Cavallaro FL, Benova L, Owolabi OO, Ali M. A systematic review of the effectiveness of counselling strategies for modern contraceptive methods: what works and what doesn’t?. BMJ Sex Reprod Health. 2020; 46:(4)254-269

National Survey of Sexual Attitudes and Lifestyles (Natsal-3): Reference Tables. 2012. (accessed 2 August 2023)

Dehlendorf C, Krajewski C, Borrero S. Contraceptive counseling: best practices to ensure quality communication and enable effective contraceptive use. Clin Obstet Gynecol. 2014; 57:(4)659-73 Side effect. 2023. (accessed 2 August 2023)

Dickson J, Hoggart L, Newton VL. Unanticipated bleeding with the etonogestrel implant: advice and therapeutic interventions. J Fam Plann Reprod Health Care. 2014; 40:(3)158-160

Faculty of Sexual and Reproductive Healthcare. Problematic Bleeding with Hormonal Contraception. 2013. (accessed 2 August 2023)

Faculty of Sexual and Reproductive Healthcare. Progestogen Only Injectable. 2020. (accessed 2 August 2023)

Faculty of Sexual and Reproductive Healthcare. UK Medical Eligibility Criteria for Contraceptive Use. 2016. (accessed 2 August 2023)

Faculty of Sexual and Reproductive Healthcare. Overweight, Obesity and Contraception. 2019. (accessed 2 August 2023)

Faculty of Sexual and Reproductive Healthcare. Combined Hormonal Contraception. 2019. (accessed 2 August 2023)

Faculty of Sexual and Reproductive Healthcare. Progestogen-only Implant. 2021. (accessed 2 August 2023)

Faculty of Sexual and Reproductive Healthcare. Progestogen-only Pills. 2022. (accessed 2 August 2023)

Faculty of Sexual and Reproductive Healthcare. Intrauterine Contraception. 2023. (accessed 2 August 2023)

Jödicke A, Dahmke H, Damke B, Schäublin M, Kullak-Ublick GA, Weiler S. Severe injection site reactions after subcutaneous administration of Sayana®: a retrospective, post-marketing analysis of WHO and Swiss spontaneous pharmacovigilance reports. Swiss Med Wkly. 2017; 147

Kelly S, Davies E, Fearns S, McKinnon C, Carter R, Gerlinger C, Smithers A. Effects of oral contraceptives containing ethinylestradiol with either drospirenone or levonorgestrel on various parameters associated with well-being in healthy women: a randomized, single-blind, parallel-group, multicentre study. Clinical Drug Investigation. 2010; 30:(5)

Rosenburg MJ, Waugh MS, Meehan TE. Use and misuse of oral contraceptives: Risk indicators for poor pill taking and discontinuation. Contraception. 1995; 51:(5)283-288

Sacco S., Merki-Feld GS, Ægidius KL Effect of exogenous estrogens and progestogens on the course of migraine during reproductive age: a consensus statement by the European Headache Federation (EHF) and the European Society of Contraception and Reproductive Health (ESCRH). J Headache Pain. 2018; 19:(76)

McGregor EA. Diagnosing migraine. Journal of Family Planning and Reproductive Health Care. 2016; 42:280-286

Salorana T, Gyllenberg F, But A, Gissler M, Laine M, Heikinheimo O. Free-of-charge long-acting reversible contraception: two-year discontinuation, its risk factors, and reasons. American Journal of Obstetrics and Gynaecology. 2020; 223:(6)

Skovlund CW, Mørch LS, Kessing LV, Lidegaard Ø. Association of Hormonal Contraception With Depression. JAMA Psychiatry. 2016; 73:(11)1154-1162

Westhoff CL, Heartwell S, Edwards S, Zieman M, Stuart G, Cwiak C, Davis A, Robilotto T, Cushman L, Kalmuss D. Oral contraceptive discontinuation: do side effects matter?. Am J Obstet Gynecol. 2007; 196:(4)412.e1-6

Wigginton B, Harris ML, Loxton D A qualitative analysis of women’s explanations for changing contraception: the importance of non-contraceptive effects. Journal of Family Planning and Reproductive Health Care. 2016; 42:256-262

Managing side effects of contraception

02 August 2023
Volume 5 · Issue 8


All contraceptive methods can cause side effects, some of which may be beneficial. Women often discontinue or change their contraception due to recognised or perceived side effects of the method. Good contraceptive counselling should include discussion of side effects, and prepare women for what to expect. Many initial side effects may with lessen with time. Explanation and understanding of this can discourage early discontinuation of methods. The Faculty of Sexual and Reproductive Healthcare offers practical and evidence-based options for management of method side effects. Using proven management strategies, in a partnership with the woman, may increase acceptability of the method and reduce early discontinuation.

It could be said that no contraception is free of side effects. While some side effects could be argued to be beneficial, most attention is placed on perceived negative side effects. Side effects may be cited by women as the reason for discontinuing or changing contraception. This article will discuss common side effects and strategies for management.

A side effect is defined as ‘any effect of a drug, chemical, or other medicine that is in addition to its intended effect, especially an effect that is harmful or unpleasant’ (, 2023).

Side effects and the meanings associated with them matter; with experience of side effects being predictive of early discontinuation, and the presence of three side effects increasing the likelihood of discontinuation by 320% (Rosenburg et al, 1995). Women report changing their contraception due to side effects, with non-contraceptive side effects cited as the main reason for this (Wigginton et al, 2016). Wigginton et al (2016) argue that it is not only side effects themselves that lead to discontinuation or change of method, but also the social meanings attached to side effects, with the example given of a negative sociocultural context of weight gain as a side effect.

Register now to continue reading

Thank you for visiting Journal of Prescribing Practice and reading some of our peer-reviewed resources for prescribing professionals. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month