SIDE-EFFECTS OF CONTRACEPTIVE PILL “THE PILL”
The actual incidence of serious side-effects of the pill is very small. These can be divided into groups: common and pleasant, less common and a nuisance, very rare and nasty, very rare and potentially disastrous.
Less common and a nuisance—some women may notice a slight pigmentation change in their facial skin. This is called chloasma, and looks a bit like a blotchy conglomeration of freckles. It is more noticeable when suntanned, and will occur in susceptible women when they become pregnant, or are on the pill. It is related to increased levels of oestrogen. It is also perfectly harmless, does not go on to become skin cancer, and can be avoided by keeping your face protected from the sun (which is what you should be doing anyway, unless you want a crinkle-cut leather-look face by the rime you are 35), and is also easily camouflaged by make-up.
If the pill tends to make your acne worse, as it does in some people, a more oestrogenic pill may improve the problem, or one of the pills with a different progesterone.
Nausea, similar to typical morning sickness experienced in early pregnancy, may affect some women taking the pill, particularly soon after starting it. In most cases it will settle after a few weeks. If it doesn’t, a change of pill or the addition of vitamin B6 may be worth trying.
There are some women who experience mood changes on the pill. These can vary from the level of minor annoyance, to marked depressive symptoms, and may in fact mean that some women should not take the pill, although this is rare. Sometimes a change to a lower dose or different type of pill will suffice.
Light vaginal bleeding at times other than when it is due can be a real drag. This ‘spotting’ or ‘breakthrough bleeding’ can happen while taking the pill. As long as it is not associated with an infection, like chlamydia, or an abnormality of the cervix, it is of little significance (except of course to the person who is getting it). It is important that infections and abnormal pap smears are excluded by an examination. If it is persistent, often a change of pill will eliminate the problem. It may be due to inadequate levels of hormone at times in the cycle. Theoretically then, it might be wise to use another form of contraception as well (like condoms) until the problem is sorted out, if you are really keen to avoid pregnancy. Often breakthrough bleeding happens for the first couple of cycles of the pill and stops spontaneously.
Spotting may also occur because of an ‘ectropion’ or ‘erosion’ on the cervix. This is a natural phenomenon in response to increased oestrogens in pregnancy, or when on the pill. It is not serious, and regular pap smears will help to pick up any abnormalities. If persistent bleeding is a problem the cervix can be treated by a gynaecologist with diathermy.
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