Hidden Risks of Birth Control Use

1. Blood Clot Formation

Hormonal contraceptives, particularly those containing estrogen, can significantly increase the risk of blood clot formation, a condition known as thrombosis. These birth control methods alter the balance of coagulation factors in the blood, making it more prone to clotting. According to the U.S. Food and Drug Administration (FDA), women using combined oral contraceptives are at a higher risk of developing blood clots compared to non-users.

One of the most severe manifestations is deep vein thrombosis (DVT), where a clot forms in the deep veins of the leg. If a clot dislodges, it can travel to the lungs, causing a potentially fatal pulmonary embolism. Warning signs of DVT include sudden leg pain, swelling, warmth, and redness. Pulmonary embolism symptoms may include shortness of breath, chest pain, and coughing up blood. Recognizing these signs early is critical for prompt treatment. For more detailed information, consult the CDC’s DVT factsheet.

2. Elevated Blood Pressure

Birth control pills, especially those containing estrogen, can contribute to elevated blood pressure in some users. The hormones in these contraceptives affect the vascular system by causing changes in the way blood vessels contract and relax, potentially leading to higher blood pressure levels. According to a review published by the National Institutes of Health (NIH), oral contraceptive use is associated with a small but significant increase in both systolic and diastolic blood pressure, particularly in women who already have hypertension or additional risk factors.

The rise in blood pressure can go unnoticed, as many individuals do not experience symptoms in the early stages. However, some may develop headaches, dizziness, blurred vision, or nosebleeds. Prolonged high blood pressure increases the risk of stroke, heart disease, and kidney problems. It is recommended that women taking birth control pills have their blood pressure monitored regularly by a healthcare provider. Further information and guidance can be found at the American Heart Association’s resource on high blood pressure.

3. Migraine Worsening

Estrogen-containing birth control methods, such as combined oral contraceptives, have been shown to influence the frequency and severity of migraines, particularly in women who experience migraines with aura. Fluctuations in estrogen levels can trigger migraines or intensify symptoms, as detailed in research from the American Academy of Neurology. Women with a history of migraine with aura face not only increased migraine attacks but also a heightened risk of stroke when using these types of contraceptives.

In contrast, non-hormonal birth control methods—such as copper intrauterine devices (IUDs) or barrier methods—do not impact hormone levels and are less likely to affect migraine patterns. If you notice changes in migraine frequency, severity, or the onset of new neurological symptoms (such as visual disturbances, numbness, or weakness), it is crucial to consult a healthcare provider promptly. The American Migraine Foundation provides further guidance on the connection between birth control and migraines and can help you determine the safest contraceptive options for your individual health profile.

4. Mood Changes and Depression

Hormonal contraceptives can significantly influence mood by altering the balance of neurotransmitters such as serotonin, dopamine, and GABA in the brain. Changes in these chemicals, triggered by synthetic hormones like estrogen and progestin, may increase the risk of mood swings, anxiety, and even clinical depression. A large Danish study published in JAMA Psychiatry found that women using hormonal contraception were more likely to be diagnosed with depression and prescribed antidepressants compared to non-users.

In real-world scenarios, some individuals report heightened emotional sensitivity, irritability, or persistent sadness after starting hormonal birth control. This contrasts with non-hormonal methods, which do not affect brain chemistry in the same way and are less frequently linked to mood disturbances. It is important to monitor your mental health closely when beginning or changing contraceptive methods. If you notice persistent changes in mood, decreased interest in activities, or thoughts of self-harm, seek help from a healthcare provider immediately. For additional information and support, visit the U.S. Department of Health & Human Services’ MentalHealth.gov resource.

5. Increased Breast Cancer Risk

Long-term use of hormonal contraceptives has been linked to a slightly increased risk of developing breast cancer. Research published by the New England Journal of Medicine found that women who used hormonal birth control for ten years or more had a 20% higher risk of breast cancer compared to those who never used these methods. The absolute risk remains low, but the association appears to be strongest with current or recent users and diminishes over time after discontinuation.

While the increased risk may be concerning, it is important to compare this with other lifestyle and genetic factors that also influence breast cancer risk. Non-hormonal contraceptives, such as copper IUDs, do not carry the same risk. Regular breast self-examinations, clinical exams, and mammography are essential for early detection, especially for women with a family history of breast cancer or other risk factors. For more guidance on breast cancer risk and screening, visit the American Cancer Society’s resource on birth control and breast cancer.

6. Liver Function Changes

Oral contraceptives are metabolized in the liver, where they can alter the production and breakdown of various enzymes. The synthetic hormones in these medications may cause mild elevations in liver enzymes, which are indicators of liver function. According to the National Institutes of Health (NIH), most healthy women experience only minor changes, but those with pre-existing liver conditions or who use birth control long-term may face greater risks, including benign liver tumors or, in rare cases, more serious complications.

This effect is similar to how other medications processed by the liver—such as certain antibiotics or anti-seizure drugs—can influence liver enzyme levels. If you are taking multiple medications, it is important to inform your healthcare provider to prevent potential interactions. Signs of liver distress can include jaundice, abdominal pain, or unexplained fatigue. Routine blood tests to monitor liver function are recommended for women on long-term oral contraceptives, particularly if they have a history of liver disease. For further information on maintaining liver health, visit the American Liver Foundation.

7. Gallbladder Disease

Estrogen-containing birth control methods have been associated with an increased risk of gallbladder disease, particularly the formation of gallstones. Estrogen can raise cholesterol levels in bile, which may promote the development of gallstones and lead to inflammation or blockages in the gallbladder. According to the National Institutes of Health (NIH), women using hormonal contraceptives face a higher incidence of gallstone-related complications compared to non-users.

For example, a woman taking combined oral contraceptives for several years might develop gallstones, resulting in symptoms such as severe upper abdominal pain, nausea, vomiting, and jaundice. These symptoms can worsen after fatty meals and may require medical evaluation or surgical intervention. It is important for users of estrogen-containing birth control to recognize these warning signs and seek prompt medical attention if they develop. Maintaining a healthy diet and staying hydrated can help reduce the risk of gallstone formation. For further details on gallbladder disease and prevention, visit the Mayo Clinic’s resource on gallstones.

