5 Lesser-Known Birth Control Side Effects

Estrogen and progesterone are natural sex hormones in your body that regulate your reproductive health. Chemically-made forms of these sex hormones — most commonly estradiol (a type of estrogen) and various progestins — are commonly found in hormonal birth control.

Estrogens and progestins work together to prevent pregnancy and regulate menstrual cycles. Progestins block the release of mature eggs from the ovaries, make it more difficult for sperm to reach an egg, and make it harder for a fertilized egg to attach to your uterus. Meanwhile, estrogens enhance the effect of progestins and help regulate menstrual cycles.

Estrogen and progesterone also play important roles in regulating many other bodily functions. Since birth control changes the levels of these hormones, it can affect these other areas of the body and lead to various side effects. And while things like breakthrough bleeding and breast tenderness are common birth control side effects, there are a few that are more surprising.

Below, we’ll discuss five lesser-known side effects of birth control, some tips on how to manage them, and changes you might experience when you stop birth control.

What are some lesser-known birth control side effects?

Nausea, changes to your period, and headaches are well-known birth control side effects. However, they aren’t the only side effects that can happen while using hormonal birth control. There are a few less common side effects that you might not expect.

1. Changes in vaginal discharge

The consistency of your discharge can change while taking birth control. This is because progestins cause your vaginal secretions to become thicker to help make it difficult for sperm to move. As mentioned above, this is one way progestins help prevent pregnancy.

Your discharge can also have a light brown color. Even when you’re not taking birth control, healthy discharge can be this color, particularly on the days surrounding your period. If you are experiencing breakthrough bleeding while on birth control, you might notice light brown discharge as well.

These instances are caused by blood mixing together with your discharge. If this becomes uncomfortable or bothersome, speak to your provider to see what options are available to lessen this side effect.

However, it’s important to be aware of what abnormal discharge may look like. If you notice any discharge that looks like cottage cheese, is yellow-green, or smells fishy, let your provider know right away. This is never normal and may be a sign of an infection that needs to be treated with medication.

2. Hair loss

Estrogen, progesterone, and androgens (like testosterone) influence hair growth. Estradiol and progestins from birth control might change hair growth by affecting proteins that control the amount of androgens at the hair follicle.

Some progestins also have varying levels of androgen activity — meaning they can act like androgens in some areas of the body. So it’s possible that changes in estrogen and progesterone levels may interfere with hair strength and growth or cause hair to fall out.

If you’re concerned about any hair loss you might be experiencing or if it continues for more than 6 months after starting birth control, ask your healthcare provider if switching to a different birth control product is right for you.

3. Dry eyes

Birth control might cause eye-related side effects, including dry eye and eye discomfort. This can cause contact lens intolerance and eye discomfort for people who wear them. It’s estimated that birth control-related eye symptoms occur in 1 in 230,000 people, so it’s not common.

Progestins may block the androgens in your eyes that regulate tear production, while estrogens may lower the amount of tears you make. Wearing contact lenses can make dry eyes worse by potentially causing eye inflammation, reducing tear production, or causing tears to dry up quicker.

People taking hormonal contraception have reported more severe dry eye symptoms than those not taking birth control. Because this side effect is uncommon, more research needs to be done to confirm if birth control hormones are the only cause of these dry eye symptoms.

4. Changes in sex drive

People taking birth control have reported a range of sex drive (libido) levels — including more than, less than, and the same libido as usual. This is because estrogen, progesterone, and testosterone can influence your sex drive. 

Though how sex drive may change while using birth control is unique for everyone, recognizing that this can happen is essential. If you notice any bothersome or frustrating changes in sex drive or function at any time after starting birth control, talk to your provider to see what options there are for you.

5. Changes in mood

Hormones — like estrogen and progesterone — can affect areas of your brain responsible for processing emotions. While many birth control options provide doses of these hormones, it’s unclear whether it can cause mood changes.

