Oral contraceptives are always being developed to minimize side effects, however there are some that your patient should be aware of:

Common Side Effects:

  • Nausea
  • Vomiting
  • Cyclical weight gain
  • Bloating
  • Melasma
  • Breast tenderness
  • Depression
  • Mood swings
  • Headaches

Rare Side Effects:

  • Blood clots
  • Thromboembolism
  • Stroke
  • Retinal artery thrombosis
  • Heart attacks
  • Benign liver tumors
  • Gallstones
  • Increase in blood pressure
  • A link with breast cancer remains controversial
  • Failure of birth control

Women Should Not Take OC’s If They Have Any Of These Conditions:

  • History of coronary heart disease
  • Very high cholesterol
  • History of blood clots or stroke
  • Late renal failure
  • Jaundice
  • Symptomatic heart valve disease
  • Breast cancer or other estrogen dependent cancer
  • Smokers

Possible Drug Interactions:

Antibiotics may interact for example:

  • Ampicillin, tetracycline, erythromycin, cotrimoxazole, nitrofuratoin (possible interactions with this drug are still controversial)
  • Rifampicin has definite effects on estrogen levels
  • Antiepileptic drugs – for example, phenytoin, phenobarbital
  • Diarrhea or laxatives may reduce absorption of OCs

How Effective Are The Methods Of Contraception?

  • Levonorgestrel implant – 99.91%
  • Progesterone intramuscular – 99.7%
  • Copper IUD – 99.2%
  • Progesterone IUD – 99.8%
  • Oral contraceptives – 97% (all types)
  • Condoms – 88%
  • Diaphragm – 82%
  • Cervical cap – 82%
  • Spermacides – 79%
  • Female condoms – 79%
  • Sponge – 76%

Suggestions For Breakthrough Bleeding While On The OCs:

If your patient should experience bleeding early in the cycle, they should switch to a pill with higher estrogen. For mid or late-cycle bleeding, switch to a lower estrogen or higher progestin pill.