Birth Control Pills, Patch, or Ring

Estrogen-progestin pills, skin patches, and vaginal rings have similar possible side effects. The pill causes hormone levels to peak and drop each day. Each weekly patch takes 3 days after application to reach a steady hormone level. The ring releases a steady dose every day throughout the day. This may explain why the ring is less likely to cause headaches and nausea than the pill or patch.

Common side effects of estrogen-progestin methods

The most common side effects are changes in menstrual periods, including:

• Very light or Reference skipped periods. If you take monthly cycles of birth control hormones for a long time, your periods might stop. This effect can last until several months after you stop taking hormones.
• Bleeding between periods (spotting). This usually decreases after a woman uses a hormonal method for 3 to 4 months.

The contraceptive skin patch may cause skin irritation at the site.

The contraceptive vaginal ring may cause:

• Vaginal discharge.
• Irritation and inflammation of the vagina (vaginitis).

Less common side effects of estrogen-progestin methods

Less common side effects include:

• Nausea and vomiting, especially during the first month of use. This side effect usually goes away after the first few months of use.
• Frequent or more severe headaches. Reference Migraine headaches Opens New Window may get worse.
• Weight gain.
• Breast tenderness for the first few months.
• Reference Depression Opens New Window or mood changes.
• Darkening of the skin on the upper lip, under the eyes, or on the forehead (chloasma). This may slowly fade after you stop using hormonal methods, but in some cases it is permanent.
• Change in interest in sex (can be more or less).

Rare but serious side effects of estrogen-progestin methods

The following symptoms are rare but serious and should be reported to your doctor immediately.

• Abdominal pain that is severe or persists may be a sign of blood clots (Reference thrombophlebitis Opens New Window) in the pelvis, liver blood clots or tumors, or gallbladder disease.
• Chest pain may be a sign of blood clots in the lungs (Reference pulmonary embolism Opens New Window), Reference heart attack Opens New Window, or heart disease. Smoking increases this risk.
• Headaches that are severe may be a sign of stroke, migraine, or high blood pressure (hypertension). Smoking increases this risk.
• Eye problems, such as blurred vision or loss of vision, may be a sign of migraine, blood clots in the eye, or a change in the shape of the Reference cornea Opens New Window.
• Severe leg pain or sudden swelling of one leg may be a sign of leg blood clots (thrombophlebitis) or deep vein thrombosis (Reference DVT Opens New Window).

If you have kidney, liver, or Reference adrenal gland Opens New Window disease, you cannot use YAZ or Yasmin. This is because the progestin in these pills can increase your potassium levels. This can be dangerous for people who have kidney, liver, or adrenal gland disease.

Some types of progestin used in certain birth control pills may cause a Reference greater risk of blood clots than other types of progestin in birth control pills. Talk to your doctor about your risk of blood clots when deciding which pill is best for you.

Patch warnings. The patch delivers more estrogen than the low-dose birth control pills do. The U.S. Food and Drug Administration (FDA) warns that women using the patch are slightly more likely to get dangerous blood clots in the legs and lungs than women using birth control pills. So talk to your doctor about your risks before using the patch.

Direct sunlight or high heat can increase, then lower, the amount of hormone released from a patch. This can give you a big dose at the time and leave less hormone for the patch to release later in the week. This increases your risk of pregnancy. Avoid direct sunlight on the hormone patch. Also avoid using a tanning bed, heating pad, electric blanket, hot tub, or sauna while you are using a hormone patch.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

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