Side Effects of the Pill: What to Expect, What Is Normal and When to Get Advice
The contraceptive pill is one of the most commonly used forms of contraception. When people search for side effects of the pill, they are often looking for clear, honest information about what may happen when starting contraception, what side effects can settle with time, and which symptoms need medical advice.
At Dr Pillmans, we believe contraception information should be simple, accurate and based on official clinical guidance. The pill can be a safe and effective option for many people, but it is not suitable for everyone. Side effects can also vary depending on whether you take the combined oral contraceptive pill or the progestogen-only pill, sometimes called the mini pill.
This guide explains the possible side effects of the pill, what the NHS says, when to seek help, and how to start or continue contraception safely.
What Do People Mean by “The Pill”?
When people talk about “the pill”, they usually mean one of two types of oral contraception:
The combined oral contraceptive pill
This contains two hormones: oestrogen and progestogen.
The progestogen-only pill
This contains only progestogen and is sometimes called the mini pill.
Both are used to help prevent pregnancy, but they work slightly differently and may have different side effect profiles. The NHS describes the combined pill and progestogen-only pill as hormonal contraception options used to prevent pregnancy.
Reference: https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/
Reference: https://www.nhs.uk/contraception/methods-of-contraception/progestogen-only-pill/
At Dr Pillmans, we provide information and access to suitable oral contraception options where clinically appropriate.
Useful Dr Pillmans pages:
Desogestrel: https://www.drpillmans.com/desogestrel-contraception/
Cerazette: https://www.drpillmans.com/cerazette-contraception/
Noriday: https://www.drpillmans.com/noriday-contraception/
Norgeston: https://www.drpillmans.com/norgeston-contraception/
Slynd: https://www.drpillmans.com/slynd-contraception/
Common Side Effects of the Combined Pill
The NHS states that some people may have side effects when they first start taking the combined contraceptive pill. Bleeding between periods, also called breakthrough bleeding, or changes to periods are common in the first few months. The NHS also states that the pill can cause high blood pressure in a small number of people. Some people report headaches, feeling sick or dizzy, and sore breasts, although the NHS notes there is not enough evidence to say whether these symptoms are caused by taking the pill. (nhs.uk)
Possible side effects reported with the combined pill may include:
- Bleeding between periods
- Changes to periods
- Headaches
- Feeling sick
- Dizziness
- Sore or tender breasts
- Mood changes
- Increased blood pressure in some people
Many people find that mild side effects settle after the first few months. However, if side effects continue, feel severe, or affect your daily life, you should speak to a pharmacist, GP, sexual health clinic or contraception service.
Common Side Effects of the Progestogen-Only Pill
The NHS states that the progestogen-only pill has few side effects, but it may change your periods. Periods may become lighter, more frequent, or stop altogether. Some people may also get spotting between periods. (nhs.uk)
Possible side effects reported with the progestogen-only pill may include:
- Irregular bleeding
- Spotting between periods
- Lighter periods
- More frequent bleeding
- Periods stopping altogether
- Acne
- Mood changes
- Weight gain
- Changes to sex drive
The NHS notes that some people may report acne, mood swings, weight gain or changes to libido, but there is not enough evidence to say whether these are caused by the progestogen-only pill. (nhs.uk)
This is important because symptoms can have many causes. Stress, illness, other medicines, weight changes, sleep, skin conditions and natural hormone changes can all affect how someone feels.
Useful Dr Pillmans pages:
Desogestrel: https://www.drpillmans.com/desogestrel-contraception/
Cerazette: https://www.drpillmans.com/cerazette-contraception/
Noriday: https://www.drpillmans.com/noriday-contraception/
Norgeston: https://www.drpillmans.com/norgeston-contraception//
Slynd: https://www.drpillmans.com/slynd-contraception//
Bleeding Changes on the Pill
Bleeding changes are one of the most common reasons people worry after starting the pill.
With the combined pill, breakthrough bleeding or changes to periods can happen during the first few months. With the progestogen-only pill, bleeding patterns can change in different ways. Periods may become lighter, irregular, more frequent, or stop altogether. (nhs.uk)
Bleeding changes can be inconvenient, but they are not always a sign that something is wrong. However, you should seek medical advice if:
- Bleeding is very heavy
- Bleeding starts after months of stable pill use
- You have pain with bleeding
- You may be pregnant
- You have bleeding after sex
- You have symptoms of infection
- You are worried or unsure
Do not ignore new, unusual or persistent bleeding. A healthcare professional can help check whether it is related to the pill or whether another cause needs to be considered.
Headaches, Migraine and the Pill
Some people report headaches while taking the pill. NHS information on hormonal contraception lists headaches among commonly reported side effects. (nhs.uk)
A mild headache is not always serious, but migraine history matters when choosing contraception. In particular, migraine with aura is important because combined hormonal contraception may not be suitable for people who experience aura.
