Side Effects of the Pill: The Good and the Bad

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When it comes to prescription medication, there’s only one that is so widely prescribed and commonly used that it is known simply as “the pill.” The birth control pill is used by millions of women worldwide and is one of the most popular methods of contraception in Australia. 

As a GP in Sydney, I advise women of all ages on their contraceptive options. Some will be trying the pill for the first time while others will be coming back for a rescript of their favourite brand.

Like all prescription medications, there are side effects of the pill. Some are positive, while others could be negative. That’s why it’s important to understand how the pill works for your particular needs. 

Positive side effects of the birth control pill

Whenever young women come to me asking to start taking the pill, they often show interest in some of the common positive side effects, such as lighter and shorter periods and helping with acne. 

When the oral contraceptive pill was first introduced to the Australian market in 1961, it was only prescribed to help prevent pregnancy. However, the way the hormones in the pill work to prevent pregnancy also has effects on periods and acne. The combined oral contraceptive pill contains a combination of estrogen and progestogen hormones. Different brands and types will have different types of estrogen and progestogen at different dosages, but all variations of the combined pill work in a similar way to prevent pregnancy. First, it stops ovulation from happening during a monthly cycle. With no egg to fertilise, you cannot get pregnant. Second, it thickens the mucus around your cervix to make it difficult for sperm to enter the womb. Third, it thins the lining of your uterus to prevent implantation of any fertilised eggs. 

The mini pill contains progestogen only. It prevents pregnancy by thickening the cervical mucus while simultaneously thinning the uterine lining. In some women it also stops ovulation from happening.

So how does the pill help with periods? What you experience during each monthly cycle is actually called withdrawal bleeding because your body is withdrawing from the lack of hormones. But because both types of the contraceptive pill thin your uterine lining, there is less to shed during the monthly cycle, resulting in lighter and shorter periods. 

The pill also helps regulate your cycles – depending on the type of pill you’re on, you’ll take a daily dose of hormones and then have a few days off with sugar pills for your period week. You may also experience lessened cramps and period pain. 

Another positive side effect of the pill has to do with acne. Hormonal acne is caused by an excess of androgen hormones, or male sex hormones. Everybody, male and female, has both male and female sex hormones. However, when women produce too many androgens, their bodies produce too much sebum, the oily substance that keeps skin and hair soft – but also clogs pores and can turn into pimples. That’s why hormonal birth control pills can help with clearing up acne – they balance out the hormones in your system and prevent excess sebum from being produced. 

Negative side effects of the birth control pill

Not getting pregnant, lighter, shorter periods and less acne all sound like great reasons to start taking the pill, but there are some negative side effects to be aware of as well. For example, the pill can cause breakthrough bleeding or spotting, tender breasts, headaches, nausea, weight gain and mood changes. These types of side effects are usually mild and subside within 2 to 3 months of taking the pill as your body adjusts to the hormones. 

There are also more significant potential side effects, such as:

  • Blood clots
  • High blood pressure
  • Liver cancer
  • Stroke
  • Heart attack
  • Gallbladder disease

There have been some studies that have shown a link to increased risk of breast cancer and cervical cancer, but also a decreased risk of endometrial, ovarian and colorectal cancers. 

It’s important to talk to your doctor about your medical history before taking the pill. Some combinations of hormones might be better suited to your needs than others.

Whether you’re thinking about starting oral contraceptives for the first time or have been taking it as your primary form of contraception for a while, it’s always a good idea to brush up on the potential side effects. Talk to your doctor or connect with one online via a digital health service to talk about your birth control pill options

Dr Ai Nhi Bui is a registered GP and medical director at Rosemary Health, a digital service connecting Australians to quality healthcare online. With over 15 years of experience, Dr Bui has an interest in women’s health issues ranging from pregnancy care and sexual health to chronic conditions.