Some people using combined hormonal contraceptives report feeling more anxious or depressed, while others report that birth control actually helped stabilize their mood. One study suggested that young women taking hormonal contraception are more at risk of developing depression. But more research is needed to know for sure.

It’s important to check in on your emotions regularly. If you notice any new or unexpected mood changes after starting birth control, speak with your healthcare provider.

Are some people more at risk of experiencing these side effects?

More research needs to be done to determine if certain people taking birth control are at higher risk of these side effects than others. But certain underlying conditions might be a risk factor for some of these lesser-known side effects.

The risk of hair loss may be higher if you have conditions that can cause hormonal imbalances, like polycystic ovary syndrome (PCOS) or thyroid problems. Your risk might also be higher if you have a strong family history of hair loss or have hair damage from coloring or perming your hair too often.

You may have a higher risk of developing dry eyes with birth control if you’re already a contact lens wearer or if you have diabetes, thyroid problems, or certain autoimmune conditions (e.g., lupus, Sjögren’s syndrome).

Though the effect of contraceptives on mood is unclear, women with a history of mental health conditions — like depression — might be more likely to experience negative mood-related symptoms while using birth control.

Current research hasn’t determined if certain people taking birth control are more at risk of changes in vaginal discharge or sex drive than others. 

How can you lower your risk of experiencing birth control side effects?

If you’re taking daily birth control, remembering to take it every day at the same time can lower the risk of breakthrough bleeding. Different birth control products have different hormone blends, so switching products might help you find a better birth control for you. It may take some trial and error, so discuss with your provider, and don’t get discouraged.

We still don’t know how to predict who will experience these less common side effects, so it’s difficult to pinpoint what you can do to prevent them. However, knowing how to manage side effects is just as important.

Here are a few tips:

• For dry eyes: Purchase over-the-counter (OTC) artificial tears, avoid dry or irritating environments (e.g., smoke, wind, air-conditioned rooms), and use a humidifier to moisturize room air. Also, limit time with or take breaks from screens and drink plenty of water throughout the day.

• For hair loss: Start by making sure your diet is well balanced and full of nutrients. You should also try to limit hair treatments and styling options that are more damaging. These steps help encourage healthy hair growth. You can also discuss trying topical minoxidil (Rogaine) with your provider if lifestyle changes don’t seem to be helping enough.

• For lower sex drive: Research suggests that extended- or continuous-cycle oral contraceptive regimens (e.g., Seasonale, Seasonique) or contraceptives that contain the progestin drospirenone (e.g., Yaz, Nextstellis) might have a positive effect on sex drive and overall sexual satisfaction. Since several medications can cause lower sex drive, it’s best to review all your medications with your healthcare provider to see if there are any potential alternatives you can take.

Can you experience unexpected side effects when you stop taking birth control?

Stopping birth control might help lessen or get rid of some side effects, but a couple of new issues may appear in their place. These temporary changes tend to occur because your body needs some time to adjust back to its normal hormonal levels and fluctuations.

Late or no periods

After stopping oral birth control, you might experience longer menstrual cycles (between 31 and 36 days) for several cycles. This means that your period might start a couple of days later than usual. If your period doesn’t return after 3 months of being off birth control, contact your healthcare provider. You should also take a pregnancy test if you’ve been sexually active during this time.

Shorter or lighter periods

To help prevent pregnancy, the lining of your uterus tends to thin while you’re taking oral birth control, which helps shorten the length and flow of bleeding. Since it takes time for this lining to return to its usual thickness, some people may experience shorter or lighter bleeding for at least six cycles after stopping oral birth control.

Acne

Estrogen and progestin help keep androgens — one of the major players in acne — at bay. This hormonal control disappears when you stop contraceptives, so don’t be surprised if you see the return of those pesky pimples.

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Written by:

Cydnee Ng, PharmD

Cydnee Ng, PharmD, is a licensed pharmacist in California. After getting licensed in 2019, she began her pharmacy career as a community pharmacist at Walgreens.

Edited 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.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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