Warning signs that you might be on the wrong pill

There are two categories of oral contraceptive medication: the combined pill and the progesterone-only pill. The combined pill contains synthetic forms of the hormones oestrogen and progesterone, while the progestogen-only pill, as its name suggests, contains a synthetic form of progesterone only.

Many different brands of each are available in the UK and can differ in terms of the amount and type of synthetic hormones used. This means that most women can find a contraceptive pill that suits them; while your doctor will do their best to prescribe the right pill for you, it is possible that you may have to try a few before finding the right one.

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Many women have no problems taking the pill, but it is possible to experience some minor side effects. Usually, these side effects are a sign that your body is adjusting to the new pill and they are likely to clear up after 2 to 3 months. However, side effects that continue for longer than 3 months can be inconvenient, and you might wish to try a different type of pill. You can consult your doctor, who will ask you about your symptoms and advise you on alternative contraception forms.

When changing pill, you should not have a break between the different packs. Your doctor will either advise you to start the new pack immediately or wait until the day after you finish your old pack. You are advised to use alternative methods of contraception during the changeover, as it may take a short time for the new pill to take effect.

Irregular or excessive bleeding

Breakthrough bleeding is the most commonly reported side effect in the first three months of taking the pill. Some women may experience spotting between bleeds, others may experience what seems to be one long period. While this is normal and not something to worry about, it can be annoying if it continues after 2 to 3 months. If you continue to bleed excessively and often, you may wish to consult your doctor for advice on alternative options.

Nausea

The synthetic hormones in oral contraceptives have different effects on different women. Some women report feeling nauseous after taking the pill, which can be unpleasant and life-disrupting. It is recommended to try taking the pill in the evening before sleep. You can speak to a doctor any time if you are suffering from nausea on the pill, and they may recommend a form of hormonal contraception that bypasses the stomach altogether, such as the implant or the IUD. If your pill is causing you to vomit, you will need to continue using another form of contraception, such as condoms, since there is no guarantee that the hormones will have had a chance to be absorbed by your body. In this case, consult your doctor as soon as possible to talk about your options.

Skin Changes

Hormonal contraceptives can cause changes in your skin, such as increased acne or facial hair. Again, this is most common in the first 2 to 3 months of starting the pill and often clears up as your body gets used to the change. However, if it is bothering you or your skin is not improving, speak to your doctor about possible alternatives. If the problem continues with an alternative pill, you may have to make a decision, based on your symptoms, about whether oral contraceptives are right for you at all.

Headaches

It is difficult to be certain that headaches are caused by your birth control, as other factors, such as lifestyle, may also be contributing. However, headaches are sometimes linked to hormonal fluctuations in women, so if you are experiencing more frequent and/or severe headaches, you can speak to your doctor for advice. The different brands of oral contraceptives vary in terms of the dosage of each hormone, and some women are more sensitive to one or both. It can be a process of trial and error to find which dosage relieves your headaches.

If you experience regular migraines, your doctor is unlikely to prescribe the contraceptive pill in the first place. Regular migraines are deemed a small risk factor of developing blood clots. Read about the link between the combined contraceptive pill and thromboembolism here.

Difficulty concentrating

If you find yourself feeling spaced-out, or have trouble concentrating or remembering certain things, there is a chance it could be to do with your contraceptive pill. The influx of hormones is thought to mimic the confusion, or ‘brain fog’, that many pregnant women experience. Again, this may be related to other factors, but if you are worried about how the pill is affecting your concentration, consult your doctor for advice.

Mood Swings

While it is true that experiencing changes in your mood may be a sign of your body adjusting to the pill, mood swings can be unpleasant and affect your emotional wellbeing. You may find yourself experiencing extreme emotional highs and lows, or feel that you are acting ‘irrationally’. Again, this may be to do with your contraceptive pill's hormone levels, and you may wish to try an alternative. A little PMS is normal, but if you feel that mood swings are affecting your well-being, it is important to speak to your doctor about your experience.

Hair loss

Hair loss is a rare side effect of the pill, and its severity can range from thinning to losing large clumps of hair. This may be an indicator that your body is especially sensitive to the hormones used in oral contraception. For help on how to deal with hair loss or try an alternative form of contraception, speak to a doctor.

Recognising severe side effects

There is a very small risk that taking combined contraceptive medication can increase your chance of developing a blood clot. This is because an influx of oestrogen can cause your blood to clot more readily. The risk of developing a blood clot on contraceptive medication is deemed extremely rare, and your doctor will not prescribe oral contraceptives if they think you are at risk. However, it is important to know the warning signs and seek urgent medical attention if you experience:

Sudden shortness of breath
Difficulty breathing, seeing or speaking
A feeling of pressure in the chest
Swelling, pain or tenderness in your legs or arms

Most women are able to take oral contraceptive medication without any problems. You can read about the different types of oral contraceptives here, and start a two-minute consultation with Dr Felix to find out which is best for you.