minimizing side effects

Side effect
Coping strategy

Fluid retention, including swollen feet, ankles, hands, or abdomen
Cut back on salt, drink plenty of water, consider taking a mild diuretic (herbal or prescription).
Abdominal bloating or gas
Try lowering the dose of either hormone; switch to another estrogen/progestogen; try a skin patch instead of a pill.
Headaches
Cut down on salt, caffeine, and alcohol; drink plenty of water; lower estrogen, progestogen, or both; avoid MPA; switch to a continuous schedule or a patch to minimize hormone fluctuations.
Breast tenderness
Cut down on salt, caffeine, and chocolate; lower the estrogen and or progestogen dose or try a different one.
Mood changes
Cut down on salt, caffeine, and chocolate; drink plenty of water; switch to progestogen or try a different one; switch to a continuous regimen or a patch to avoid hormonal fluctuations; exercise regularly.
Nausea
Take pills with meals or in the evening before bedtime; switch to a lower estrogen or progestogen dose; try a different oral estrogen; switch to a patch.
Skin irritation under the patch
Keep skin under patch very clean; switch to a patch with a different adhesive; apply patch to a different area; switch to oral estrogen.