8. Reduced Bone Density

Certain hormonal birth control methods, particularly the injectable progestin-only contraceptive Depo-Provera (medroxyprogesterone acetate), have been found to reduce bone mineral density over time. The medication suppresses estrogen production, a hormone critical for bone maintenance. Studies, such as those cited by the National Institutes of Health (NIH), have shown that women using Depo-Provera for extended periods may experience a greater decline in bone density compared to non-users or those using non-hormonal methods.

Lower bone mineral density increases the risk of osteoporosis and bone fractures, especially with long-term use or if other risk factors are present. This risk typically decreases after discontinuing Depo-Provera, with partial or full recovery of bone density over time. For comparison, users of non-hormonal contraceptives do not experience these bone density changes. Women who choose injectable contraception should consider regular bone health screenings, such as bone mineral density tests, and maintain a diet rich in calcium and vitamin D. For more information on how birth control may affect bone health and preventive strategies, visit the NIH Osteoporosis and Related Bone Diseases Resource Center.

9. Eye Health Complications

Though rare, hormonal birth control can cause eye health complications, especially in women with other vascular risk factors. Estrogen in contraceptives can increase the likelihood of blood clot formation, which may affect the small vessels supplying the retina. According to the American Academy of Ophthalmology (AAO), one potential complication is a retinal vein occlusion, where a blood clot blocks a retinal vein, leading to sudden vision changes or loss.

For example, a woman on combined oral contraceptives who experiences a sudden onset of blurred vision or visual field loss may be experiencing a retinal clot. Other symptoms could include eye pain or seeing flashes of light. These events require immediate medical evaluation to prevent permanent vision impairment. Regular eye exams are essential for anyone using hormonal birth control, particularly if there is a history of migraines, high blood pressure, or smoking. Monitoring eye health and promptly reporting any visual disturbances can help ensure early detection and treatment. For additional details, visit the AAO’s resource on contraceptives and vision.

10. Decreased Libido

Hormonal birth control can affect sexual desire in some users, leading to a decrease in libido. The synthetic hormones, particularly progestin and estrogen, may lower levels of free testosterone—a hormone involved in sexual arousal and satisfaction. Research published in the Journal of Sexual Medicine found that some women on oral contraceptives report less interest in sex compared to their natural menstrual cycles, where hormonal fluctuations often boost libido around ovulation.

In contrast, women not using hormonal contraception may notice increased sexual desire at certain points in their natural cycle, driven by their body’s own hormone patterns. If a decrease in libido becomes concerning, practical steps include open communication with a partner, exploring alternative forms of contraception, or switching to a non-hormonal method such as a copper IUD. Consulting with a healthcare provider can help identify whether the contraceptive is the cause and explore possible solutions. For more details on sexual health and hormonal birth control, visit the Planned Parenthood resource on sex and birth control.

11. Weight Fluctuations

Weight fluctuations are a commonly reported concern among birth control users, although the effects can vary widely between individuals. Hormonal birth control may cause weight gain or loss through mechanisms such as fluid retention, changes in appetite, or shifts in metabolism. According to a review by the National Institutes of Health (NIH), most studies indicate that combined oral contraceptives have a minimal impact on weight, with average changes of less than 2 kg. However, some individuals, especially those using progestin-only injectables like Depo-Provera, may experience more significant weight gain.

Conversely, others may observe minor weight loss, particularly if appetite decreases. Because responses are highly individualized, it’s important to track physical changes after starting a new contraceptive method. Keep a journal of weight, dietary habits, and exercise routines to identify any patterns or triggers. If weight changes become pronounced or concerning, consult a healthcare provider for evaluation and potential alternative contraception options. For more information on birth control and weight management, visit the Planned Parenthood’s guide to birth control safety.

12. Skin Reactions and Acne

Hormonal birth control can have varying effects on skin health, particularly acne, depending on the formulation and the individual’s unique hormonal balance. Certain combination birth control pills containing estrogen and specific types of progestin are FDA-approved for acne treatment and can reduce breakouts by lowering levels of androgens, hormones that stimulate oil production. According to the American Academy of Dermatology Association (AAD), many users notice clearer skin within several months of starting these contraceptives.

However, other hormonal contraceptives—especially progestin-only options—may worsen acne or trigger new breakouts, as some progestins can act similarly to androgens. Non-hormonal methods, such as copper IUDs, do not affect acne one way or another. It is important to monitor your skin’s response after beginning a new contraceptive. Keep track of changes in breakout frequency, severity, and location. If acne worsens or leads to significant skin irritation, consult with a dermatologist or healthcare provider to discuss alternative options. For further guidance on how birth control affects acne, visit the AAD’s resource on birth control and acne.

13. Increased Cervical Cancer Risk

Long-term use of oral contraceptives has been associated with a slightly elevated risk of developing cervical cancer. Research summarized by the National Cancer Institute indicates that women who use birth control pills for five years or more are at a higher risk, particularly if they also have a persistent infection with human papillomavirus (HPV), the primary cause of cervical cancer. The risk appears to increase with longer duration of contraceptive use and declines after discontinuation.

It is important to consider that HPV infection rates play a major role in cervical cancer development, and birth control does not affect HPV transmission. However, hormonal changes may make cervical tissue more susceptible to HPV’s effects. Regular cervical cancer screening—such as Pap smears and HPV testing—is crucial for early detection, especially for women using oral contraceptives long-term. Practicing safe sex and considering HPV vaccination are additional protective measures. To learn more about the relationship between birth control and cervical cancer, as well as recommended screening intervals, visit the American Cancer Society’s cervical cancer prevention page.

14. Yeast and Vaginal Infections

Hormonal birth control can influence the natural balance of bacteria and yeast in the vaginal environment, sometimes resulting in an increased risk of infections such as yeast infections (candidiasis) and bacterial vaginosis. The estrogen and progestin in many contraceptives may alter the vaginal flora by changing pH levels and reducing the populations of protective lactobacilli. According to the National Institutes of Health (NIH), these changes can create conditions more favorable for the overgrowth of yeast or harmful bacteria.

