Potential side effects of taking too many birth control pills and when to call a doctor

• You likely won't experience major side effects after taking an extra dose of birth control pills.
• When taking two large doses as emergency contraception, you may experience nausea and vomiting.

Accidentally taking an extra birth control pill or two is unlikely to cause any serious harm. Even larger doses usually won't cause any lasting health concerns.

While it's possible to take too many birth control pills, it's very difficult to do so — especially unintentionally, says Dr. Yana Markidan, a gynecologist in private practice and Fellow of the American Congress of Obstetricians and Gynecologists.

"It is an extremely safe drug," she says.

That said, you could experience some side effects after taking a large number of birth control pills. Even a single daily dose can cause symptoms like bloating and nausea for some people, says Dr. Monte Swarup, OB-GYN, Fellow of the American Congress of Obstetricians and Gynecologists, and founder of HPD Rx.

Read on to learn the potential effects of taking multiple doses of birth control pills, plus get guidance on when to seek medical care.

Signs of an overdose

If you've taken several doses of oral contraceptives at once, you might notice the following symptoms anywhere from a couple of hours to two days afterward:

• Sore or tender breasts
• Nausea and vomiting
• Rash on your face, limbs, or torso
• Headaches
• Mood swings
• Fatigue

You may also experience vaginal bleeding anywhere from two to seven days after the overdose.

"It is hard to generalize about how many pills it would require to cause adverse effects," Markidan says. This is because the type and amount of hormones contained in the pill varies between brands, and each person's reaction will vary, too, she says.

In one 2016 study, women in Sri Lanka who intentionally overdosed on birth control pills — taking anywhere from 10 pills to a whole pack — most commonly experienced bad headaches, nausea, and vomiting.

Is an overdose dangerous?

Taking more than your prescribed dose of birth control pills usually isn't dangerous, but it's still important to consider the types and dosages of hormones involved and pay attention to any side effects.

Many birth control pills contain both estrogen and progestin, a lab-made form of the hormone progesterone. Others contain only progestin. Progestin and estrogen both play roles in preventing pregnancy by halting ovulation.

As your dosage increases, so do the chances of side effects. But most of these effects remain minor, Markidan says.

It takes around 48 hours for progestin and estrogen to clear your system, so any side effects should pass quickly, without a visit to the emergency room.

Note: Even young children who accidentally ingest birth control pills generally only have short-term symptoms, like an upset stomach and diarrhea, and most likely won't experience any serious side effects or lasting harm.

You'd usually have to take large quantities of most progestins and estrogen for multiple days to experience any serious effects, such as deep vein thrombosis, commonly called blood clots.

A more serious concern to consider: how a high dose of birth control could interact with other medications, such as:

• Anti-seizure medications: These may become less effective when taken with a combined estrogen and progestin pill, so you may have an increased risk of seizures.
• Potassium supplements: These could cause potassium overdose, or hyperkalemia, when taken with progestin-only pills. Hyperkalemia is a potentially life-threatening condition that can cause irregular heart rhythms and paralysis.

It's essential to talk to your doctor about all of your medications so they can help you avoid serious interactions. If you do take more than your prescribed dose of birth control, it may be worth a quick phone call to check in with your doctor about potential interactions or medication incompatibilities.

Signs of a medical emergency

The following signs could suggest a rare, but serious allergic reaction to the dyes, progesterone, or other additives in your birth control pills:

• Dizziness and fainting
• Severe pain
• Changes in heart rate
• Chest pain
• Seizure
• Difficulty breathing
• Swelling around your face

Leg pain, especially in your calf or near your thigh, could also suggest a cause for concern, Swarup says. Pain in this area can indicate a blood clot or deep vein thrombosis, which can be life-threatening.

In these cases, it's important to seek medical help immediately by:

• Calling Poison Control at 800-222-1222 if you think you might be having a reaction but want more information.
• Calling 911 for immediate emergency care or going to the ER.
• Calling your regular doctor to determine next steps.

