Acne. Spider veins. Ceaseless nausea. Mood swings. Anxiety. Depression. Read the #MyPillStory hashtag on Twitter, and oral contraceptives may seem like the biggest disaster to hit women's health since the thalidomide crisis during your mom's early childhood. Adverse effects of the Pill are a legitimate concern for women on all iterations of estrogen and progesterone replacements. But the recent buzz on social media may distract from the Pill's many upsides.
I rounded up the research and spoke with Sherry Ross, MD, ob-gyn and women's health expert at Providence Saint John's Health Center in Santa Monica, California, to get the DL on what actually happens when you go on the Pill.
Here are 19 known side effects of going on birth control pills—the bad, the good, and the bizarre.
Though expected to last only up to three months, some women feel queasy when they start the Pill, Ross says. Taking your pill with a meal can help reduce how icky you feel during the time your body needs to adjust to new levels of estrogen and progesterone.
2. Breast tenderness.
Alas, this downside of oral contraceptives can apparently last for up to 18 months on the Pill, according to a report by the American Family Physician. Sorry.
Changes in the ups and downs of your body's sex hormones can lead to water retention and bloating. These effects may be particularly strong for women suffering from irritable bowel syndrome and other gastrointestinal tract disorders. That being said, many women feel better six months into a new pill regimen.
A 2005 study published in the American Journal of Obstetrics and Gynecology found that approximately 10 percent of women feel headachy within a month of starting the pill. Once the body acclimates to a new oral contraceptive, however, the study authors conclude most reports of headaches go away.
5. Increased appetite.
Perhaps you recall from ever having PMS that hormones can make you super hungry. Same goes when you alter your estrogen and progesterone levels via birth control. But an increased appetite doesn't always lead to packing on pounds, Ross points out. In fact, she says, "there's still no definitive proof that birth control directly causes weight gain."
6. Yeast infections.
Some women may need to invest in a few more Monostat packs after they go on the pill. Ross says this is likely due to changes in the use of tampons and new patterns of bleeding induced by the Pill.
7. Mood swings—and other emotional issues.
This issue is complicated. While some women with a history of mood issues—depression, anxiety, even insomnia—tend to see an increase in their symptoms' severity once they go on some birth control pills, others report that going on the Pill improves their psychological turmoil. (More on this below.)
8. Blood clots.
Newer versions of birth control pills (like Yasmin) appear to put some women at an elevated risk of blood clots compared to "first-generation" pills, whose progesterone has a different chemical makeup. So long as gynecologists and patients monitor side effects, this can be kept under control. But be sure to bring this up with your doctor, just to be safe.
9. Brown spots on your face.
Oral contraceptives have been found to increase women's risk of a skin condition called melasma, which can make your face break out in some brown-colored splotches. Research shows, however, that this is more likely to occur in women who have a family history of the skin issue. Switching from the pill to an IUD may be able to resolve this, several case studies suggest.
10. Lower sex drive.
Some women report decreases in their libido once they begin the Pill, Ross says. But she points out that much of this may be due to birth control's shorter-term side effects—think bloating, breast pain. (Who wants to be sexual when everything hurts and you feel like there's a balloon in your belly?)
That said, many women report that their sex drive picks back up again—or even gets stronger than pre-Pill levels—about nine months into their new hormone regimen.
11. Reduced risk of certain cancers.
A 2011 review of studies examining the link between birth control and cancer risk found that incidences of endometrial and ovarian cancers dropped by 30 to 50 percent among women without a history of HIV or HPV.
12. Fewer cramps.
With a more regulated regimen of estrogen and progesterone entering your body, your periods get on a more predictable schedule. Often, once you get adjusted to the Pill, Ross says "your periods may become lighter, which can mean less painful menstrual cramping."
13. Clearer skin.
Because acne is largely influenced by high levels of male hormones, like androgen, balancing it out with female hormones (estrogen and progesterone) can help scale back the prevalence of pimples on your face.
14. Mood improvements.
Yes, some women with a history of emotional issues have found the Pill worsens their symptoms. But others claim it's offered a boost to their psychological well-being. Evidence suggests the Pill can, for many women, decrease depression.
15. Stronger ligaments (maybe).
Apparently birth control pills are linked with lower incidences of knee injuries. The researchers who found this correlation peg it to birth control's regulation of estrogen, which—if too high—may weaken young women's ligaments.
16. Fewer complications from anemia.
Studies suggest a link between oral contraceptive use and fewer incidences of anemia. Likely, researchers believe, because the Pill can boost iron levels and the protein molecule hemoglobin in the bloodstream, both of which are lowered in cases of anemia.
17. Less pain during sex.
In some cases, going on the Pill can increase a woman's vaginal lubrication and, as a result, make intercourse a heck of a lot less painful—especially if she experienced it as such prior to going on the Pill.
18. Greatly reduced chance of pregnancy.
Remember that one? It's kind of why birth control was created. In case you needed a reminder.
19. Changes in mate preference.
Studies have also found a fascinating link between the use of oral contraceptives and women's preference for certain traits in their partners. Going on birth control can, according to some evidence, make women more inclined to choose nurturing men over sexually exciting ones, while going off birth control may influence how attractive we consider our significant others—and not for the better.
All this goes to show that, like any medication, the Pill's got its own ups and downs. The trick, Ross says, is to find the right combination of hormones for you and allow about three months for your body to make that call.
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This article originally appeared on Cosmopolitan.com. Minor edits have been made by the Cosmo.ph editors.