For example, a woman may notice increased vaginal itching, discharge, or odor after starting a new hormonal contraceptive—signs that may indicate an infection. To minimize risk, maintain good hygiene by wearing breathable cotton underwear, avoiding scented products, and practicing safe sex. If symptoms such as persistent itching, unusual discharge, or discomfort occur, consult a healthcare provider for diagnosis and treatment. Regular gynecological check-ups are also important for monitoring vaginal health while using hormonal contraception. For more detailed information and preventive tips, visit the CDC’s resource on vaginal yeast infections.

15. Irregular Bleeding

Irregular bleeding, including breakthrough bleeding and spotting between periods, is a common side effect of hormonal birth control—particularly during the first few months of use. These symptoms occur as the body adjusts to synthetic hormones, which can alter the natural menstrual cycle and the stability of the uterine lining. According to the American College of Obstetricians and Gynecologists (ACOG), irregular bleeding is especially frequent with progestin-only pills, hormonal IUDs, and birth control implants.

Combined oral contraceptives often cause spotting when doses are missed or taken inconsistently. Injectable birth control and implants may lead to unpredictable bleeding patterns or even amenorrhea (absence of periods) over time. While most cases of irregular bleeding are harmless and resolve within a few cycles, heavy or persistent bleeding warrants medical evaluation. Keep track of menstrual changes and consult a healthcare provider if bleeding is accompanied by severe pain, dizziness, or signs of anemia. For more guidance on managing breakthrough bleeding and when to seek help, visit the Planned Parenthood’s guide to birth control pill side effects.

16. Allergic Reactions

While uncommon, allergic reactions to birth control methods—whether oral pills, patches, rings, or intrauterine devices—can occur and may be serious. These reactions may be triggered by active ingredients, dyes, preservatives, or even the materials used in contraceptive devices. For example, some women may develop a sensitivity to latex in condoms or the plastic or metal components in IUDs. The National Institutes of Health (NIH) describes cases of both mild and severe allergic responses to contraceptive products.

Symptoms of an allergic reaction may include skin rash, itching, swelling, hives, or localized redness at the site of a patch or device. In rare but serious cases, anaphylaxis may develop, characterized by difficulty breathing, swelling of the face or throat, rapid pulse, or severe dizziness. Anaphylaxis is a medical emergency—immediate treatment and emergency services are essential. Always inform your healthcare provider of any known allergies before starting a new contraceptive method. If you suspect an allergic reaction, discontinue use and seek prompt medical attention. For more information on allergic reactions to medications, visit the CDC’s resource on allergies and medical products.

17. Fluid Retention and Swelling

Estrogen-containing birth control can cause the body to retain excess water, resulting in swelling—also known as edema—most commonly in the hands, feet, and ankles. Estrogen promotes sodium retention in the kidneys, which leads to water being held in the tissues. According to the National Institutes of Health (NIH), mild fluid retention is a frequent and generally benign side effect of oral contraceptives, though it can be uncomfortable.

Women using progestin-only or non-hormonal contraceptives usually report fewer issues with swelling, highlighting the role of estrogen in this process. To help minimize discomfort, maintain regular physical activity, reduce sodium intake, and elevate your legs periodically throughout the day. Compression stockings can also be useful for those prone to swelling. While mild edema usually resolves on its own, persistent or severe swelling—especially if accompanied by pain, redness, or shortness of breath—may indicate a more serious problem, such as a blood clot. In such cases, prompt medical evaluation is crucial. For additional tips on managing fluid retention, visit the Mayo Clinic’s resource on edema.

18. Delayed Fertility Return

Some birth control methods can delay the return of normal fertility after discontinuation, though the extent and duration vary by type. For example, most women who stop using combined oral contraceptives or hormonal IUDs regain fertility within a month or two. However, injectable contraceptives like Depo-Provera are known to cause a longer delay, with ovulation often resuming between 9 and 12 months after the last injection in some cases. According to the American College of Obstetricians and Gynecologists (ACOG), this delay is not permanent, but it can impact family planning.

The timeline for fertility return also depends on individual health factors and the duration of contraceptive use. Women wishing to conceive soon after stopping birth control should discuss their plans with a healthcare provider to set realistic expectations. Tracking ovulation and menstrual cycles can help gauge when fertility is returning. For those planning future pregnancies, it may be beneficial to discontinue certain methods several months in advance. For more information on fertility expectations following contraception, visit the NHS guide to fertility after birth control.

19. Nutrient Deficiencies

Hormonal birth control can affect the body’s absorption and metabolism of certain essential nutrients, potentially leading to deficiencies over time. Studies have shown that women taking oral contraceptives may have lower blood levels of vitamins such as B6, B12, folate, vitamin C, and some minerals like magnesium and zinc. According to the National Institutes of Health Office of Dietary Supplements, these deficiencies are typically mild but can become clinically significant with prolonged use, especially for those with inadequate dietary intake.

Maintaining a balanced diet rich in leafy greens, whole grains, lean proteins, fruits, and nuts can help counteract potential nutrient losses. Consider incorporating foods high in B-vitamins (such as legumes and fortified cereals) and folate (such as spinach and lentils). For some individuals, a daily multivitamin or targeted supplement may be beneficial; however, it is best to consult a healthcare provider before beginning any supplementation. Regular blood tests can help monitor nutrient status and guide dietary or supplement adjustments. For more information on nutrition and women’s health, visit the Academy of Nutrition and Dietetics’ resource for women.

20. Thyroid Function Changes

Hormonal contraception may subtly affect thyroid function by influencing how thyroid hormones circulate in the bloodstream. Estrogen in birth control pills increases the production of thyroid-binding globulin, a protein that binds to thyroid hormones and can alter the ratio of bound versus free (active) hormones. According to the National Institutes of Health (NIH), these changes rarely cause overt thyroid disease but may lead to mild shifts in hormone levels, particularly in individuals with underlying thyroid conditions.

For example, a woman with borderline hypothyroidism might notice increased fatigue, weight gain, or sensitivity to cold after starting hormonal birth control, as the active free hormone levels become slightly lower. Signs to monitor include persistent tiredness, unexplained weight changes, hair thinning, or changes in menstrual cycles. If such symptoms develop, it is important to discuss them with a healthcare provider, who may recommend thyroid function testing to determine if adjustments to medication or contraception are needed. For more information on thyroid health and how it may intersect with reproductive hormones, visit the American Thyroid Association’s guide to thyroid disease and reproductive health.

