Estarylla 28 Day Side Effects: What's Normal and What's Not

Estarylla 28 Day is a combination oral contraceptive containing Norgestimate 0.25 mg and Ethinyl Estradiol 0.035 mg. Like all hormonal birth control, it can cause side effects — most of which are mild and temporary. But some require immediate medical attention.

This guide covers the full range of Estarylla 28 Day side effects based on FDA labeling, explains who's most at risk for complications, and tells you exactly when to call your doctor.

What Is Estarylla 28 Day?

Estarylla 28 Day is a monophasic combination oral contraceptive made by Sandoz. It contains 21 active blue tablets and 7 inert green tablets. It's FDA-approved for pregnancy prevention and for treating acne vulgaris in females aged 15 and older. For a deeper look at the medication, see our complete guide to Estarylla 28 Day.

Common Side Effects

Most people who take Estarylla 28 Day experience mild side effects, especially during the first 1 to 3 months. These typically improve as your body adjusts to the hormones:

• Nausea — One of the most common early side effects. Taking the pill with food or at bedtime often helps.
• Headache — Mild headaches are common in the first few weeks.
• Breast tenderness — Swelling or soreness in the breasts usually subsides after 2 to 3 cycles.
• Breakthrough bleeding or spotting — Irregular bleeding between periods is very common in the first 1 to 3 packs. It does not mean the pill isn't working.
• Bloating — Mild water retention can cause bloating, especially in the first month.
• Weight change — Some people notice a small weight gain (usually water weight), though studies show most combination pills cause minimal long-term weight change.
• Mood changes — Some people experience mood swings, irritability, or depressive symptoms.
• Decreased libido — A reduced sex drive is reported by some users.
• Nausea or vomiting — Usually mild and improves after the first pack.
• Contact lens intolerance — Hormonal changes can affect tear production, making contacts uncomfortable.
• Swelling of ankles or feet — Mild fluid retention is possible.

If any of these side effects are severe or don't improve after 3 months of use, talk to your doctor. They may suggest a different formulation or a non-hormonal method.

Serious Side Effects

Serious side effects from Estarylla 28 Day are rare but potentially life-threatening. Seek immediate medical attention if you experience any of the following:

• Blood clots (deep vein thrombosis or pulmonary embolism) — Symptoms include sudden leg swelling, pain, warmth, or redness in one leg; sudden shortness of breath; or chest pain. Combination oral contraceptives increase the risk of blood clots by 3 to 4 times compared to non-users.
• Stroke — Sudden numbness or weakness on one side of the body, confusion, trouble speaking, vision changes, or severe headache with no known cause.
• Heart attack — Chest pain or pressure, pain radiating to the arm or jaw, shortness of breath, cold sweats.
• Liver problems — Yellowing of the skin or eyes (jaundice), dark urine, severe abdominal pain, or unusual fatigue.
• Gallbladder disease — Sharp pain in the upper right abdomen, especially after eating fatty foods.
• High blood pressure — Oral contraceptives can raise blood pressure. Your provider should check it at each visit.
• Severe headache — A sudden, unusually severe headache unlike any you've had before — especially with vision changes — needs immediate evaluation.
• Vision changes — Sudden partial or complete loss of vision, or double vision.
• Severe allergic reaction — Hives, difficulty breathing, swelling of the face or throat.

The Boxed Warning: Smoking and Cardiovascular Risk

Estarylla 28 Day carries an FDA boxed warning — the most serious type of safety warning:

Cigarette smoking increases the risk of serious cardiovascular side effects from oral contraceptive use. This risk increases with age and with the number of cigarettes smoked. Women who use oral contraceptives should not smoke. Women over 35 who smoke should not use combination oral contraceptives.

This isn't a suggestion — it's a hard contraindication. If you smoke and are over 35, your doctor should prescribe a different method of contraception.

Who's Most at Risk for Serious Side Effects?

Certain groups face higher risks when taking combination oral contraceptives like Estarylla 28 Day:

• Smokers over 35 — Significantly increased risk of blood clots, stroke, and heart attack
• People with a history of blood clots — Should not take combination oral contraceptives
• People with migraine with aura — Increased stroke risk; this is a contraindication
• People with uncontrolled high blood pressure — Should not use combination pills
• People with diabetes with vascular complications — Higher cardiovascular risk
• People who are immobilized — Prolonged bed rest or major surgery increases clot risk; your doctor may recommend stopping Estarylla 28 Day 4 weeks before planned surgery
• Postpartum women — Not recommended during the first 4 to 6 weeks after delivery, especially if breastfeeding

For a full list of contraindications, see our Estarylla 28 Day overview.

How to Manage Common Side Effects

Most side effects are manageable with simple strategies:

Nausea

Take the pill at bedtime instead of in the morning. Taking it with a small snack can also help. If nausea persists beyond the first pack, contact your provider.

Breakthrough Bleeding

Spotting between periods is extremely common in the first 1 to 3 months. Don't stop taking the pill — continue as directed. If breakthrough bleeding persists after 3 months, or if it's heavy, talk to your doctor.

Headaches

Mild headaches often respond to over-the-counter pain relievers like Acetaminophen or Ibuprofen. Stay hydrated and make sure you're getting enough sleep. If headaches become severe or are accompanied by visual changes, seek medical attention immediately.

Mood Changes

Give it 2 to 3 months to see if mood symptoms stabilize. If depression or anxiety worsens, talk to your doctor. A different formulation with a different progestin may work better for you.

Breast Tenderness

This typically resolves on its own within the first 2 to 3 cycles. A well-fitting supportive bra can help in the meantime.

Bloating and Weight Changes

Mild water retention usually subsides after the first month or two. Reducing sodium intake and staying active can help. True weight gain from oral contraceptives is minimal in most studies.

When to Call Your Doctor

Contact your healthcare provider if you experience:

• Side effects that don't improve after 3 months
• Heavy breakthrough bleeding (soaking through a pad or tampon every hour)
• Mood changes that affect your daily life
• A new or worsening migraine pattern

Go to the emergency room or call 911 if you experience:

• Sudden severe chest pain or shortness of breath
• Sudden severe headache unlike any before
• Sudden vision changes or loss of vision
• Sudden weakness or numbness on one side of your body
• Severe leg pain or swelling in one leg
• Signs of a severe allergic reaction (difficulty breathing, facial swelling)

A helpful memory tool is the word ACHES: Abdominal pain (severe), Chest pain, Headaches (severe), Eye problems (vision changes), Severe leg pain. Any of these symptoms while on combination oral contraceptives warrants emergency evaluation.

Final Thoughts

Most people tolerate Estarylla 28 Day well, and common side effects like nausea, spotting, and breast tenderness usually resolve within the first few months. Serious side effects are rare but real — especially for smokers over 35 and people with certain cardiovascular risk factors.

The key is staying informed and knowing when something isn't right. If you have concerns about side effects, don't stop taking Estarylla 28 Day without talking to your provider first — stopping abruptly without a backup method puts you at risk for unintended pregnancy.

For more about this medication, check out our guides on how Estarylla 28 Day works and drug interactions to watch for. And if you need help finding it at a pharmacy, Medfinder can help you locate Estarylla 28 Day in stock near you.