"i had to give this medication a 10 because, ultimately, it is extremely effective in the prevention of pregnancy. i started taking this pill when i was 17 and i&#039;m now 21. as a teenager, it was great. no acne and predictable periods. but i gained a lot of weight (i was usually 109-115 and now i&#039;m 135-140), mostly in my thighs and lower abdomen that would not go away. i also completely lost my libido. it was devastating. i have terrible mood swings and am usually completely incapacitated every first day of my period. i also started to have quite a bit of spotting for the last year and a half. i&#039;m always nauseous, dizzy, tired, achy, and depressed. it also increased my migraines and made them much worse. i do not recommend this."