21. Blood Sugar Alterations

Some hormonal contraceptives, particularly those containing higher doses of estrogen or certain types of progestin, may impact glucose metabolism and insulin sensitivity. This effect is most pronounced in individuals with pre-existing risk factors for diabetes, such as prediabetes or polycystic ovary syndrome (PCOS). Research summarized by the National Institutes of Health (NIH) indicates that while most healthy women do not experience significant changes, those with impaired glucose tolerance may notice mild increases in blood sugar levels while using hormonal contraception.

For example, a woman with prediabetes who starts on a combined oral contraceptive may observe slightly elevated blood glucose readings during routine monitoring. Symptoms of poor blood sugar control can include increased thirst, frequent urination, fatigue, and blurred vision. Regular monitoring of blood glucose is advisable for women with diabetes risk factors who are considering or currently using hormonal birth control. Discussing alternative contraceptive options with a healthcare provider may be warranted for those with a history of insulin resistance. For further information on diabetes and women’s reproductive health, visit the CDC’s overview of diabetes.

22. Increased Risk of Stroke

Estrogen-containing birth control methods, such as combined oral contraceptives, are associated with a small yet notable increase in the risk of ischemic stroke. This risk is magnified in women who have additional risk factors such as smoking, migraine with aura, high blood pressure, or a history of blood clots. According to the American Heart Association, the risk of stroke in healthy, non-smoking women under 35 is very low, but it rises when oral contraceptives are combined with smoking or other vascular conditions.

For instance, a smoker over age 35 taking combined oral contraceptives is at a significantly higher risk for stroke compared to non-smokers or those using progestin-only or non-hormonal methods. Symptoms of stroke include sudden numbness or weakness, confusion, trouble speaking, vision changes, dizziness, or severe headache. Prevention tips include avoiding smoking, managing blood pressure, and discussing personal risk factors with a healthcare provider before starting or continuing estrogen-containing contraception. For more information on stroke risk and prevention in women, visit the Stroke.org’s resource on women and stroke.

23. Headaches and Tension

Hormonal fluctuations caused by birth control use can trigger headaches or worsen existing headache disorders, such as tension-type headaches and migraines. The introduction of synthetic estrogen and progestin alters the body’s natural hormone patterns, which can influence the dilation and constriction of blood vessels in the brain. According to the American Migraine Foundation, some women experience more frequent or severe headaches after starting or switching contraceptives, while others may notice improvement if their migraines are linked to natural hormonal shifts during the menstrual cycle.

Compared to the natural menstrual cycle, where hormone levels rise and fall predictably, birth control can either steady these fluctuations or introduce new patterns that some individuals find problematic. Management strategies include tracking headache frequency and triggers, maintaining regular hydration and sleep schedules, and considering non-hormonal or progestin-only contraceptive options if headaches persist. Over-the-counter pain relievers or prescribed medications may help, but it’s important to consult a healthcare provider before making changes. For further guidance on managing headaches related to birth control, visit the Planned Parenthood’s guide to pill side effects.

24. Nausea and Digestive Upset

Nausea is a relatively common side effect experienced by some users of hormonal birth control, especially when starting a new pill or patch. The presence of synthetic estrogen and progestin can irritate the stomach lining or affect gastrointestinal motility, resulting in symptoms such as queasiness, indigestion, or even vomiting. According to the American College of Obstetricians and Gynecologists (ACOG), nausea is most likely to occur in the first few weeks of use and typically subsides as the body adjusts.

For example, a woman may feel mild nausea after taking her morning birth control pill, particularly if it’s taken on an empty stomach. To minimize discomfort, consider taking the pill with food or at bedtime to reduce stomach irritation. Staying hydrated and eating small, frequent meals can also help. If nausea persists beyond the initial adjustment period, switching to a lower-dose pill or a non-oral contraceptive method may provide relief. Severe or persistent digestive upset should be discussed with a healthcare provider. For more coping tips and detailed information, visit the Healthline guide to birth control side effects.

25. Hair Loss or Growth

Hormonal birth control can influence hair growth patterns due to the androgenic properties of certain contraceptives. Pills or devices that contain progestins with higher androgenic activity may cause hair thinning (telogen effluvium) or, in some cases, unwanted hair growth (hirsutism) on areas such as the face, chest, or back. According to the American Academy of Dermatology Association (AAD), this is more likely in women predisposed to androgen sensitivity or with a family history of hair loss.

Conversely, some combination birth control pills with anti-androgenic properties can actually improve scalp hair density and reduce excess hair growth, especially in women with conditions like polycystic ovary syndrome (PCOS). If you notice significant hair shedding or the development of coarse, dark hair in new areas after starting a contraceptive, track these changes and consult a healthcare provider. Gentle hair care practices—such as avoiding heat styling, reducing chemical treatments, and using mild shampoos—can help minimize damage. For persistent or distressing hair changes, exploring alternative contraceptive options may be necessary. For more information on the link between birth control and hair changes, visit the AAD’s resource on birth control and hair loss.

26. Sexual Pain (Dyspareunia)

Hormonal birth control can lead to changes in vaginal lubrication and tissue elasticity, sometimes resulting in sexual pain known as dyspareunia. The reduction in estrogen caused by certain contraceptives—especially progestin-only pills or injectable methods—may decrease natural lubrication and cause thinning of vaginal tissues, leading to dryness, irritation, and discomfort during intercourse. According to the National Institutes of Health (NIH), these side effects are more common in women sensitive to hormonal fluctuations or with a history of vaginal dryness.

For example, a woman who switches from a combined oral contraceptive to a progestin-only method might notice increased dryness and pain during sex. Treatment options include using water-based lubricants, engaging in longer foreplay, and maintaining open communication with a partner. If symptoms persist, a healthcare provider may recommend switching to a different contraceptive method or prescribing topical estrogen therapy in select cases. Regular gynecological check-ups can help monitor vaginal health and address symptoms early. For additional tips and information about managing dyspareunia related to birth control, visit the Planned Parenthood’s resource on vaginal dryness.

27. Reduced Lactation

Some types of birth control, particularly those containing estrogen, can interfere with lactation and reduce breast milk supply in breastfeeding women. Estrogen suppresses the hormones necessary for milk production, which can be problematic for mothers hoping to maintain exclusive breastfeeding. According to the Centers for Disease Control and Prevention (CDC), combined oral contraceptives are more likely to affect milk volume than progestin-only pills, known as the “mini-pill,” which are generally considered safer for use during lactation.

