The side-effects of the pill have often been documented. There are effects attributable to the oestrogen component and those blamed on the progestogen content.
The oestrogen component may produce some or all of the following side-effects: menstrual migraine, and increased risk of blood clots forming, and increased blood pressure; a weight increase due to salt and fluid retention; slight breast development. Indeed, this may be quite pronounced, and many younger women poorly endowed by nature often take the Pill essentially for this reason.
There may be an increase in the fat deposits around the buttocks. Often leg cramps appear, which are usually worse at night. Nausea and depression are fairly common. Some women notice a reduced sexual desire, a rather ironical side-effect when it is considered what the Pill is intended to provide – normal and free sexual intercourse without the risk of pregnancy. Many take the Pill, and find they no longer have any sexual desire in any case, which makes the entire exercise redundant. This has often led to marital disputes, the male, believing his wife is “protected,” and is just being mean and un -cooperative in refusing to participate in what he believes is a normal part of marriage – sexual relations.
Often the vaginal secretions are increased. This may reach a stage where it can become embarrassing. Suppression of lactation occurs, and this is more likely to be seen when the Pill is re-started after a confinement.
On the other hand the progestogen content of the Pill can also create its own set of side-effects. Often there is an early weight gain. Frequently there are nervous reactions such as depression, irritability, chronic fatigue, and a loss of interest in normal sexual activity. Often this lack of interest increases progressively as the Pill is continued. These side-effects are much like those induced by progesterone formation before a normal menstrual period occurs, in the so-called “pre-menstrual tension” syndrome which will be discussed in another chapter.
If the patient suffers from facial pimples, these are invariably worsened. (Similarly, in the non-pill-takers, pimples are notorious in the week preceding menstruation.) There may be an increase in “breakthrough bleeding” (that is, bleeding occurring part way through a packet of the pills).
In many women, blotchy markings appear on the face and parts exposed to the sun. This is termed “chloasma.” It may look unattractive and can upset some women who are self-conscious about facial skin appearances. It may also appear on the abdomen, chest, back, and old surgical scars. Usually the areolar area—the normally pinkish area surrounding the nipples -turns a darker shade also. When this occurs, it remains darker for the rest of one’s life. Incidentally, this occurs about the third month of pregnancy as well, and occurs for the same reason in women who have not taken the Pill before. Often there may be delay in reestablishing normal menstrual periods after the Pill has been discontinued. This is often a very worrying problem, and will be further considered later on.
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