Table 2:

Highly Effective Contraceptive Methods and Their Reported Side Effects (sorted alphabetically)^*

Method & Typical Use Efficacy**	Reported Serious Side Effects	Reported Less Serious Side Effects***
Combined Hormonal Contraceptive Pill (aka “the pill”) 8% failure	• Blood clots in  deep veins of legs or  lungs  • Heart attack  • Increased  blood pressure  • Stroke	• Acne (increased and/or  reduced)  • Breast tenderness  • Change in bleeding patterns,  including no bleeding, lighter  bleeding, and breakthrough  bleeding  • Dizziness  • Headache  • Mood changes  • Nausea  • Weight change
Contraceptive Patch 8% failure	• Blood clots in  deep veins of legs or  lungs  • Heart attack  • Increased  blood pressure  • Stroke	• Abdominal pain  • Breast tenderness and pain  • Change in bleeding patterns,  including no bleeding, lighter  bleeding, prolonged bleeding, and  breakthrough bleeding  • Flu symptoms/upper  respiratory infection  • Headache  • Irritation, redness, or  inflammation of the vagina  • Nausea  • Skin irritation at placement  site  • Vomiting
Contraceptive Ring 8% failure	• Blood clots in  deep veins of legs or  lungs  • Heart attack  • Increased  blood pressure  • Stroke	• Change in bleeding patterns,  including no bleeding, lighter  bleeding, prolonged bleeding, and  breakthrough bleeding  • Headache  • Irritation, redness, or  inflammation of the vagina  • White vaginal discharge
Contraceptive Implant 0.05% failure	No known serious side effects	• Abdominal pain  • Acne  • Breast tenderness  • Bruising, pain, and/or  infection at insertion site  • Change in bleeding patterns,  including no bleeding, lighter  bleeding, prolonged bleeding, and  breakthrough bleeding  • Dizziness  • Headache  • Mood changes  • Nausea  • Reduced acne  • Weight change
Contraceptive Injection (“the shot”) 3% failure	No known serious side effects	• Abdominal bloating and  discomfort  • Change in bleeding patterns,  including no bleeding, lighter  bleeding, prolonged bleeding, and  breakthrough bleeding  • Dizziness  • Headache  • Loss of bone density  • Mood changes  • Reduced sex drive  • Weight gain
Mirena IUD 0.1% failure	• Uterine  Perforation	• Acne  • Breast tenderness or pain  • Change in bleeding patterns,  including no bleeding, lighter  bleeding, prolonged bleeding, and  breakthrough bleeding  • Dizziness  • Headache  • Mood changes  • Nausea  • Weight gain
Paragard IUD 0.8% failure	• May  contribute to anemia  • Pelvic  Inflammatory Disease  (PID)  • Uterine  Perforation	• Change in bleeding patterns,  including prolonged bleeding,  heavy bleeding, and breakthrough  bleeding  • More cramps and pain during  monthly bleeding
Progestin-Only Pill 8% failure	No known serious side effects	• Abdominal pain  • Breast tenderness  • Change in bleeding patterns,  including no bleeding, lighter  bleeding, prolonged bleeding, and  breakthrough bleeding  • Dizziness  • Headache  • Mood changes  • Nausea

^*Compiled from Family Planning: A Global Handbook for Providers (2011)

^**Typical use efficacy based on Trussell’s (2004) estimates of percentage of women who will experience an unintended pregnancy during one year of typical use of a method. Typical use estimates are generally lower than “perfect” use, which entails correct and consistent use of a method.

^***Less serious side effects are included regardless of whether they may be perceived as positive, negative, or neutral.