For example, a new mother who starts an estrogen-containing pill soon after childbirth may notice a decline in milk output or her baby’s increased fussiness and poor weight gain. If concerns about milk supply arise, switching to a progestin-only method, a non-hormonal IUD, or barrier contraception may help maintain lactation. Other tips for supporting milk supply include frequent breastfeeding or pumping, staying hydrated, and ensuring proper nutrition. If problems persist, consult a lactation consultant or healthcare provider for personalized guidance. For more information on safe birth control options while breastfeeding, visit the CDC’s resource on contraception and breastfeeding.

28. Interactions with Other Medications

Birth control pills and other hormonal contraceptives can interact with certain medications, potentially reducing contraceptive effectiveness or altering the effects of the other drugs. Notable interactions occur with some antibiotics, such as rifampin, and antiepileptic medications like phenytoin and carbamazepine. These drugs can speed up the breakdown of contraceptive hormones in the liver, resulting in lower hormone levels and an increased risk of unintended pregnancy. According to the Centers for Disease Control and Prevention (CDC), most common antibiotics do not affect birth control, but specific ones, including rifampin, do pose a risk.

For example, a person taking rifampin for tuberculosis or certain seizure medications may experience reduced birth control effectiveness. It is crucial to inform your healthcare provider and pharmacist about all medications and supplements you are taking. In cases of known interaction, using a non-hormonal backup method, such as condoms, is recommended. Regularly reviewing your medication list with a pharmacist or healthcare provider can help avoid unexpected interactions. For a comprehensive list of drug interactions with hormonal contraceptives, visit the FDA’s guide on drug interactions with hormonal contraceptives.

29. Increased Blood Lipids

Oral contraceptives, especially those with higher estrogen content, can raise blood lipid levels—including cholesterol and triglycerides—in some women. Estrogen increases the production of certain lipoproteins in the liver, which can result in elevated total cholesterol, LDL (“bad”) cholesterol, and triglyceride levels, while sometimes raising HDL (“good”) cholesterol as well. According to the National Institutes of Health (NIH), these changes are generally modest in healthy individuals but may be more pronounced in those with underlying lipid disorders, obesity, or a family history of cardiovascular disease.

Women with pre-existing high cholesterol or cardiovascular risk factors should discuss alternative contraceptive options, such as progestin-only or non-hormonal methods, which have a lesser impact on lipid profiles. Regular monitoring of blood lipid levels is important for women using oral contraceptives, particularly if they have other risk factors. A heart-healthy diet, regular exercise, and periodic blood tests can help manage and detect changes early. If significant increases in cholesterol or triglycerides are observed, a healthcare provider may recommend adjusting the contraceptive method. For more information on birth control and blood lipid changes, visit the American Heart Association’s cholesterol resource.

30. Autoimmune Flare-Ups

In rare cases, hormonal birth control may exacerbate autoimmune conditions such as systemic lupus erythematosus (SLE) or other inflammatory disorders. The synthetic hormones in contraceptives can modulate immune system activity, sometimes triggering flare-ups in susceptible individuals. According to the Lupus Foundation of America, women with lupus or a history of blood clots are at increased risk of complications and should carefully consider contraceptive choices.

Patient stories include experiences of worsening joint pain, skin rashes, or fatigue shortly after starting a new hormonal contraceptive. Some report increased frequency and severity of lupus flares, while others notice new autoimmune symptoms. Warning signs to watch for include persistent joint swelling, unexplained fevers, severe fatigue, rashes, or mouth ulcers. It is vital for women with autoimmune diseases to consult both their rheumatologist and gynecologist before starting or changing birth control methods. In some cases, progestin-only or non-hormonal options may be safer. For further information and patient experiences related to autoimmune flares and birth control, visit the Lupus Foundation’s resource on hormones and lupus.

31. Risk of Melasma

Melasma is a form of hyperpigmentation that appears as brown or grayish patches, typically on the face, and is often triggered by hormonal changes. Birth control pills and other estrogen-containing contraceptives can increase the risk of developing melasma, especially in individuals with a genetic predisposition or those who have previously experienced pigmentation changes during pregnancy (“the mask of pregnancy,” or chloasma). According to the American Academy of Dermatology Association (AAD), the hormonal stimulation of melanocytes (pigment-producing cells) is a key factor in this process.

Melasma caused by birth control shares similarities with pregnancy-related melasma, including its pattern and tendency to worsen with sun exposure. Preventing and managing melasma involves diligent sun protection: using broad-spectrum sunscreen daily, wearing wide-brimmed hats, and seeking shade. If pigmentation develops, consider consulting a dermatologist for topical treatments such as hydroquinone or retinoids. Switching to a non-hormonal contraceptive may also be recommended if melasma becomes severe or persistent. For more information on melasma and strategies for prevention and treatment, visit the AAD’s melasma prevention resource.

32. Sleep Disturbances

Hormonal fluctuations caused by birth control can impact sleep quality and patterns for some users. Changes in estrogen and progestin levels may disrupt the natural circadian rhythm, leading to difficulties falling asleep, staying asleep, or experiencing restful sleep. According to the Sleep Foundation, some women report more frequent insomnia, vivid dreams, or daytime fatigue after starting or switching hormonal contraceptives.

User stories highlight a range of experiences—from trouble winding down at night to waking up multiple times or feeling unrested in the morning. While some individuals notice improvements in premenstrual sleep disturbances with birth control, others find their sleep issues worsen. Strategies for improvement include maintaining a consistent sleep schedule, limiting screen time before bed, practicing relaxation techniques, and avoiding caffeine late in the day. If sleep problems persist, consider tracking symptoms in a journal and discussing them with a healthcare provider, who may suggest adjusting the contraceptive method or referring to a sleep specialist. For more information and practical tips on managing sleep challenges related to hormonal changes, visit the Sleep Foundation’s guide to birth control and sleep.

