Healthy women who do not smoke cigarettes have almost no chance of having a severe side effect from taking oral contraceptives. For most women, more problems occur because of pregnancy than will occur from taking oral contraceptives. However, for some women who have special health problems, oral contraceptives can cause some unwanted effects. Some of these unwanted effects include benign (not cancerous) liver tumors, liver cancer, or blood clots or related problems, such as a stroke. Although these effects are very rare, they can be serious enough to cause death. You may want to discuss these effects with your doctor.
Smoking cigarettes during the use of oral contraceptives has been found to greatly increase the chances of these serious side effects occurring. To reduce the risk of serious side effects, do not smoke cigarettes while you are taking oral contraceptives. Cigarette smoking increases the risk of serious cardiovascular side effects from oral contraceptive use. The risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in women over 35 years of age.
The following side effects may be caused by blood clots. Get emergency help immediately if any of the following side effects occur:
Abdominal or stomach pain (sudden, severe, or continuing); coughing up blood; headache (severe or sudden); loss of coordination (sudden); loss of vision or change in vision (sudden); pains in chest, groin, or leg (especially in calf of leg); shortness of breath (sudden or unexplained); slurring of speech (sudden); weakness, numbness, or pain in arm or leg (unexplained)
Check with your doctor as soon as possible if any of the following side effects occur:
More common-usually less common after the first 3 months of oral contraceptive use
Changes in the uterine bleeding pattern at menses or between menses, such as decreased bleeding at menses, breakthrough bleeding or spotting between periods, prolonged bleeding at menses, complete stopping of menstrual bleeding that occurs over several months in a row, or stopping of menstrual bleeding that only occurs sometimes
Headaches or migraines (although headaches may lessen in many users, in others, they may increase in number or become worse); increased blood pressure; vaginal infection with vaginal itching or irritation, or thick, white, or curd-like discharge
For women with diabetes mellitus
Mild increase of blood sugar-Faintness, nausea, pale skin, or sweating
Mental depression; swelling, pain, or tenderness in upper abdominal area
For women who smoke tobacco
Pains in stomach, side, or abdomen; yellow eyes or skin
For women with a history of breast disease
Lumps in breast
Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
Abdominal cramping or bloating; acne (usually less common after first 3 months and may improve if acne already exists); breast pain, tenderness, or swelling; dizziness; nausea; swelling of ankles and feet; unusual tiredness or weakness; vomiting
Brown, blotchy spots on exposed skin; gain or loss of body or facial hair; increased or decreased interest in sexual intercourse; increased sensitivity of skin to sunlight; weight gain or loss.
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.