Hormonal birth control pills can cause mild side effects, including acne, bloating, and spotting. Having certain health conditions, such as epilepsy or migraine with aura, may increase your risk for more serious side effects.

Birth control pills are oral contraceptives that contain hormones, which prevent your ovaries from releasing eggs during ovulation. They also encourage the thickening of cervical mucus to act as a barrier between sperm and any eggs that may be released.

In the past, there was only one option for taking oral contraceptives. It involved taking a daily hormone pill for 21 days followed by a placebo pill (usually made of sugar) for 7 days. During this week of placebo pills, you’d have your period.

Today, there are many variations of the pill. Some only include four days of placebo pills, while others don’t have any placebo pills, allowing you to skip your period altogether.

The freedom that birth control pills provide does come with a few side effects, though. Read on to learn more about them and other things to consider about the pill.

All forms of hormonal birth control can cause a range of side effects. Most are mild and may resolve after the first two or three months of taking the pill.

These include:

  • acne
  • bleeding or spotting between periods
  • bloating
  • blood pressure above your usual range
  • depression
  • fatigue
  • feeling dizzy
  • fluid retention
  • headache
  • increased appetite
  • insomnia
  • melasma (dark patches on the face)
  • mood swings
  • nausea
  • tenderness or pain in the breasts
  • vomiting
  • weight gain

If you’re having a hard time adjusting to the pill or you have side effects that last for more than three months, talk to your doctor. They might suggest switching to a different pill or birth control method.

If you decide to stop taking the pill, make sure to use a backup method of birth control, such as a condom, to avoid unintended pregnancy.

Nearly all forms of birth control involving estrogen can increase your risk of certain health problems. But according to Planned Parenthood, these risks aren’t common. More serious potential side effects of birth control pills include:

If you smoke or are over the age of 35, your risk of these more serious side effects increases.

You doctor might also suggest another method if you:

  • are scheduled for a surgical procedure that will limit your mobility during recovery
  • developed jaundice during a pregnancy or while on the pill
  • get migraines with auras
  • have a history of very high blood pressure or stroke
  • have an elevated BMI or are considered to be obese
  • have chest pain or have had a heart attack
  • have diabetes-related complications that affect your blood vessels, kidneys, nerves, or vision
  • have had uterine, breast, or liver cancer
  • have heart or liver disease
  • have irregular periods of breakthrough bleeding
  • have previously had a blood clot
  • take any over-the-counter or prescription medication that could interact with the hormones

To minimize your risks of serious side effects, be sure to tell your doctor if you:

  • are breastfeeding
  • are taking medication for epilepsy
  • feel depressed or have been diagnosed with depression
  • have diabetes
  • have high cholesterol
  • have kidney, liver, or heart disease
  • recently had a baby
  • recently had a miscarriage or abortion
  • take any herbal supplements
  • think you may have a lump or changes in one or both of your breasts

If you’re concerned about these side effects, nonhormonal birth control may be a better option for you. Read about the different options for birth control without hormones.

The pill is generally safe to take over a long period of time. But there is some research that suggests it might raise your risks of developing some types of cancer.

According to the American Cancer Society, taking birth control pills may increase your risk of breast cancer or cervical cancer over time. The longer you use them, the higher the risk.

However, there have been conflicting study results regarding this risk: some show an increased risk of breast cancer while others show no increase in risk.

But taking the pill is also linked to a reduced risk of other cancers. A recent large, long-term study found that the pill consistently lowered the risk of ovarian and endometrial cancer.

A 2017 study found a similar reduction in the risk of colorectal cancer associated use of the pill.

If you’re concerned about your risk of certain types of cancer, talk to your doctor. They can help you weigh any other factors that might increase your risk and help you choose an option you’re comfortable with.

In addition to potential side effects and risks, there are a few other things to consider before deciding to use birth control pills:

  • Frequency. You’ll need to take the pill every day at the same time. If you miss one dose, you’ll need to use a backup form of birth control for the next seven days to prevent pregnancy. In addition, after a lapse in contraception, you may have spotting or light bleeding after the missed pills.
  • Intimacy. The pill doesn’t interfere with any sexual activities. You won’t have to pause to take it during sex.
  • Time line. The pill takes about seven days to start working. If you’re sexually active during that time, you’ll need to use a backup form of contraception.
  • Protection. While it helps to prevent pregnancy, birth control pills don’t provide any protection against sexually transmitted infections. You’ll need to use an additional form of birth control, such as condoms, to avoid sexually transmitted infections.

The birth control pill is a popular, effective way to prevent unintended pregnancy and is generally accepted as a safe method of birth control. However, it can cause serious side effects in rare cases.

Talk to your doctor to weigh the benefits and risks of the pill and to discuss alternatives, including the shot or patch.