Levonorgestrel Side Effects

Medically reviewed by Drugs.com. Last updated on Jan 4, 2025.

For healthcare professionals

Applies to levonorgestrel: intrauterine device, oral tablet, subcutaneous implant.

General adverse events

The most commonly reported adverse effects are alterations of menstrual bleeding patterns, nausea, abdominal/pelvic pain, headache/migraine, dizziness, fatigue, amenorrhea, ovarian cysts, genital discharge, acne/seborrhea, breast tenderness, and vulvovaginitis.^[Ref]

Genitourinary

• Very common (10% or more): Irregular menstrual bleeding (67%), infrequent menstrual bleeding (up to 57%), ovarian cyst (31.2%), menstrual changes (up to 31.9%), decreased uterine bleeding (23.4%), prolonged menstrual bleeding (22%), vulvovaginitis (20.2%), amenorrhea (18.4%), genital discharge (up to 14.9%), heavier menstrual bleeding (13.8%),vaginal infections (13.6%), vulvovaginal infections (13.3%), lighter menstrual bleeding (12.5%), increased scheduled uterine bleeding (11.9%), breast tenderness (10.7%)
• Common (1% to 10%): Dysmenorrhea, breast pain/discomfort, upper genital tract infection, genital tract bleeding, pelvic inflammatory disease, endometritis, dyspareunia, pelvic discomfort/pain, delay of menses more than 7 days, vaginal discharge, bleeding not related to menses
• Uncommon (0.1% to 1%): Uterine spasm, cervicitis/Papanicolaou smear normal class II, change in vaginal secretion
• Rare (less than 0.1%): Uterine perforation
• Frequency not reported: Breast enlargement, vaginal candidiasis, changes in cervical erosion, changes in cervical secretion, ectopic pregnancy
• Postmarketing reports: Oligomenorrhea, irregular menstruation^[Ref]

Gastrointestinal

• Very common (10% or more): Nausea (up to 23.1%), abdominal/pelvic pain (up to 22.6%)
• Common (1% to 10%): Diarrhea, vomiting
• Uncommon (0.1% to 1%): Abdominal distension
• Frequency not reported: Bloating, abdominal cramps^[Ref]

Other

• Very common (10% or more): Fatigue (16.9%)
• Common (1% to 10%): Partial/complete IUS expulsion, weight increased
• Uncommon (0.1% to 1%): Edema, change in body weight
• Very rare (less than 0.01%): Face edema
• Frequency not reported: Decreased weight, sepsis, group A streptococcal sepsis
• Postmarketing reports: IUS breakage, procedural bleeding^[Ref]

Nervous system

• Very common (10% or more): Headache (up to 16.8%), dizziness (11.2%)
• Common (1% to 10%): Migraine
• Postmarketing reports: Stroke, syncope, IUS insertion related vasovagal reaction or seizure^[Ref]

Psychiatric

• Common (1% to 10%): Depression/depressed mood, mood changes, mood swings, decreased libido, nervousness
• Frequency not reported: Changes in libido^[Ref]

Dermatologic

• Very common (10% or more): Acne/seborrhea (15%)
• Common (1% to 10%): Alopecia, hirsutism
• Uncommon (0.1% to 1%): Pruritus, eczema, pigmentation changes/hyperpigmentation
• Rare (less than 0.1%): Rash, urticaria
• Frequency not reported: Chloasma, melasma
• Postmarketing reports: Angioedema^[Ref]

Cardiovascular

• Postmarketing reports: Increased blood pressure, arterial/venous thrombotic events, pulmonary emboli, deep vein thrombosis, stroke^[Ref]

Musculoskeletal

• Common (1% to 10%): Back pain^[Ref]

Oncologic

• Frequency not reported: Benign/malignant liver tumors
• Postmarketing reports: Breast cancer^[Ref]

Ocular

• Frequency not reported: Contact lens intolerance^[Ref]

Metabolic

• Frequency not reported: Diabetes mellitus^[Ref]

Hypersensitivity

• Frequency not reported: Allergic reaction
• Postmarketing reports: Hypersensitivity reactions^[Ref]

Frequently asked questions

• Can Plan B make your period late or cause bleeding?
• Can you drink alcohol after taking Plan B?
• How effective is Plan B and how late can you take it?
• How many times can you take Plan B?
• What's the weight limit for Plan B?
• What are my birth control options and how effective are they?
• Mirena, Kyleena, Skyla & Liletta - What's the difference?

Further information

Levonorgestrel side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer