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Birth control pills and patches, when used correctly, are very effective in preventing pregnancy. They’re safe for most healthy women and can even be used to treat a few health problems. However, as with almost all drugs, there are also some potential unwanted side effects and risks.

1. Breakthrough bleeding: Your monthly visit is bad enough, but for some women their cycle is unpredictable. Unexpected vaginal bleeding is one of the most common birth control complaints. Having too little estrogen can cause your uterine lining to build up excessively, leading to random spotting.

2. For some women, birth control pills and patches can increase blood pressure. Those extra hormones can also make it a little more likely that you’ll form a blood clot. That risk is substantially higher if you’re a smoker or are over age 35. The risk of blood clots is also greater if you have high blood pressure, pre-existing heart disease, or diabetes.

3. It’s a mood-saver for many women, but it’s a mood-killer for others. Pill users are twice as likely to be depressed as nonusers. But any emotional side effects can generally be alleviated by using a different pill formulation. So don’t suffer, tell your doctor if you have any worsening of depression symptoms.

4. Headache, dizziness and breast tenderness are some common side effects of birth control medication. However, these side effects seem to go away after you’ve been taking the Pill for a while. If they don’t, switching brands may help.

5. If you’re breastfeeding, steer clear of pills that contain estrogen; they can decrease breast-milk production by up to 5 percent. Progestin-only pills like Nor-Qd or Orthomicronor don’t interfere with lactation, but have to be taken at the same time every day, since they are slightly less effective than combination pills.

6. Weight gain. While most birth controls are actually proven to not cause weight gain in the general population, everyone responds differently to different medications. Estrogen is known to increase satiety by having an inhibitory effect on appetite, so having low estrogen can make you hungrier. Progesterone, on the other hand, stimulates your appetite, which helps explain those pesky PMS chocolate cravings since the hormone is at its highest levels the two weeks between ovulation and your period.

7. For many women, birth control can improve acne. Others may experience breakouts of acne or notice no change at all. It may also cause brown pigmentation of the skin. Sometimes, these hormones cause unusual hair growth. However, oral contraceptives are also the main treatment for hirsutism, a condition that causes coarse, dark hair to grow on the face, back, and abdomen.