33. Digestive Tract Inflammation

While rare, some studies suggest a potential association between hormonal birth control use and an increased risk of developing inflammatory bowel conditions, such as Crohn’s disease and ulcerative colitis. The proposed mechanism involves hormonal influences on immune function and gut permeability, which may contribute to inflammation in the digestive tract. Research published in the journal Gastroenterology indicates a modestly higher risk of Crohn’s disease among women who have used oral contraceptives, especially with prolonged use.

Symptoms to watch for include persistent abdominal pain, diarrhea, blood in the stool, unexplained weight loss, and fatigue. While the overall risk remains low for most users, those with a personal or family history of inflammatory bowel disease should discuss these concerns with their healthcare provider before starting hormonal contraception. Early recognition and intervention are important if digestive symptoms develop. Regular monitoring and open communication with a gastroenterologist can help manage risk. For more information on inflammatory bowel diseases and their potential links to hormonal factors, visit the Crohn’s & Colitis Foundation.

34. Anxiety Symptoms

Hormonal fluctuations triggered by birth control use can heighten anxiety symptoms in individuals who are sensitive to changes in neurotransmitter balance. The synthetic estrogen and progestin in contraceptives can alter levels of serotonin, dopamine, and GABA, all of which play key roles in emotional regulation. Studies, such as those discussed by the Anxiety & Depression Association of America (ADAA), suggest that some users experience increased nervousness, restlessness, or panic attacks after starting or changing hormonal birth control.

Real-world experiences include reports of new or worsening anxiety, difficulty concentrating, irritability, and a sense of being “on edge.” While many adjust after several cycles, others may find anxiety symptoms persist or interfere with daily life. Self-check strategies include keeping a mood journal to track timing and severity of symptoms, practicing deep breathing or mindfulness, and maintaining a healthy lifestyle with regular exercise and sleep. If anxiety becomes disruptive, consult a healthcare provider to discuss possible adjustments to the contraceptive method or referral to a mental health specialist. For additional support and resources on managing anxiety and hormonal changes, visit the ADAA’s resource on hormones and anxiety.

35. Allergic Reactions to Device Materials

Allergic reactions to the materials used in intrauterine devices (IUDs) or contraceptive implants, while rare, can occur in sensitive individuals. Some IUDs contain metals such as copper or nickel, which are known allergens for certain people. For example, a person with a nickel allergy may develop localized or systemic reactions after the insertion of a copper IUD, including itching, redness, vaginal discharge, or, in severe cases, widespread hives and swelling. According to the National Institutes of Health (NIH), there have been documented cases of hypersensitivity to IUD components, particularly in those with a history of metal allergies.

Symptoms of allergic reactions may include persistent discomfort, skin rash near the genital area, pelvic pain, or even systemic allergic symptoms. If any signs develop after device insertion, it’s crucial to seek medical evaluation promptly. Before choosing a device, inform your healthcare provider of any known allergies to metals or plastics. Patch testing or selecting non-metallic alternatives may be appropriate for those at risk. For more information on metal allergies and contraceptive device safety, visit the American College of Allergy, Asthma & Immunology’s resource on contact dermatitis.

36. Blood Iron Levels

Hormonal birth control methods, particularly combined oral contraceptives and hormonal IUDs, often reduce the volume and frequency of menstrual bleeding. This decreased blood loss can lead to increased iron stores in the body, which may benefit women at risk for iron deficiency anemia. According to the Centers for Disease Control and Prevention (CDC), lighter periods are associated with improved iron status and lower rates of anemia among birth control users.

However, not all users experience reduced bleeding; some, especially those using progestin-only methods or newly starting a contraceptive, may have episodes of heavy or irregular bleeding. Excessive blood loss can deplete iron stores over time and lead to symptoms of anemia, such as fatigue, weakness, pale skin, or shortness of breath. Monitoring menstrual patterns and being alert to signs of anemia are important for long-term health. Maintaining a diet rich in iron—such as leafy greens, beans, and lean meats—or taking supplements when recommended can support healthy iron levels. For more information on iron and anemia, visit the CDC’s resource on iron and anemia.

37. Loss of Menstrual Period (Amenorrhea)

Some hormonal birth control methods, particularly hormonal IUDs, contraceptive implants, and progestin-only injections (like Depo-Provera), can lead to loss of menstrual periods—a condition known as amenorrhea. This occurs because these contraceptives thin the uterine lining and suppress ovulation, resulting in little or no menstrual bleeding. According to the American College of Obstetricians and Gynecologists (ACOG), amenorrhea is a common and medically safe side effect for many users.

The absence of periods can be seen as a benefit, offering relief from menstrual pain, heavy bleeding, and related symptoms. However, some individuals may find amenorrhea unsettling or worry about underlying health concerns. It’s generally not harmful, but sudden loss of periods—especially if accompanied by other symptoms such as pelvic pain or abnormal discharge—should be evaluated by a healthcare provider. Amenorrhea may also mask early signs of pregnancy, so those at risk should consider periodic pregnancy testing. If you have questions about the pros and cons of amenorrhea, or if you experience any unexpected changes, consult your clinician for personalized guidance. For more details, visit the ACOG’s FAQ on amenorrhea.

38. Breast Tenderness

Breast tenderness is a common side effect of hormonal birth control, particularly those containing estrogen. The synthetic hormones can cause breast tissue to swell or become more sensitive, similar to the changes experienced during the premenstrual phase of the menstrual cycle. According to the Planned Parenthood, this discomfort often develops soon after starting a new contraceptive and typically subsides within a few months as the body adjusts.

The sensation is often described as a dull ache, heaviness, or swelling in one or both breasts, mirroring premenstrual breast pain but sometimes occurring more consistently. Home care tips include wearing a supportive bra, applying warm or cold compresses, and avoiding caffeine or salty foods, which may exacerbate tenderness. Over-the-counter pain relievers can also provide relief when needed. If breast pain is severe, persistent, or accompanied by other symptoms such as lumps, discharge, or skin changes, it’s important to consult a healthcare provider to rule out other causes. For further information on breast tenderness and management strategies, visit the Breastcancer.org resource on breast pain.

39. Sexually Transmitted Infection (STI) Risk

Hormonal birth control methods, including pills, patches, injections, and IUDs, are highly effective at preventing pregnancy but do not offer any protection against sexually transmitted infections (STIs). In fact, some research suggests that hormonal changes may increase susceptibility to certain infections, such as chlamydia or HIV, by altering the vaginal lining or immune response. According to the Centers for Disease Control and Prevention (CDC), only barrier methods—such as condoms and dental dams—provide reliable protection against STIs.

