Central nervous system: Dizziness, headache, mental depression, migraine.
Dermatologic: Melasma (may persist), rash (allergy).
Endocrine: Breast pain, tenderness, enlargement, secretion, diminution in lactation when given immediately postpartum.
Gastrointestinal: Abdominal cramps, bloating, cholestatic jaundice, nausea and vomiting (occurring in approximately 10-30% of patients during the first cycle, less common with low doses, and the majority resolve in 3 months).
Genital urinary: Amenorrhea during and after treatment; breakthrough bleeding (the majority, more than 80%, resolve in 3 months), spotting, change in menstrual flow, change in cervical erosion and secretions, invasive cervical cancer, temporary infertility after discontinuation, vaginal candidiasis.
Ophthalmic: Changes in corneal curvature (steepening), contact lens intolerance, neuro-ocular lesions (e.g., retinal thrombosis, optic neuritis).
Miscellaneous: Edema, reduced carbohydrate tolerance, weight change (increase or decrease), prevalence of cervical chlamydia trachomatis may be increased; hirsutism (rare).
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