Reviewed by Usama Ali, MPharm (GPhC: 2224726). Last reviewed: April 2026.
Side effects of the contraceptive pill are usually mild. Not everyone gets them. For many people, any effects settle within the first 2 to 3 months as the body adjusts to the change in hormones.
The most commonly reported side effects across both the combined pill and the mini pill include irregular bleeding or spotting, nausea, headaches, breast tenderness, mood changes, and acne.
Starting a new pill means introducing hormones your body is not used to. Some temporary effects are normal in the first few weeks.
Spotting or irregular bleeding is the most common early side effect, particularly with the mini pill. Nausea is more common with the combined pill because of the oestrogen. Taking your pill with food or in the evening can help with this.
"The first three months are the adjustment period," says Usama Ali, MPharm (GPhC: 2224726), pharmacist at Contraception Direct. "We always say give it time if the side effects are manageable. But if they're making you miserable, come back to us sooner and we can look at alternatives."
The mini pill contains only progestogen, so it avoids oestrogen-related side effects like nausea and bloating. The trade-off is that changes to your bleeding pattern are more common.
You may find your periods become irregular, lighter, more frequent, or stop altogether. Acne, breast tenderness, headaches, and mood changes are also reported. These are listed in the Cerelle SPC and apply to all desogestrel mini pills.
The mini pill does not carry an increased risk of blood clots. This is one of its advantages over the combined pill.
The combined pill contains both oestrogen and progestogen. The oestrogen component can cause nausea, headaches, breast tenderness, and fluid retention, particularly in the first few weeks.
The combined pill carries a small increased risk of venous thromboembolism (blood clots). For levonorgestrel-containing pills, the risk is approximately 5 to 7 per 10,000 users per year, compared to about 2 per 10,000 in non-users (FSRH, 2023). Pills containing desogestrel, gestodene, or drospirenone carry a slightly higher risk. For context, the risk during pregnancy is around 29 per 10,000.
| Side effect | Combined pill | Mini pill |
|---|---|---|
| Irregular bleeding | Less common (regular withdrawal bleeds) | More common, especially early on |
| Nausea | More common (oestrogen) | Less common |
| Headaches | Can occur, especially during the 7 day break | Can occur |
| Breast tenderness | Common initially | Common initially |
| Mood changes | Reported by some | Reported by some |
| Bloating | More common (oestrogen-related) | Less common |
| Acne | Often improves (anti-androgenic pills) | May worsen in some people |
| Blood clot risk | Small increased risk | No increased risk |
Neither pill type is better or worse overall. The right choice depends on your body, your medical history, and which side effects matter most to you. Your pharmacist can help you find the right pill.
Stopping the pill means your body returns to its natural hormone cycle. Your periods may take a few months to settle back into a regular pattern. If you had heavy or painful periods before starting, those symptoms may return.
Some people notice temporary acne, mood changes, or changes to their skin and hair. These settle as your body readjusts. Stopping the pill does not affect your long-term fertility. Your natural fertility returns quickly, usually within days, regardless of how long you were taking it.
Most side effects settle within 2 to 3 months. This adjustment period is normal. If you have only just started a new pill, it is usually worth giving it at least 3 months before deciding whether it suits you.
If side effects are severe or affecting your daily life, do not wait the full 3 months. Speak to your pharmacist sooner.
Serious side effects are rare. But you should seek urgent medical attention if you experience any of the following while taking the combined pill: painful swelling in one leg (especially the calf), sudden chest pain or difficulty breathing, a severe or unusual headache, sudden changes in your vision, or collapse.
These could be signs of a blood clot (venous thromboembolism). Call 999 or go to A&E. Do not wait for a GP appointment. The mini pill does not carry this risk.
If side effects are mild and you have recently started or switched pills, give your body time. Three months is reasonable for most people.
If side effects persist, your pharmacist can help you switch. Moving from the combined pill to the mini pill (or the other way around) is common. So is switching between brands within the same type. Many people try more than one pill before finding what works.
Do not stop taking your pill without speaking to a pharmacist or GP first. Stopping without advice could leave you without contraceptive protection.
With Contraception Direct, you can book a free phone consultation to review your current pill or discuss switching.