For individuals with multiple partners or those who are not in mutually monogamous relationships, using condoms in addition to hormonal birth control is strongly recommended to reduce the risk of infection. Regular STI screenings, open communication with partners, and prompt treatment of any infections are also key components of sexual health. Relying solely on hormonal contraception can lead to a false sense of security regarding STIs. For more information about STI prevention, symptoms, and testing, visit the CDC’s comprehensive STI prevention resource.

40. Rare Blood Vessel Inflammation (Vasculitis)

Vasculitis, or inflammation of the blood vessels, is a very rare but reported complication associated with hormonal contraception. Vasculitis can affect small or large vessels, causing a variety of symptoms depending on the organs involved. Published case reports in the National Institutes of Health (NIH) literature describe instances where women developed symptoms of vasculitis—such as skin rashes, joint pain, fever, or numbness—shortly after starting or while using oral contraceptives or other hormonal birth control.

Warning signs of vasculitis may include persistent, unexplained skin purpura or red spots, swelling, muscle or joint pain, unexplained fevers, or tingling and weakness in the limbs. Because vasculitis can lead to serious complications if not identified and treated, it is important to seek prompt medical attention if these symptoms arise, particularly soon after starting new medication. Diagnosis typically involves blood tests, imaging, and sometimes a biopsy. If you have a personal or family history of autoimmune diseases, discuss your risks with your healthcare provider before choosing hormonal contraception. For further reading, visit the NIH’s resource on vasculitis.

41. Ovarian Cyst Formation

Hormonal birth control can influence the risk of developing ovarian cysts, depending on the type of contraceptive used. Combined oral contraceptives are often prescribed to help prevent the formation of functional ovarian cysts by suppressing ovulation. According to the Mayo Clinic, consistent use of these pills generally lowers the risk of new cysts forming.

However, progestin-only methods, such as the “mini-pill,” implants, or hormonal IUDs, may not always suppress ovulation as effectively, potentially allowing cysts to develop or persist in some women. Most ovarian cysts are benign and resolve without intervention, but symptoms can include pelvic pain, bloating, or a feeling of fullness. Sudden severe pain, fever, or vomiting may indicate a ruptured cyst or ovarian torsion, both of which require urgent medical attention. If you experience persistent pelvic discomfort or changes in your menstrual cycle while using birth control, consult a healthcare provider for evaluation. For more information on ovarian cysts, their relationship to contraceptives, and recommended management, visit the U.S. Office on Women’s Health resource on ovarian cysts.

42. Delayed Puberty in Adolescents

The use of hormonal contraceptives in adolescents has raised concerns about the potential impact on the timing and progression of puberty. Hormonal birth control can suppress the body’s natural hormonal cycles needed for pubertal development, potentially leading to delayed or altered timing of puberty-related changes. According to research summarized by the American Academy of Pediatrics (AAP), while most teens who begin contraceptives after the onset of puberty experience normal development, those who start before full maturation may be at risk for delayed growth or secondary sexual characteristic development.

Most available data suggest that hormonal contraception is safe for most adolescents, but careful consideration is warranted, especially for those with underlying endocrine or growth concerns. Healthcare providers should evaluate the stage of puberty before prescribing contraceptives for non-contraceptive reasons, such as menstrual regulation. Age-appropriate care includes regular monitoring of growth, bone density, and sexual development, ensuring the chosen method is suitable for the individual’s maturity. Open communication between the adolescent, parents, and healthcare professionals is essential for safe and effective contraceptive use. For more information, visit the ACOG’s resource on puberty and menstrual health.

43. Risk of Ectopic Pregnancy

While hormonal birth control methods are highly effective at preventing pregnancy, no method is 100% foolproof. If pregnancy occurs while using certain types of contraception—particularly progestin-only methods like the “mini-pill,” implants, or intrauterine devices (IUDs)—there is a slightly increased likelihood that the pregnancy will be ectopic, meaning it develops outside the uterus, most often in the fallopian tube. According to the American College of Obstetricians and Gynecologists (ACOG), ectopic pregnancies are rare but can be life-threatening if not treated promptly.

Warning symptoms of ectopic pregnancy include sharp or stabbing abdominal pain, shoulder pain, vaginal bleeding, dizziness, or fainting. These symptoms can develop quickly and require immediate medical attention. If you suspect you might be pregnant while using any form of birth control and experience these symptoms, seek emergency care right away. Early diagnosis and intervention are crucial for preventing complications and preserving fertility. For more information about ectopic pregnancy risks, symptoms, and when to seek help, visit the ACOG’s FAQ on ectopic pregnancy.

44. Increased Appetite

Hormonal birth control can influence appetite-regulating hormones, leading to increased hunger and, for some users, overeating or changes in food cravings. Progestin, in particular, is known to stimulate appetite, which can result in greater caloric intake and potential weight gain for certain individuals. According to the National Institutes of Health (NIH), appetite changes are more commonly reported with progestin-only injectables like Depo-Provera compared to combined oral contraceptives or non-hormonal methods.

Some users notice a preference for high-carbohydrate or sugary foods, mimicking natural premenstrual cravings but on a more consistent basis. If increased appetite becomes an issue, practical strategies include planning balanced meals, incorporating plenty of fiber and protein to increase satiety, and avoiding keeping tempting snacks readily available. Mindful eating practices, such as paying attention to hunger and fullness cues, can also be helpful. If appetite changes are significant or lead to unwanted weight gain, consider discussing alternative contraceptive options with your healthcare provider. For more tips on managing appetite and healthy eating habits, visit the Academy of Nutrition and Dietetics’ healthy eating resource.

45. Pelvic Inflammatory Disease (PID)

Pelvic Inflammatory Disease (PID) is an infection of the female reproductive organs that can occur when bacteria spread from the vagina to the uterus, fallopian tubes, or ovaries. The risk of PID is slightly increased shortly after the insertion of intrauterine devices (IUDs), particularly in women with pre-existing sexually transmitted infections (STIs) at the time of insertion. According to the Centers for Disease Control and Prevention (CDC), while the overall risk is low, it is highest during the first three weeks after IUD placement.

