* The text shows a compilation of possible side effects of a pill. However, please refer to the patient information leaflet of your product as side effects may vary from one product to another.
You should not use the pill if you have any of the conditions listed below. If you do have any of the conditions listed below, you must tell your doctor. Your doctor will discuss with you what other form of birth control would be more appropriate.
Using a combined hormonal contraceptive increases your risk of developing a blood clot compared with not using one. In rare cases a blood clot can block vessels and cause serious problems.
Blood clots can develop
Recovery from blood clots is not always complete. Rarely, there may be serious lasting effects or, very rarely, they may be fatal.
It is important to remember that the overall risk of a harmful blood clot due to the pill is small.
Breast cancer has been observed slightly more often in women using combination pills, but it is not known whether this is caused by the treatment. For example it may be that more tumors are detected in women on combination pills because they are examined by their doctor more often. The occurrence of breast tumors becomes gradually less after stopping the combination hormonal contraceptives. It is important to regularly check your breasts and you should contact your doctor if you feel any lump.
In rare cases, benign liver tumors, and in even fewer cases malignant liver tumours have been reported in pill users. Contact your doctor if you have unusually severe abdominal pain.
* Frequency may vary between products
** Back pain is not observed with all products available to the public.
Allergic reactions including rash, hives (urticaria), angioedema (characterized by sudden swelling of e.g. the eyes, mouth, throat) and blood pressure increase have been reported with similar products. The risk of perforation is increased in breast-feeding women. Cases of sepsis (very severe systemic infection, which may be fatal) have been reported following IUD insertion.
Procedural pain, procedural bleeding, insertion-related vasovagal reactions with dizziness or syncope (fainting) and seizure (fit) in epileptic patients in connection with insertion or removal procedures have been reported with similar products as well.
It is uncommon to become pregnant while using an IUS. However, if you become pregnant while using it, the risk that the pregnancy could develop outside the womb (have an extrauterine or ectopic pregnancy) is increased. Women who have already had an extrauterine pregnancy, surgery of the fallopian tubes or a pelvic infection carry a higher risk for this type of pregnancy. An extrauterine pregnancy is a serious condition, which calls for immediate medical attention and may impact future fertility.
The following signs and symptoms could mean that you may have an extrauterine pregnancy and you should see your doctor immediately (see also section “Pregnancy, breast feeding and fertility”):
An IUS is likely to affect your menstrual cycle. It can change your menstrual periods so that you have spotting (a small amount of bleeding), shorter or longer periods, lighter or heavier bleeding, or no bleeding at all.
You may have bleeding and spotting between menstrual periods, especially during the first 3 to 6 months. Sometimes the bleeding is heavier than usual at first.
Overall, you are likely to have a gradual reduction in the amount and number of days of bleeding each month. Some women eventually find that periods stop altogether.
The monthly thickening of the lining of the womb may not happen due to the effect of the hormone and therefore there is nothing to come or shed away as a menstrual period. It does not necessarily mean that you have reached menopause or are pregnant. Your own hormone levels usually remain normal.
When the system is removed, your period should soon return to normal.
The IUS inserter and the IUS itself are sterile. Despite this, there is an increased risk of pelvic infection (infections in the lining of the womb or the fallopian tubes) at the time of placement and during the first 3 weeks after the placement.
Pelvic infections in IUS users are often related to the presence of sexually transmitted diseases. The risk of infection is increased if you or your partner has multiple sexual partners or if you have had pelvic inflammatory disease (PID) before.
Pelvic infections must be treated promptly.
Pelvic infections such as PID may have serious consequences and it may impair fertility and increase the risk of a future extrauterine pregnancy (pregnancy outside the womb). The IUS must be removed if you experience recurring PID or if an infection is severe or does not respond to treatment.
The muscular contractions of the womb during menstruation may sometimes push the IUS out of place or expel it. It is rare but possible for an IUS to come out during your menstrual period without you noticing.
It is also possible for your IUS to partially expel from your womb, meaning that it is displaced but not completely expelled (you and your partner may notice this during sexual intercourse). If the IUS is completely or partially expelled, you will not be protected from pregnancy.
Penetration or perforation of the wall of the womb may occur rarely during placement of an IUS, although the perforation may not be detected until some time later. If an IUS becomes lodged outside the cavity of the womb, it is not effective at preventing pregnancy. You may need surgery to have the IUS removed.
The risk of perforation may be increased:
Since the contraceptive effect of the IUS is mainly due to its local effect in the womb, ovulation (release of the egg) usually continues while using an IUS. Sometimes an ovarian cyst may develop. In most cases there are no symptoms.
