The pill suppresses your own hormones and takes over control of your cycle. As a result you may experience side effects, from headaches and tender breasts to changes in your mood or libido. In most women these complaints are mild and settle after a few months, but that is not the case for everyone.
I notice that many women wonder whether their complaints are caused by the pill and whether they can have their hormones tested to find out. In this article I explain how the pill works, which side effects are common, when it is better to seek help and why a hormone test while on the pill is hard to interpret. Lunara does not prescribe contraception, but can map your hormones if you have stopped or still have complaints.
How does the contraceptive pill work?
The combined pill contains synthetic versions of the female hormones oestrogen and progesterone. These hormones dampen the signals from your brain, so your ovaries usually no longer release an egg. This is how the pill prevents pregnancy, according to the Farmacotherapeutisch Kompas.
Because the pill puts your own cycle on hold, it in effect takes over the hormonal control. The bleeding you get in the pill-free week is not a real period, but a withdrawal bleed. Your natural hormone fluctuations are largely paused while you are on the pill.
What are common side effects of the pill?
Common side effects of the pill are headaches, nausea, tender breasts, breakthrough bleeding and mood changes. According to Thuisarts.nl these complaints are usually mild and often disappear within two to three months, as your body gets used to the hormones. In some women they last longer.
Whether you get complaints, and which ones, differs a lot from person to person. One pill contains a different type of progestogen than another, which can matter for how you feel. The table below lists a number of common complaints, with what often helps and when to seek help.
| Side effect | What it is | What often helps or when to seek help |
|---|---|---|
| Breakthrough bleeding | Small bleeds outside the pill-free week, mainly the first months | May settle on its own; if it lasts beyond three months, discuss it with your GP |
| Headache | Mild headache, sometimes around the pill-free week | Usually temporary; with severe or new migraine with aura, seek help |
| Tender breasts | A tense or sore feeling in the breasts | Often settles after a few months; if it lasts, discuss it |
| Nausea | A slightly sick feeling, especially at the start | Taking the pill with food can help; if it lasts, discuss it |
| Mood changes | Low mood, irritability or less interest in sex | Keep track of it; with persistent low mood, contact your GP |
This table is meant as general information, not as medical advice. What suits you and whether a different pill is useful, you discuss with your GP. They look at your whole situation and your history.
Which side effects are serious and when to seek help?
Most side effects of the pill are harmless, but a small number are not. The most important is a raised chance of thrombosis, a blood clot. With signs such as a painful, swollen or red calf, sudden shortness of breath or chest pain, contact a doctor straight away.
This risk is small in most women, but it is real. According to the Farmacotherapeutisch Kompas, the chance of thrombosis is higher with certain pills and in women who smoke, are older or have had a clot before.
Play it safe and always seek help when in doubt.
Does the pill affect your hormone values in the blood?
Yes, and that is exactly why a hormone test while on the pill says little. The pill suppresses your own FSH and LH, the hormones with which your brain controls your ovaries. As a result your own oestradiol and often your testosterone are low too, so these values do not reflect your natural situation.
In addition, the combined pill raises your SHBG, the protein that binds sex hormones. A high SHBG means less free, active hormone is available. An oestradiol value you measure while on the pill therefore gives no reliable picture of your own production.
If you want to map your natural hormone profile, it is more useful to wait until you have been off the pill for a while. Read more about this in our overview on birth control and your hormones.
What happens to your hormones when you stop?
When you stop the pill, your body has to take back hormonal control itself. Your brain starts making FSH and LH again, your ovaries get going and your own cycle returns. In most women this happens within a few weeks to months.
During that transition you may notice that your skin, mood or cycle fluctuates for a while. That can be part of your own hormone balance recovering. How this unfolds and which values you can test then, you can read in our article on coming off the pill and hormone recovery.
If you mainly experience mood complaints around the pill, also look at our article on the pill and your mood. There we go deeper into the possible link between contraception and your mood.
Testing your own hormones
Lunara does not prescribe contraception, but can map your hormones if you have stopped or still have complaints. With the Hormone test for women you can have values such as oestradiol, FSH, LH and SHBG drawn without a referral at one of the more than 750 draw locations.
Your blood is taken in the morning and every result is assessed by a BIG-registered doctor. Keep in mind that values you measure while on the pill are hard to interpret, because the pill suppresses your own hormones.
A test is a starting point for a conversation, not a replacement for your GP. You always discuss an abnormal result with a professional.
Frequently asked questions
How long do side effects of the pill last?
In many women the complaints settle within two to three months, as the body gets used to the hormones. If they last longer or are severe, discuss it with your GP. Sometimes a different pill suits better.
Can I test my hormones while on the pill?
You can, but the result says little about your natural hormones. The pill suppresses your own FSH, LH and oestradiol and raises your SHBG. For a reliable picture it is better to wait until you have been off it for a while.
When should I see a doctor about side effects?
Seek help straight away with signs of thrombosis, such as a painful swollen calf, sudden shortness of breath or chest pain. With persistent low mood or severe new migraine, contact is also wise.
Does the pill cause weight gain?
Large-scale research finds no clear evidence that the combined pill causes lasting weight gain. Some women notice fluid retention at the start. If you are unsure, discuss it with your GP.
Does Lunara prescribe contraception?
No. Lunara does not prescribe the pill or other contraception. We can map your hormones with a blood test, for example if you have stopped or still have complaints, with an assessment by a doctor.
References
- Thuisarts.nl. I use the contraceptive pill. Dutch College of General Practitioners (NHG).
- NHG. NHG Guideline Contraception. Dutch College of General Practitioners.
- Farmacotherapeutisch Kompas. Oral contraceptives (combined preparations). Zorginstituut Nederland.
Every blood test result through Lunara includes a professional assessment by a BIG-registered doctor. Lunara does not prescribe contraception and does not replace contact with your GP. For treatment decisions, discuss your results with your GP.
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