What are side effects of oral contraceptives?
When I was posed this question, and considered it for a blog topic, the pharmacist purist in me balked a bit. To give you an “inside look” into the practice of pharmacy, behind the scenes, when we are just speaking to each other, the inside jokes, this is one of those questions that just opens a big, huge, can of worms, like nightcrawlers.
At the end of the day oral contraceptives are drugs, medications if you will, synthetic hormones.
The reason I can say “we” as in the collective pharmacist “we” dislike the question about side effects is simple – all medications have side effects. As in every. Single. One.
It doesn’t matter if it comes in a pretty pink clam shell with a name like “Camilla,” “Heather,” or some other feminine name given to no other drug in my pharmacy, or if it is supposed to make you a “better woman,” a “more feminine woman,” by having a lighter, or non-existent period, or if it’s the “cutest” pill you take. It is a medication, a drug, a synthetic hormone you are taking, and it has side effects.
This drug has played a role in giving women power over their reproduction, but as with every drug, you must weigh the risks versus the benefits, and realize you are taking a medication not a vitamin.
I will start with the typical side effects, the common side effects experienced by up to 10% of users. After talking to thousands of women over 20 years in pharmacy, the most common side effects I see in practice are moodiness, blood clots, weight gain, emotional lability, acne, breakthrough bleeding, and headaches.
It can be confusing because sometimes oral contraceptives are prescribed to treat some of these conditions such as acne or abnormal bleeding. I want to take a moment to explain this. Hormonal contraceptives are synthetic hormones, usually a synthetic estradiol and a synthetic progestin.
The progestin does not act like progesterone, but more so like estrogens or androgens (testosterone) or even anti-androgens. The side effect profile of the oral contraceptives is that of imbalanced hormones.
Therefore, if you are physiologically imbalanced hormonally, and instead of working with your natural cycle and getting to the root of the imbalance, you can essentially bandage the problem by shutting down your natural hormone production with oral contraceptives. They are sometimes used to “treat” or more honestly “cover up” imbalanced hormones by giving your body synthetic hormones to shut down your ovarian function.
The side effect not often, if ever, discussed that I am keenly passionate about is shutting down your natural cycle. This is pharmacologically classified as the mechanism of action of the oral contraceptive, essentially giving your body exogenous, synthetic hormones and those hormones tell your brain you have enough hormones, and therefore your brain does not tell your ovary to function.
If you need chemical or oral contraception, and clearly understand the side effects, it is completely acceptable to take on this risk of not understanding the wealth of information your natural reproductive cycle can tell you about the health of your reproductive organs and the health of the communication between your brain and ovary.
However, if oral contraceptives are being taken to cover up imbalanced hormones, and a woman does not fully understand how they are working, then I believe we need to fully educate and explore other options before turning to an oral contraceptive.
We can support your natural cycle and often correct these imbalances without shutting off a woman's cycle, thereby correcting the underlying issue without impacting future fertility or shutting down a woman’s innate flow of communication with herself – her cycle.
TANYA MANONI is a Chattanooga-native but earned her BS in chemistry and PharmD at the University of Utah. She brings with her years of experience in compounding and pharmacy corporate management. Tanya's professional interests include not only BHRT, women’s health, and dermatology, but also nutrition and fitness, in which she became interested while playing NCAA Division I college soccer. While living in Utah, Tanya earned her level 1 certification in avalanche search and rescue, and she continues to enjoy snowboarding, hiking, and mountain biking. She lives in Chattanooga with her husband and two kids, so you will find her running between soccer fields and dance studios in her free time.