Most hormonal medicine side effects settle within the first three months and can wait for a routine appointment. A small number cannot wait at all. This page sorts them by urgency.
Common hormonal medicine side effects
Routine appointment is right for irregular bleeding or spotting in the first months, breast tenderness, mild headaches, nausea, bloating, skin changes, mood changes that are noticeable but manageable, and reduced libido.
These are worth raising rather than tolerating, particularly if they persist past three months, since switching method often resolves them. They are simply not emergencies. See hormonal medicine side effects.
Bleeding, mood, skin, weight and cycle changes
Bring the appointment forward for bleeding that is heavy enough to affect daily life, bleeding that starts after a settled pattern, persistent low mood, or a side effect making you consider stopping. That last one matters: stopping contraception without an alternative in place is how unintended pregnancies happen.
Bleeding that continues beyond three to six months on a new method is worth investigating rather than waiting out indefinitely. See irregular bleeding on hormonal medicine.
Serious warning signs that need medical attention
Emergency care now. These are signs of a clot or stroke, and matter most with oestrogen-containing methods:
- Pain, swelling, warmth or redness in one calf or thigh
- Sudden breathlessness, chest pain worse on breathing in, or coughing up blood
- Sudden severe headache unlike any you have had before
- Weakness or numbness on one side, difficulty speaking, or sudden loss of vision
- Severe abdominal pain, or yellowing of the eyes or skin
- Swelling of the face or throat, or difficulty breathing
See hormonal medicine and blood clot symptoms.
Same day, do not wait:
- Very heavy bleeding, or bleeding causing dizziness or breathlessness
- Severe pelvic pain, or a missed period with abdominal pain
- Fever with unusual or foul-smelling discharge, particularly after a device was fitted
- A new breast lump
- Severe or persistent low mood, or thoughts of self-harm
- Being unable to feel the threads of an intrauterine device, or the implant in your arm
- Migraine with aura starting for the first time while on a combined method
That last one is easy to miss. Aura means visual disturbance, flashing lights or zigzag lines before the headache. If it begins after years on the pill it still needs reporting, because it changes whether a combined method remains suitable. See hormonal contraception and migraine.
Who may be at higher risk?
Lower your threshold for seeking advice if you smoke and are over 35, have a personal or family history of blood clots, have high blood pressure, or have recently had surgery or a period of immobility. Clot risk is also higher in the first months of starting a combined method and after giving birth.
What to discuss with your doctor, pharmacist or clinic
- Which symptoms should send me straight to an emergency unit?
- How long should I give this before deciding it does not suit me?
- If I want to stop, what should I use instead and from when?
- Given my history, is an oestrogen-containing method still suitable?
- Do any of my other medicines or supplements affect it?
A pharmacist can answer questions about missed pills and interactions quickly, without an appointment.
Related contraception, HRT and hormonal medicine guides
- Hormonal contraception side effects
- Women’s health and hormonal medicine side effects
- HRT side effects
- Serious medication side effects
- Report a hormonal medicine side effect
Medical Disclaimer: This content is for informational and educational purposes only and does not constitute medical diagnosis, prescription, or professional advice. Always read the patient information leaflet and consult a qualified doctor or pharmacist regarding any medicine or health concern.