You should seek medical advice before continuing the pill if you develop:
- A new type of migraine
- Migraine with aura
- Sudden severe headache
- Headache with weaknessgnant
- Headache with vision changes
- Headache with confusion
- Headache that feels very different from usual
If you are unsure whether your migraine includes aura, speak to a healthcare professional before using or continuing the combined pill.
Mood Changes and the Pill
Some people report mood changes while using hormonal contraception. NHS information includes mood swings among commonly reported side effects of hormonal contraception. (nhs.uk)
Mood changes can be difficult to assess because mood may also be affected by stress, sleep, relationships, work, mental health conditions, other medicines and life events. If you feel your mood has changed after starting the pill, it is still worth discussing. You do not have to simply put up with side effects that affect your quality of life.
You should seek help urgently if you experience severe low mood, thoughts of self-harm, or feel unsafe.
Acne and Skin Changes
The progestogen-only pill may be associated with acne in some people, although the NHS notes there is not enough evidence to say whether acne is caused by the progestogen-only pill. (nhs.uk)
Some combined pills may improve acne for some people, while others may notice skin changes. If acne becomes troublesome after starting contraception, a clinician can help decide whether to continue, change pill type, or consider another option.
Breast Tenderness and Nausea
Some people report sore breasts, breast tenderness or feeling sick when they first start taking the pill. The NHS lists sore breasts, feeling sick and dizziness as symptoms some people report with the combined pill. (nhs.uk)
These symptoms often settle, but not always. If nausea is severe, persistent, or you vomit soon after taking your pill, you should check the patient information leaflet and seek advice. Vomiting or severe diarrhoea can affect how well the pill works.
Weight Gain and the Pill
Weight gain is often one of the biggest worries people have about the pill. The NHS lists weight gain among commonly reported side effects of hormonal contraception, but the NHS also says there is not enough evidence to say whether weight gain is caused by the progestogen-only pill. (nhs.uk)
The Faculty of Sexual & Reproductive Healthcare guidance on contraception in young people states that young people may be advised that there is no evidence of weight gain with combined hormonal contraception use. (cosrh.org)
Weight can change for many reasons, including diet, activity, stress, age, sleep, fluid retention, health conditions and other medicines. If you are concerned about weight changes after starting the pill, speak to a clinician rather than stopping suddenly without advice.
Sex Drive and the Pill
Some people report changes to sex drive while using hormonal contraception. NHS information on the progestogen-only pill says some people may report changes to libido, but there is not enough evidence to say whether this is caused by the pill. (nhs.uk)
Sex drive can be affected by many factors, including mood, tiredness, stress, relationship factors, physical health, pain, medicines and hormones. If a change in libido is affecting you, it is reasonable to ask for advice. A different pill or contraception method may suit you better.
Serious Risks of the Pill
Most people who use the pill do not experience serious problems. However, some risks are important to understand.
The combined pill contains oestrogen, and this means it is not suitable for everyone. Certain medical conditions and risk factors can increase the risk of serious problems such as blood clots. NICE CKS covers combined hormonal contraception and highlights the need for clinical assessment and advice before use. (CKS)
You should seek urgent medical help if you develop:
- Chest pain
- Shortness of breath
- Coughing blood
- Severe leg pain
- Swelling, heat or redness in one calf
- Sudden weakness or numbness
- Sudden vision changes
- Severe sudden headache
- New migraine with aura
These symptoms do not always mean a serious problem is happening, but they should be checked urgently.
Who May Not Be Suitable for the Combined Pill?
The combined pill may not be suitable for everyone. A clinician will usually ask about medical history and risk factors before deciding whether it is appropriate.
The combined pill may not be suitable for some people with:
- Migraine with aura
- Uncontrolled high blood pressure
- A history of blood clots
- Some heart or circulation problems
- Certain liver conditions
- A history of breast cancer
- Smoking over a certain age
- Very high BMI with other risk factors
- Some medicines that interact with contraception
This is why a consultation is important. The aim is not simply to provide the pill quickly, but to provide it safely.
Can Side Effects Settle After Starting the Pill?
Yes, some side effects can settle after the first few months. The NHS states that breakthrough bleeding or changes to periods are common in the first few months of taking the combined pill. (nhs.uk)
However, you should not ignore symptoms that are severe, worrying or persistent. If a side effect affects your daily life, it is worth discussing. You may need advice, reassurance, a different pill, or another contraception option.
Should I Stop Taking the Pill If I Get Side Effects?
Do not stop the pill without considering pregnancy risk and alternative contraception. If you stop the pill and have sex without another reliable method, you may become pregnant.
If side effects are mild, you may choose to continue and monitor them. If they are severe, persistent or worrying, get advice. If you have symptoms of a possible blood clot, stroke, severe allergic reaction, or new migraine with aura, seek urgent medical help.
