The Link Between Hormonal Contraception and Nausea
Nausea is one of the most common side effects when starting hormonal birth control pills [1.2.1, 1.3.2]. While vomiting is less likely to occur, it can happen [1.2.3]. This reaction is primarily linked to the introduction of synthetic hormones, particularly estrogen, into your system [1.3.2, 1.3.4]. Estrogen can irritate the stomach lining and increase the production of stomach acid, leading to feelings of queasiness [1.3.3, 1.3.4]. Progesterone, another hormone in some pills, can also contribute by slowing digestion [1.3.3].
This side effect is most common during the first few days or weeks of starting the pill as your body adjusts [1.2.1]. For most people, nausea is temporary and mild, fading as the body gets used to the new hormone levels, typically within two to three months [1.7.1, 1.7.5].
Managing Nausea from Birth Control
If you're experiencing nausea, there are several strategies you can employ to minimize the discomfort:
- Take it with food or at night: Taking your pill with a meal or right before bedtime can help prevent an upset stomach [1.4.1, 1.4.5]. Taking it on an empty stomach may increase the risk of nausea [1.3.2].
- Eat bland foods: When you feel nauseous, sticking to bland foods like crackers, rice, bananas, and toast (the BRAT diet) can be gentler on your stomach [1.4.6]. It's also wise to avoid spicy, fried, or fatty foods [1.4.3, 1.4.6].
- Stay hydrated: Dehydration can worsen nausea. Drink plenty of clear, cold liquids throughout the day [1.4.2, 1.4.3].
- Try natural remedies: Some people find relief by consuming ginger (in teas or candies) or peppermint [1.3.5, 1.4.2]. Acupressure on a specific point on the wrist (the Neiguan point) may also help alleviate nausea [1.3.5].
- Consider medication: Over-the-counter antacids or anti-nausea medications can be effective. A doctor might also prescribe stronger antiemetics if the nausea is persistent and disruptive [1.2.2, 1.2.4].
What to Do If You Vomit After Taking the Pill
Timing is crucial if you vomit after taking your oral contraceptive. The pill is generally considered absorbed after two to three hours [1.2.3, 1.2.4].
- If you vomit less than 2-3 hours after taking it: Your body likely did not absorb the hormones, and it should be treated as a missed pill. You should take another active pill as soon as possible [1.2.3, 1.5.3].
- If you vomit more than 3 hours after taking it: Your body has most likely absorbed the pill, and you do not need to take another one [1.5.4, 1.5.5].
If you are unable to keep a pill down, or if you miss two or more consecutive pills due to vomiting, you should use a backup method of contraception, such as condoms, for at least the next seven days [1.2.2, 1.2.6]. If vomiting persists, it is important to contact your doctor [1.5.4].
Comparing Pill Types and Nausea Risk
Not all birth control pills carry the same risk of causing nausea. The dosage of estrogen is a key factor.
| Pill Type | Hormone Content | Nausea Likelihood | Other Considerations |
|---|---|---|---|
| Combination Pills | Estrogen and Progestin | Higher, due to estrogen irritating the stomach lining [1.3.6]. | Very effective. Higher doses of estrogen can cause more side effects, but also help stabilize the uterine lining, reducing breakthrough bleeding [1.6.1]. |
| Low-Dose Combination Pills | Lower dose of Estrogen and Progestin | Lower than standard combination pills [1.6.3, 1.6.6]. | May have fewer side effects like headaches and nausea [1.6.3]. |
| Progestin-Only Pills (Mini-Pill) | Progestin only | Significantly less likely to cause nausea because they contain no estrogen [1.3.6, 1.6.2]. | Must be taken at the same time every day to be effective. May cause more breakthrough bleeding [1.6.1, 1.7.3]. |
When to Contact a Doctor
While initial nausea is common, you should consult a healthcare provider if:
- The nausea or vomiting is severe or disruptive to your daily life [1.2.2].
- The side effects persist for longer than three months [1.2.1, 1.7.2].
- You suspect you might be pregnant, as vomiting can also be a sign of early pregnancy [1.2.2].
- You experience severe abdominal pain, chest pain, severe leg pain, or shortness of breath, which could be signs of a rare but serious side effect like a blood clot [1.3.5].
A doctor can help rule out other causes, adjust your prescription to a lower-dose or progestin-only pill, or suggest alternative contraceptive methods [1.2.2, 1.5.4].
Alternatives to Nausea-Inducing Pills
If oral contraceptives continue to cause stomach upset, several other effective birth control methods bypass the stomach and are less likely to cause nausea:
- Hormonal IUDs (Intrauterine Devices): A low-hormone method with progestin that is placed in the uterus [1.2.1].
- Copper IUD: A hormone-free option [1.2.1].
- Contraceptive Implant: A small, progestin-only rod inserted under the skin of the upper arm [1.9.2].
- Vaginal Ring: A flexible ring that releases low doses of hormones and bypasses the gastrointestinal system [1.9.2].
- Barrier Methods: Options like condoms have no hormonal side effects [1.9.5].
Conclusion
Vomiting can be a side effect of birth control pills, though it is less common than simple nausea [1.2.3]. This reaction is typically caused by the estrogen in the pills and usually subsides within three months as the body adjusts [1.7.4, 1.7.5]. By taking the pill with food or at bedtime, managing your diet, and knowing what to do if you get sick, you can often manage this side effect. If nausea and vomiting persist or are severe, a healthcare provider can recommend a lower-dose pill or an alternative form of contraception that better suits your body.
For more information, you can visit Kaiser Permanente's guide to birth control side effects [1.2.1].
