7 Aygestin (Norethindrone Acetate) Side Effects You Should Know About

• Common Aygestin side effects include menstrual changes, weight changes, and breast tenderness. Mood swings and skin changes are also possible.

• Rare but serious Aygestin side effects include severe depression, liver problems, and an increased risk of blood clots. Review your medical history with your prescriber to assess your risk of these serious side effects before starting Aygestin.

Aygestin (norethindrone acetate) is a progestin — a lab-made form of the hormone progesterone. Your prescriber may recommend taking it to balance your hormone levels if you’re having abnormal vaginal bleeding or missing menstrual periods (secondary amenorrhea). Aygestin can also help ease symptoms of endometriosis, a condition that causes heavy, painful periods.

Even though Aygestin works like a natural hormone, it can still cause side effects. Knowing about them in advance can help you know what to expect and get the most from your medication.

Note: Brand-name Aygestin is no longer made. The medication is only available as generic norethindrone acetate. A lower dose of norethindrone is also found in some birth control pills. However, this article will only focus on the side effects of the higher-dose (5 mg) version. We’ll refer to it as Aygestin throughout to help avoid confusion.

Aygestin side effects at a glance

Below is a list of common and rare Aygestin side effects to know about. Keep in mind that this isn’t a full list. Talk with your healthcare team about any concerns you have about side effects, even if they aren’t listed here.

Mild Aygestin side effects include:

• Breakthrough bleeding (unexpected bleeding between periods)

• Spotting

• Changes in menstrual flow

• Lack of periods

• Edema (fluid retention)

• Weight changes

• Changes in vaginal discharge

• Headaches

• Skin changes, such as acne or patches of darkened skin

• Swollen or tender breasts

• Nausea

• Trouble sleeping

• Mood swings

• Itchy skin

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Rare or serious Aygestin side effects include:

• Severe depression

• Liver problems

• Increased cholesterol levels

• Increased risk of blood clots

• Increased risk of breast cancer

• Vision changes

Let’s take a closer look at seven Aygestin side effects and what to do about them.

1. Irregular menstrual bleeding or spotting

Aygestin may cause changes in menstrual flow or bleeding patterns, including:

• Lighter or heavier menstrual flow

• Spotting

• Breakthrough bleeding

• No periods (amenorrhea)

As mentioned, Aygestin is a progestin — a lab-made version of the hormone progesterone. In a typical menstrual cycle, progesterone helps develop the lining of the uterus (endometrium) to prepare for a possible pregnancy. If pregnancy doesn’t happen, your progesterone and estrogen levels drop, triggering the shedding of the uterine lining and the start of your menstrual flow (period).

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Aygestin mimics this natural process by helping to mature and stabilize the lining of your uterus. But not everyone will have the same menstrual side effects — and that’s partly because the dosage and treatment length can vary depending on how it’s prescribed.

For example, if you’re taking Aygestin for just 5 to 10 days to help regulate your periods, menstrual bleeding typically starts within a week after you stop taking the medication. That’s because in this case, Aygestin mimics natural progesterone levels during your cycle.

But if you take Aygestin on a daily basis for conditions such as endometriosis, it can interfere with your natural menstrual cycle. Menstrual bleeding can become irregular, or it may stop altogether.

Regardless, it’s a good idea to wear a pantyliner or dark-colored bottoms until you know how Aygestin affects your cycle. It’s also helpful to keep period products handy when you’re on the go, just in case. If breakthrough bleeding is becoming annoying or your period seems unusually heavy or absent, reach out to your prescriber for guidance.

2. Weight changes

Weight changes, including weight gain and weight loss, are both possible Aygestin side effects. Aygestin impacts your hormone levels, and hormones play a role in your appetite and mood, as well as how your body stores fluid. Because of this, it’s not unusual to notice weight changes while taking Aygestin. But in most cases, they aren’t significant.

For some, weight gain may be related to fluid retention, or “water weight,” which can make you feel bloated or puffy. While this can be uncomfortable, it’s usually mild and temporary. Limiting salt in your diet may help. Getting regular exercise, staying hydrated, and eating mindfully can also help combat weight gain while taking Aygestin.