If you want to stop or change the pill, speak to a pharmacist, GP, sexual health clinic or contraception service about how to switch safely.
What If I Miss Pills or Have Vomiting or Diarrhoea?
Missed pills, vomiting and diarrhoea can affect how well the pill works. What you should do depends on the type of pill you take, how many pills you missed, where you are in the packet, and whether you have had sex.
The NHS provides specific advice for missed pills and for sickness or diarrhoea for both combined pills and progestogen-only pills.
Reference: https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/
Reference: https://www.nhs.uk/contraception/methods-of-contraception/progestogen-only-pill/
If you are unsure, check your patient information leaflet and seek advice as soon as possible. You may need emergency contraception or extra contraception such as condoms for a short time.
Can I Change to a Different Pill?
Yes, but it is best to get advice before changing. Different pills can have different hormone types, doses and instructions. Switching incorrectly may leave you at risk of pregnancy.
You may consider asking about a different pill if:
- Side effects do not settle
- Bleeding is troublesome
- Your mood feels affected
- You develop acne or skin changes
- You have headaches or migraines
- You develop a new medical condition
- You start a medicine that may interact
- You are no longer suitable for your current pill
A clinician can help decide whether to continue, switch pill type, or consider a different contraceptive method.
Benefits of the Pill
Although this page focuses on side effects, it is also important to understand why many people choose the pill.
Depending on the type of pill and individual suitability, benefits may include:
- Effective pregnancy prevention when used correctly
- Convenient daily use
- Reversible contraception
- No procedure required
- Control over starting and stopping
- Lighter or more predictable bleeding for some people
- Reduced period pain for some people using certain pills
The best contraception is the one that is safe for you, suits your routine, and is used correctly.
Why Choose Dr Pillmans for Contraception Advice?
Dr Pillmans is designed for patients who want contraception access to be private, straightforward and clinically responsible.
Complete Your Consultation Online
You can complete your contraception consultation from home, without needing to arrange a GP appointment where an online service is suitable.
Clinically Reviewed
Your answers are reviewed to check whether oral contraception is suitable for you.
Clear Side Effect Advice
We provide practical information about possible side effects, missed pills, warning symptoms and when to seek help.
Discreet and Confidential
Contraception is personal. Dr Pillmans gives patients a confidential way to access support.
Safe Signposting
If the pill is not suitable, or if your symptoms need further assessment, you may be signposted to your GP, sexual health clinic, urgent care or emergency services depending on the situation.
Side Effects of the Pill FAQs
Commonly reported side effects of hormonal contraception include headaches, feeling sick, mood swings, weight gain, sore breasts and acne. The exact side effects may depend on whether you take the combined pill or the progestogen-only pill.
Reference: https://www.nhs.uk/contraception/choosing-contraception/side-effects-and-risks-of-hormonal-contraception/
The NHS states that bleeding between periods or changes to periods are common in the first few months. Some people report headaches, feeling sick or dizzy, and sore breasts. The combined pill can also cause high blood pressure in a small number of people.
Reference: https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/side-effects/
The NHS states that the progestogen-only pill may change your periods. Periods may be lighter, more frequent or stop altogether, and spotting can happen. Some people report acne, mood swings, weight gain or changes to sex drive, although the NHS says there is not enough evidence to say whether these are caused by the progestogen-only pill.
Reference: https://www.nhs.uk/contraception/methods-of-contraception/progestogen-only-pill/side-effects-and-risks/
Bleeding between periods, also called breakthrough bleeding, can happen when starting the combined pill and is common in the first few months. The progestogen-only pill can also change bleeding patterns. You should seek advice if bleeding is heavy, persistent, new after stable use, happens after sex, or is associated with pain or pregnancy risk.
Yes, the progestogen-only pill can cause periods to stop altogether for some people. The NHS states that the progestogen-only pill may make periods lighter, more frequent, or stop.
Reference: https://www.nhs.uk/contraception/methods-of-contraception/progestogen-only-pill/side-effects-and-risks/
Some people report weight gain with hormonal contraception. However, the NHS states there is not enough evidence to say whether weight gain is caused by the progestogen-only pill. FSRH guidance on contraception in young people states there is no evidence of weight gain with combined hormonal contraception use.
Reference: https://www.nhs.uk/contraception/methods-of-contraception/progestogen-only-pill/side-effects-and-risks/
Reference: https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-guideline-contraception-young-people-may-2019.pdf
Some people report mood changes or mood swings while using hormonal contraception. Mood can also be affected by many other factors, so it is important to discuss symptoms with a healthcare professional if they are persistent, severe or worrying.