Note: When speaking with a healthcare professional, you'll need to tell them the specific brand of birth control you use, as well as how many pills you took.

Can a birth control overdose end a pregnancy?

Some people intentionally take a lot of birth control pills as a form of emergency contraception or to end an unwanted pregnancy.

It's important to understand that no amount of birth control pills will terminate a pregnancy.

"Birth control pills work to prevent the release and fertilization of the egg. Once the egg is fertilized, birth control pills are not effective," Markidan says.

If you're concerned about a potential pregnancy, reach out to a healthcare professional as soon as possible to talk over your options.

Birth control as emergency contraception

You can use some brands of birth control as emergency contraception, according to Planned Parenthood. Called the Yuzpe method, this approach requires pills that contain both progestin and estrogen.

This method is effective up to 86% of the time if used within 72 hours after sex, but that rate drops to 56% if you wait more than 72 hours. If you wait more than 120 hours, it likely won't prevent ovulation.

Quick tip: You'll take two doses of birth control pills 12 hours apart. Each dose should contain 100 micrograms of ethinyl estradiol — only brands of birth control that use this type of estrogen will work. The number of pills to take per dose depends on your brand of birth control, but with many brands, you'll take 4 pills.

Yuzpe isn't necessarily recommended due to the greater likelihood of side effects, like nausea and vomiting, compared to other methods, Markidan says. But it can work, if it's your only option for emergency contraception.

When to reach out

It's a good idea to talk with your doctor for more information about any concerns regarding your birth control, Swarup says.

You may also want to consider reaching out for more support if:

You want a different type of contraception

Many birth control pills come in packaging designed to make it easy to tell if you've taken your daily dose. But it's also important to take your pill at roughly the same time every day for them to be most effective.

If you have trouble remembering to take pills on a schedule or frequently forget doses, you might want to consider a different type of birth control.

An intrauterine device (IUD) or birth control implant are both long-acting reversible contraception (LARC) methods and highly effective ways to prevent pregnancy, Swarup says.

You want gender-affirming hormone therapy

Birth control pills contain estrogen, the same hormone used in gender-affirming feminizing hormone therapy. Even so, a daily dose doesn't provide enough estrogen to produce feminizing effects if you were assigned male at birth.

Even taking several pills a day won't guarantee the effects you want — and taking this many pills could increase your risk of serious health conditions, like blood clots.

A trusted doctor can offer more support with finding the right hormone therapy for your needs.

You think you might be pregnant

The easiest way to confirm a suspected pregnancy involves taking an at-home pregnancy test, which can detect a pregnancy as early as a week after conception.

If you get a positive result and need to terminate the pregnancy, reach out for healthcare as soon as you can, since your options and timeline might vary depending on where you live. Talking with a healthcare professional doctor can help you sort out your options.

You're having suicidal thoughts

"Intentional overdosing to cause self-harm does happen, even with birth control pills," Markidan says.

If that's the case for you, emergency care is important even if you don't experience any physical side effects, she says.

If you've taken a lot of birth control pills because you were contemplating suicide, they're unlikely to cause life-threatening harm, but it's still important to reach out in a crisis.

To get help now:

• Call 988 to reach the Suicide and Crisis Lifeline.
• Text 741-741 to get text support from Crisis Text Line.
• Call or text a friend or family member you trust for in-the-moment support — and assistance finding a therapist, if you want to speak with one.

Insider's takeaway

If you accidentally doubled up on your daily dose of birth control or intentionally took too many pills, you might feel worried and uncertain about the side effects you could experience. But it's rare for even a whole pack of birth control pills to have serious or life-threatening side effects.

Keep in mind that even with prescribed use, birth control pills can cause some symptoms. For instance, you might experience spotting, mood fluctuations, nausea, and breast tenderness for up to several months after starting the pill, Markidan says.

If you have concerns about any physical symptoms you experience, your OB-GYN or other healthcare professional can offer more information and guidance with revisiting your options for birth control.