Causes of the side effects of the pill
The contraceptive pill is a very common contraceptive method. It is a hormone preparation which, depending on the type of pill, supplies the body with estrogens and progestins. In comparison to single-phase and two-phase preparations, minipills consist only of progestins.
The pill thus intervenes strongly in the hormone balance of the woman, keeps the oestrogen and progestin concentration in the body high and thus prevents the production of the hormones FSH (follicle stimulating hormone) and LH (luteinising hormone). This prevents ovulation. However, the hormones estrogen and progestin not only influence the woman’s cycle, but are also attributed other functions which explain the sometimes far-reaching side effects of the pill. For example, estrogen slows down the growth of bones and has a positive effect on bone formation. It also has a protective effect on blood vessels.
What are the side effects of the pill?
In addition to the above-mentioned tasks of the estrogen, there are also many effects of the hormone that lead to negative effects in the body. Firstly, it affects the clotting of the blood in the body, which increases the risk of thrombosis, and retains more water and sodium chloride (NaCl) in the body. On the other hand, it can cause nausea and occasional diarrhea, as well as spotting and bleeding between meals.
Allergic reactions and hypersensitivity disorders are rarely described. Changes in weight and appetite may occur. Headaches (possibly migraines), nervousness, dizziness and mood swings occur more frequently when taking the pill.
A reduction in libido, i.e. the sex drive, can occur, and in some cases it can be greatly increased. The breast can become sensitive to pain and it can increase in size. The strength of menstruation can change, as can the purity of the skin.
Taking the pill increases the risk of some tumors and diabetes mellitus. The most important side effects are explained in more detail below. A frequently discussed side effect of the pill is a change in weight.
In some cases it can lead to a sharp increase in weight. In some cases, however, weight loss is also reported. Weight gain is generally caused either by muscle building, water retention or an increase in body fat.
The pill retains more water and NaCl in the body, thus leading to water retention, and an increase in body fat is being discussed. Combined preparations are supposed to increase the appetite so that body fat can at least increase through increased food intake. Scientific evidence of a general strong increase in weight in women using hormonal contraception has not yet been found, as there is no good study situation for this.
Women usually gain some weight continuously over the years, regardless of whether they take the pill or not. Therefore, a strong influence on women’s weight is considered unlikely. In individual cases, however, strong weight changes may still occur.
The contraceptive pill increases the risk of thrombosis in women who are often young. In the event of a thrombosis, a blood clot forms in a vessel which can be completely blocked. The clot can also be carried away, so that other, often vital vessels become blocked.
This happens, for example, in the case of a pulmonary embolism. It can also affect a leg vessel, for example, so that leg vein thrombosis occurs. The risk of such a thrombosis is increased when taking the pill, as it increases the number of clotting factors.
These are important for closing wounds and can lead to thrombosis if taken in excessive quantities. The pill also reduces the number of opponents of the clotting factors, i.e. the factors that are actually intended to prevent excessive clotting. There are differences in the pill preparations with regard to the increased risk of thrombosis.
In particular, the new third and fourth generation birth control pills are associated with an increased risk of thrombosis due to their progestin (especially desogestrel, dienogest, gestoden and drospirenone). It is important to note, however, that the risk of thrombosis is increased in the first few months after taking the pill, but then it drops dramatically again. Smoking also increases the risk considerably.
The combination of smoking and taking the pill should therefore be avoided. Being very overweight can also increase the risk. The contraceptive pill can lead to skin impurities such as acne, rashes, pigmentation problems caused by taking the pill, increased body and facial hair and hair loss in women.Much more frequently, however, a targeted use of the pill for acne is reported.
This is particularly noticeable among young women. Acne develops mainly because the body produces more of the male sex hormone androgen during puberty. The hormones in the pill weaken the effect of the androgen and can thus counteract acne.
The active ingredients dienogest, drospirenone, cyproterone acetate and chlormadinone are said to be particularly effective. However, the contraceptive pill is not approved for the special treatment of acne. In addition, as described above, it has a high potential for side effects, so that its use should be carefully weighed up.
Psychosis is a group of serious mental illnesses in which there is a temporary, almost complete loss of contact with reality. Typical psychotic syndromes are delusions (false beliefs about reality) or hallucinations (sensory perceptions without a realistic stimulus). So far, no connection between psychoses and the use of the pill has been found.
Taking the contraceptive pill can lead to mood swings and even depression. This is warned in the package inserts of the pill. Many women report a depressive mood or that they are more unbalanced when taking the pill.
A clear indication of a connection between a manifest, diagnosed depression and the pill has not yet been found. A study from 2016 showed an increased prescription of antidepressants in Danish women taking the pill. This may be an indication of an increased incidence of depression when taking the pill.
Breast cancer is diagnosed slightly more frequently in women who take the pill than in women of the same age who do not take the pill. When the pill is discontinued, after ten years there is no difference between former pill users and other women. However, it should be noted that breast cancer is quite rare in women under 40 years of age, so the additional risk from the pill is quite small compared to the overall risk of breast cancer.
The Pill can in rare cases lead to benign liver tumours (focal, nodular hyperplasia and liver cell adenomas) and in very rare cases to malignant liver tumours (liver cancer). The Pill also increases the risk of cervical cancer. In contrast, long-term use of an estrogen and progestin pill is said to reduce the risk of cancer of the uterus (endometrium cancer) and ovaries (ovarian cancer).
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