Some people report acne with the progestogen-only pill, although the NHS states there is not enough evidence to say whether acne is caused by the progestogen-only pill. If acne becomes troublesome, ask for advice about alternative options.
Some people report headaches while taking the pill. You should seek medical advice urgently if you develop a sudden severe headache, headache with weakness or vision changes, or new migraine with aura.
It depends on the type of migraine. Migraine with aura is particularly important because the combined pill may not be suitable. Always mention migraine history during your consultation.
The NHS states that the combined pill can cause high blood pressure in a small number of people. This is why blood pressure may be checked before and during use of the combined pill.
Reference: https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/side-effects/
Some side effects can be more noticeable in the first few months, especially bleeding changes. If side effects do not settle or are difficult to manage, speak to a healthcare professional.
Seek urgent medical help if you develop chest pain, shortness of breath, coughing blood, severe leg pain or swelling, sudden weakness, sudden vision changes, severe sudden headache, or a new migraine with aura.
Do not stop the pill without considering pregnancy risk and alternative contraception. If side effects are mild, you may decide to monitor them. If they are severe, persistent or worrying, get medical advice.
Yes, but you should get advice before switching. Changing pills incorrectly may affect pregnancy protection, and a different method may be more suitable.
No. The pill helps prevent pregnancy but does not protect against sexually transmitted infections. Condoms can help reduce the risk of STIs.
Yes, some medicines and herbal products can affect hormonal contraception. Always mention regular medicines, recent medicines and herbal products such as St John’s Wort during your consultation.
Vomiting can affect pill absorption. What you should do depends on the type of pill and timing. Check the patient information leaflet and seek advice if unsure.
Follow the missed pill advice for your specific pill type. If you are unsure, check your patient information leaflet and seek advice from a pharmacist, GP, sexual health clinic or contraception service.
Start Your Contraception Consultation with Dr Pillmans
If you are searching for side effects of the pill, contraceptive pill side effects, combined pill side effects, mini pill side effects, or progestogen-only pill side effects, Dr Pillmans can help you access clear information and suitable contraception support.
Complete your online consultation and receive guidance based on your health and suitability.
Useful Dr Pillmans pages:
Free contraception: https://www.drpillmans.com
Contraception: https://www.drpillmans.com/contraception/
Desogestrel: https://www.drpillmans.com/desogestrel-contraception/
Cerazette: https://www.drpillmans.com/cerazette-contraception/
Noriday: https://www.drpillmans.com/noriday-contraception/
Norgeston: https://www.drpillmans.com/norgeston-contraception/
Slynd: https://www.drpillmans.com/slynd-contraception/
Emergency contraception: https://drpillmans.com/emergency-morning-after-pill/
Article Information
Authored by: Dr Pillmans Clinical Team
Written by: Dr Pillmans Clinical Team
Website: www.drpillmans.com
Last reviewed: June 2026
Clinical focus: Side effects of the pill, combined pill side effects, progestogen-only pill side effects, oral contraception and online contraception support.
References
- NHS — Side effects and risks of the combined pill
URL: https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/side-effects/ - NHS — Side effects and risks of the progestogen-only pill
URL: https://www.nhs.uk/contraception/methods-of-contraception/progestogen-only-pill/side-effects-and-risks/ - NHS — Side effects and risks of hormonal contraception
URL: https://www.nhs.uk/contraception/choosing-contraception/side-effects-and-risks-of-hormonal-contraception/ - NHS — Combined pill
URL: https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/ - NHS — Progestogen-only pill
URL: https://www.nhs.uk/contraception/methods-of-contraception/progestogen-only-pill/ - NICE CKS — Contraception: combined hormonal methods
URL: https://cks.nice.org.uk/topics/contraception-combined-hormonal-methods/ - NICE CKS — Combined oral contraceptive management
URL: https://cks.nice.org.uk/topics/contraception-combined-hormonal-methods/management/combined-oral-contraceptive/ - NICE BNF — Hormonal contraceptives
URL: https://bnf.nice.org.uk/treatment-summaries/contraceptives-hormonal/ - FSRH / CoSRH — Combined Hormonal Contraception Guideline
URL: https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-guideline-combined-hormonal-contraception-october-2023.pdf - FSRH / CoSRH — Contraception for Young People Guideline
URL: https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-guideline-contraception-young-people-may-2019.pdf
What Are the Main Types of Contraceptive Pill?
There are two main types of contraceptive pill:
Combined oral contraceptive pill
Progestogen-only pill, also called the mini pill
The NHS lists both the combined pill and the progestogen-only pill as contraceptive methods. The combined pill contains progestogen and oestrogen, while the progestogen-only pill contains progestogen only.
Reference: https://www.nhs.uk/contraception/methods-of-contraception/
Both types are used to help prevent pregnancy, but they are not the same. They contain different hormones, may suit different people, and have different instructions if a pill is missed.
