ba?)
What to do about a side effect
- Check it is not a red flag. If it is, go to the ER.
- Track it. Note what, when and how bad, in the side effect tracker. It also makes a summary you can show your doctor.
- Rule out missed pills. Missed or late pills cause spotting. Check the Missed Pill Helper.
- Give it about 3 months unless it is severe.
- Talk to a doctor about switching. Do not stop without another method lined up. The find my method quiz can help you prepare.
Three legal routes
Talk to a doctor about switching
If a side effect lasts past 3 months or worries you, a doctor can suggest a different pill or method. Pills need a prescription in the Philippines. Pick the route that suits you. For adults 18 and over.
Free at a health center
Barangay health centers, RHUs, DOH hospitals and Likhaan. Subject to supply.
See an OB-GYN in person
Clinic visit, prescription in hand. Bring it to any licensed pharmacy.
Online consult
A licensed doctor by video or chat. From ₱700 on some platforms.
Online consult options
For adults 18 and over. Fees are set by each provider and can change.
Frequently asked questions
Normal lang ba ang side effects sa unang buwan ng pills?
Oo, karaniwan. Spotting, pananakit ng dibdib, pagduduwal at pagsakit ng ulo ay madalas sa unang tatlong buwan at kadalasang nawawala. Kung hindi nawala pagkatapos ng tatlong buwan, kausapin ang doktor tungkol sa pagpapalit.
Should I stop my pills if I have side effects?
Do not stop suddenly without a plan, because you can get pregnant. Unless it is an emergency, keep going and talk to a doctor about switching. If you stop, start another method or use condoms.
Which method has the fewest side effects?
Every method has possible side effects, and they differ from person to person. The copper IUD and condoms have no hormonal side effects. A doctor can help you match a method to what bothers you most.
Can birth control cause cancer?
The combined pill slightly raises the risk of breast and cervical cancer while you take it, and that falls back over about 10 years after stopping. It lowers the risk of womb, ovarian and bowel cancer.
This guide is for information. Talk to a doctor before starting, stopping or switching birth control.
Sources
- Combined pill: risks and side effects, NHS
- Combined pill: who can and cannot take it, NHS
- Family Planning: A Global Handbook for Providers, WHO and Johns Hopkins CCP
- Combination contraceptives: effects on weight (Gallo et al.), Cochrane / PubMed
- When will fertility return after using hormonal contraception?, Patient.info