Symptoms of PID may overlap with other gynecological conditions and include lower abdominal pain, abnormal vaginal discharge, fever, painful intercourse, and irregular bleeding. Early detection and prompt treatment are crucial to prevent complications such as infertility or chronic pelvic pain. Preventive measures include STI screening before IUD insertion, using barrier methods, and regular gynecological check-ups. If you experience symptoms suggestive of PID, seek medical attention promptly. For more information on PID risks, prevention, and management, visit the CDC’s resource on pelvic inflammatory disease.

46. Impact on Partner Relationships

The side effects of hormonal birth control, such as mood changes, decreased libido, or physical symptoms, can significantly influence intimacy and communication within partner relationships. Shifts in emotional state, sexual desire, or physical comfort may lead to misunderstandings or tension between partners. According to relationship counselors cited by the Psychology Today, some couples report increased irritability or withdrawal, while others notice changes in sexual satisfaction and closeness after starting or switching contraception.

Comparative stories highlight both challenges and solutions: one partner may feel rejected due to decreased interest in sex, while another may be concerned about their own emotional volatility. Open and empathetic communication is essential—sharing concerns, discussing experiences, and validating each other’s feelings can strengthen the relationship. Couples counseling or individual therapy can offer strategies to manage side effects and navigate changes together. If intimacy issues persist, discussing alternative contraceptive options with a healthcare provider may help. For more advice on maintaining healthy relationships and communicating about birth control, visit the Psychology Today’s relationship resource.

47. Masking Underlying Health Issues

Hormonal birth control is often used to regulate menstrual cycles, reduce pain, or control heavy bleeding, but these benefits can sometimes mask symptoms of underlying health conditions. Disorders such as polycystic ovary syndrome (PCOS), endometriosis, or thyroid dysfunction may go undetected if their hallmark symptoms—irregular periods, pelvic pain, or abnormal bleeding—are suppressed by contraceptive hormones. According to the National Institutes of Health (NIH), this delayed diagnosis can prevent timely intervention and effective management of the root cause.

For example, a young woman using birth control to control heavy or irregular periods may not realize she has PCOS or a bleeding disorder until she stops the medication. Similarly, endometriosis pain can be masked by continuous birth control use, leading to years before proper diagnosis. To avoid these pitfalls, regular medical checkups and open communication with healthcare providers are crucial—even when symptoms seem well managed. Routine screening and periodic evaluation of menstrual and reproductive health can help identify underlying issues early. For more information on the importance of recognizing hidden conditions, visit the Mayo Clinic’s resource on endometriosis diagnosis.

48. Environmental Impact

The hormones found in birth control pills and other contraceptives are not fully metabolized by the body and can be excreted in urine, eventually entering water systems. Studies have shown that synthetic estrogens, such as ethinyl estradiol, can persist in the environment and disrupt aquatic ecosystems. According to the U.S. Environmental Protection Agency (EPA), these hormones may cause reproductive abnormalities in fish and other wildlife, including altered sex ratios and reduced fertility.

Compared to other pharmaceuticals, hormones in birth control are particularly potent, even at low concentrations. Improper disposal of unused pills—such as flushing them down the toilet—can further contribute to environmental contamination. Practical tips include returning unused medications to pharmacy take-back programs or following local guidelines for safe disposal in household trash (often mixed with unpalatable substances like coffee grounds). Every user can help minimize environmental impact by using only necessary medications and disposing of them responsibly. For more information on pharmaceutical disposal and environmental protection, visit the FDA’s guide to safe medicine disposal.

49. Hormone Withdrawal Symptoms

Discontinuing hormonal birth control can trigger a range of withdrawal symptoms as the body readjusts to its natural hormonal rhythms. Common experiences include mood swings, irritability, acne flare-ups, and irregular menstrual cycles. Some users also report temporary changes in libido, headaches, breast tenderness, or changes in appetite. According to the Healthline, these symptoms are typically temporary and can last from a few weeks to several months, depending on the individual and the type of contraceptive used.

User stories often mention feeling emotionally unbalanced or noticing a return of premenstrual symptoms that had been managed by birth control. Adaptation strategies include maintaining a healthy lifestyle, tracking symptoms in a journal, and practicing stress-reducing techniques such as mindfulness or regular exercise. Staying hydrated, eating a balanced diet, and getting adequate sleep can also help the body transition more smoothly. If symptoms are severe or persist beyond several months, consulting a healthcare provider is recommended to rule out underlying conditions or to discuss alternative management options. For more information on discontinuing birth control and what to expect, visit the Healthline’s guide to birth control withdrawal.

50. False Sense of Security

Relying solely on hormonal birth control for pregnancy prevention can create a false sense of security, leading some individuals to overlook other critical aspects of sexual and reproductive health. While birth control pills, patches, implants, or IUDs are highly effective at preventing pregnancy, they do not protect against sexually transmitted infections (STIs) or replace the need for regular health screenings. According to the Centers for Disease Control and Prevention (CDC), exclusive use of hormonal contraception may result in reduced condom use, lower STI screening rates, and missed opportunities for early detection of infections or other reproductive health issues.

In contrast, dual-method use—combining hormonal birth control with barrier methods like condoms—provides both pregnancy prevention and significant protection against STIs. Regular gynecological exams and open discussions with healthcare providers about sexual health remain essential, regardless of contraceptive method. For those in non-monogamous relationships or with new partners, consistent condom use and routine testing are strongly recommended. Recognizing the limitations of hormonal contraception and adopting comprehensive preventive measures can help ensure overall sexual and reproductive well-being. For more information on dual protection and best practices, visit the CDC’s dual protection resource.

Conclusion

Awareness of the hidden risks associated with birth control use is critical for making informed decisions about reproductive health. While hormonal contraceptives offer significant benefits, they also carry complex side effects that may go unnoticed without regular monitoring. Consulting with healthcare providers for personalized guidance, ongoing screenings, and routine checkups ensures early detection and management of potential complications. Open dialogue and proactive care empower individuals to balance contraceptive effectiveness with their overall well-being. For more on making safe, informed contraceptive choices and the importance of regular medical advice, visit the Planned Parenthood birth control resource or the CDC’s contraception guide.

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