An ovarian cyst may require medical attention, or more rarely surgery, but it usually disappears on its own. If you get any side effects, talk to your doctor or nurse.
Note: If any of the side-effects become serious or if you notice any side-effects not listed here, contact your doctor.
Pelvic infections in intrauterine device users are often related to sexually transmitted diseases. Pelvic infections must be treated promptly as they may impair fertility and increase the risk of an ectopic pregnancy (pregnancy outside the womb). The intrauterine device must be removed if there are recurrent pelvic infections or infections of the lining of the womb or if an acute infection is severe or does not respond to treatment within a few days. Consult a doctor without delay if you have persistent lower abdominal pain, fever, and pain in conjunction with sexual intercourse or abnormal bleeding1.
The muscular contractions of the womb during menstruation may sometimes push the intrauterine device out of place or expel it1. Possible symptoms are pain and abnormal bleeding1. If the intrauterine device is displaced, the effectiveness may be reduced1. If it is expelled, you are no longer protected against pregnancy.
Rarely, most often during placement, the intrauterine device may penetrate or perforate the wall of the womb which may decrease the protection against pregnancy1. The risk of perforation may be increased if the intrauterine device is placed shortly after having given birth, in lactating women, or in women with the womb fixed and leaning backwards (towards the bowel)1.
If the intrauterine device has become lodged outside the cavity of the womb, it is not effective and must be removed as soon as possible.
If you become pregnant with the intrauterine device in place, you should have it removed as soon as possible1. If you leave the intrauterine device in place during pregnancy, the risk of having a miscarriage, infection or preterm labor will be increased1. If you become pregnant, the risk that you could carry the fetus outside of your womb (have an ectopic pregnancy) is relatively increased1. You carry a higher risk if you have already had an ectopic pregnancy, or surgery on the tubes leading from the ovaries to the womb or a pelvic infection1.
There may well be changes to your periods following placement of the intrauterine device. The number of bleeding and spotting (a small amount of blood loss) days may increase during the first few months and bleeding may be heavier1. The most common reasons for discontinuation of IUD use are unacceptable vaginal bleeding and pain2.
A common side effect of using a contraceptive implant is a change to your periods. You may experience a change in frequency (absent, less, more frequent or continuous), intensity (reduced or increased) or in duration1. Around 1 in 5 women experience an absence of bleeding while another 1 in 5 women have frequent and/or prolonged bleeding1. Occasionally, heavy bleeding has been observed1. In clinical trials, bleeding changes were the most common reason for stopping treatment (about 11 %)1. The bleeding pattern that you experience during the first 3 months generally indicates your future bleeding pattern1.
However, such changes do not indicate that the implant is not working or is not suitable for you, but you should consult your doctor if bleeding is heavy or prolonged1.
If any of the side effects become serious or if you notice any side effects not listed here, contact your doctor.
Although weight gain has been reported as a side-effect, scientific studies have shown that women generally do not put on weight as a result of using the implant2. Other effects occasionally seen include an increase in blood pressure and oily skin1.
If you experience a swollen face, tongue or pharynx, difficulty in swallowing, hives or difficulty in breathing, contact your doctor immediately1.
It is not known whether studies relating to cancer in women who daily take a combined oral contraceptive containing two different female hormones (i.e. the Pill) are also applicable to women who use a different hormonal contraceptive, such as implants containing only a progestin1. Breast cancer has been found slightly more often in women using combined oral contraceptive pills, but it is not known whether this is caused by the treatment1. For example, it may be that tumors are found more in women on combined oral contraceptive pills, because they are examined by the doctor more often1. The increased occurrence of breast cancer becomes gradually less after stopping the combined oral contraceptive1. It is important to regularly check your breasts and you should contact your doctor if you feel any lump in your breasts or if a close relative has or ever had breast cancer1.
In rare cases, benign and even more rarely malignant liver tumors have been reported in women using the Pill1. If you experience severe abdominal pain, you should contact your doctor immediately.Thrombosis
A blood clot in a vein (known as a ‘venous thrombosis’) can block the vein. This can happen in veins in the leg, the lung (a lung embolus), or other organs. Using any combined hormonal contraceptive increases your risk of developing such clots compared with someone not taking any combined hormonal contraceptive1. The risk is not as high as the risk of developing a blood clot during pregnancy1. The risk with progestin-only methods like the contraceptive implant is believed to be lower than in users of pills that also contain oestrogens1. If you suddenly notice possible signs of a thrombosis, you should see your doctor immediately1.