If you’re concerned about weight changes while taking Aygestin, talk to your prescriber. And let your healthcare team know in advance if you have heart, kidney, or other health conditions that could be affected by fluid retention.

3. Sore breasts

Breast tenderness or enlargement can happen while taking Aygestin. These side effects are usually mild and may go away over time.

The following tips may help with sore breasts:

• Choose a supportive, well-fitting bra to reduce pressure and movement.

• Cut back on caffeine and fatty foods, which can sometimes make breast tenderness worse.

• Apply a warm or cool compress.

• Try an over-the-counter (OTC) pain reliever, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).

If your breast tenderness becomes uncomfortable or doesn’t improve, let your prescriber know. They may suggest adjusting your dose or checking for other causes.

Aygestin may also increase your risk of breast cancer, especially with long-term use or if you have a history of this condition. If you notice a new lump in your breast, or changes in how your breast or nipple look, let your prescriber know right away. These can be signs of breast cancer.

4. Skin changes

Aygestin can cause changes to your skin, such as acne and hyperpigmentation (dark-colored skin patches). These issues may resolve on their own as your body adjusts to Aygestin. But for some people, they may persist even after they stop taking it.

You can often manage acne on your own with OTC skin care products. Wearing sunscreen and protecting your skin from the sun can help reduce the appearance of hyperpigmentation. And OTC hydroquinone cream may help lighten dark patches. If your skin issues become severe or bothersome while taking Aygestin, reach out to your healthcare team for guidance.

5. Mood swings

Mood swings are another reported Aygestin side effect. This is likely due to how it affects your hormone levels. You may feel more irritable or down than usual. But in most cases, these symptoms are short-lived and go away on their own.

In rare cases, Aygestin may cause severe depression. This side effect seems more likely if you’ve had depression in the past. So be sure to let your prescriber know about your mental health history before starting treatment.

In many cases, you can manage mood changes with lifestyle changes, such as getting regular exercise, managing stress, and maintaining healthy sleep habits. But for more severe or long-lasting depression, therapy and/or medications are helpful options.

Keep in mind that anxiety and depression are more common among women dealing with abnormal menstrual bleeding — a condition that Aygestin is often prescribed to treat. So, for some people, mental health symptoms may actually improve as their periods become more predictable.

But if your mood changes feel severe or you have thoughts of self-harm, contact your prescriber right away. You may need to stop taking Aygestin or adjust your dose.

If you or someone you know is having thoughts of suicide, you’re not alone, and help is available. Call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.

6. Liver problems

Although rare, liver problems can occur while taking Aygestin. Reports of such issues include cholestatic jaundice (a type of liver dysfunction) and changes in liver enzyme levels seen on blood tests.

Symptoms of a possible liver issue include:

• Yellowing of the skin or eyes (jaundice)

• Itchy skin

• Belly pain

• Dark urine

• Pale stools

• Nausea and vomiting

• Fatigue

If you notice any of these symptoms, contact a healthcare professional right away. And tell your prescriber if you’ve had liver problems in the past before starting Aygestin.

7. Increased risk of blood clots

Aygestin may increase your risk of developing blood clots. Clots can form in your legs (deep vein thrombosis), lungs (pulmonary embolism), or other parts of your body and cause serious harm.

Warning signs of a blood clot may include:

• Sudden pain, warmth, or swelling in your leg or arm

• Chest pain

• Trouble breathing

• Vision changes

• Weakness on one side of your body

If you notice any of these symptoms, get emergency medical help right away. Your healthcare team can check for a blood clot and start treatment if needed. They may also recommend stopping Aygestin to help prevent future clots.

Good to know: Aygestin is not recommended for people who have already gone through menopause or have other factors that increase the risk of blood clots. Be sure to tell your prescriber if you have a history of blood clots or any heart or circulation problems before starting Aygestin. They can determine if it’s a safe option for you.

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Written by:

Patricia Weiser, PharmD

Patricia Weiser, PharmD, has 16 years of pharmacist experience. She previously held positions as a community pharmacist, pharmacy manager, and hospital pharmacist.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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